What your smile can reveal about your health

Have you noticed that your gums bleed — even slightly — when brushing your teeth or after flossing? This is actually a common sign of gum disease, says Periodontist Dr Fleur Creeper.

“Healthy gums should not bleed when brushing with regular pressure, and when we are using floss,” says the gum specialist.

Periodontal disease, or gum disease, is a bacterial infection that affects the gum and bone supporting the teeth. There are two types of gum disease: gingivitis, which affects only the gums and can be reversed with good oral hygiene; and periodontitis, a more severe condition which develops from untreated gingivitis, causing tooth loosening and loss.

According to the Australian Dental Association, 65 per cent of Australians haven’t visited a dentist in more than two years. In addition, 25 per cent of adults only brush their teeth once a day and 40 per cent never use floss or other products to clean between their teeth on a day-to-day basis, putting themselves at risk of gum disease from the build-up of plaque on teeth and along the gum line.

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Cleaning your teeth twice a day is ideal for oral health

Can gum disease affect my overall health?
Australians who put oral health lower on their list of priorities could be putting themselves at risk of other health concerns.

Recent research from the University at Buffalo found that postmenopausal women with gum disease were at higher risk for cancers of the breast, lung, oesophagus, and melanoma. A cohort of more than 65,000 women aged between 54 and 86 were part of the study, and those with a history of periodontal disease had a 14 per cent higher risk of overall cancer, regardless of whether they had ever smoked.

Moreover, studies have shown that chronic periodontitis may increase the risk of heart disease, stroke, and other health problems.

However, Dr Creeper says the link with diabetes has had the most evidence of causation. “People with diabetes, especially Type 2 diabetes are more prone to gum disease because diabetes affects the way that small blood vessels react … It can affect their sugar levels.”

“Treating the gum disease can actually help their insulin control,” she adds.

Is the link between heart disease, cancers, and your dental health proven?
“There definitely is an increased risk [with heart disease],” says Dr Creeper. “There’s some sort of link but I don’t think anything’s actually been definitely proven, cause and effect.”

The main relationship between gum disease and other health issues such as cardiovascular disease and cancers, says Dr Creeper, is the way the body reacts to the bacteria present in the mouth and gums, which cause gum disease.

“It’s all about the inflammation, so it’s not an infection as such — gum disease — it’s just inflammation,” she explains. “Inflammation we know is not good for the body generally, and that’s where the link might come through with cardiovascular disease, the link between arthritis. There are other lung conditions — pneumonia — and there’s some sort of question mark about osteoporosis.”

But it’s not all doom and gloom: according to a US study by the Forsyth Institute, treating gum disease by reducing inflammation in the artery wall can reduce the risk of a heart attack.

How do you know you have gum disease?
While there is often little to no pain when it comes to gum disease, common signs include:

  • Bleeding gums, especially when brushing, flossing, or eating
  • Bad breath, or halitosis
  • Swollen, red, or tender gums
  • Loose teeth
  • Spaces between your teeth that weren’t previously there
  • Food getting stuck between your teeth when it did not occur previously
  • Sores in the mouth

Seeing a dentist regularly can ensure any signs of concerns are spotted early, says Dr Creeper. “Don’t wait for the bad news, you want to get good news that you’re doing a great job and everything’s fine.”

Key tips for a healthy smile
Dr Creeper offers this dental checklist for maintaining healthy gums:

  • Brush your teeth properly twice a day: “Most people brush once a day, but twice a day is better.”
  • Floss or clean between your teeth with interdental brushes: “People miss the cleaning in between the teeth — that’s two surfaces on every tooth that you’re going to miss if you’re not cleaning between your teeth.”
  • See your dentist regularly: “For most people, probably once or twice a year. Having a dentist that you see regularly, like a family dentist, is best because they can monitor you, notice any changes in your dental health, and give you specific advice on how to care for your teeth and mouth.”
  • Drink plenty of water: “Tap water has fluoride, which is good for teeth.” She also notes that maintaining hydration very important. “As we age, sometimes saliva levels can diminish and those taking medication can have a side effect of dry mouth. If you’ve got a dry mouth, the plaque bacteria — that can cause gum disease and tooth decay — are sort of more sticky, so they’re harder to get off.”
  • Remove partial dentures daily and give them a thorough clean: “I’d normally advise not to sleep with it in, keep it out— let everything have a rest. With my patients I say, ‘When you take your socks and shoes off when you go to bed — and let your feet out for air — it’s the same with your mouth.’”

How do you maintain your dental health?

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