Oral Systemic Connection

Good oral hygiene affects your overall health

Presented by: Dr Diana Bueno
Principal Dentist
VIP Dental Clinic, Miranda NSW

Recommendations from European
Federation of Periodontology

“Periodontal diseases and cardiovascular diseases are widespread non-communicable diseases that have a significant impact on health and quality of life. Periodontal diseases (gingivitis and periodontitis) are probably the most common disease of mankind¹: about 80% of people aged over 35 suffer from them and severe periodontitis is the sixth most prevalent disease worldwide, affecting about 800 million people (about 10% of the global population).² If untreated, periodontitis causes tooth loss and it is associated with poorer nutrition, speech, and self-confidence and a lower quality of life.”

European Federation of Periodontology, World Heart Federation

“Periodontal diseases and diabetes are both chronic diseases that become more common as people get older. About 80% of people aged over 35 suffer from some kind of gum complaint and about 7% of the population suffers from diabetes, although in many cases this goes undiagnosed. There are strong associations between the two diseases. Indeed, there is a two-way (bidirectional) relationship between periodontal disease and diabetes. This means that people with periodontitis have a higher risk of diabetes and patients with diabetes are three times more likely to develop periodontal disease.”

European Federation of Periodontology

The mouth has a microbiome

The mouth has a microbiome, just like the gut! Having a balanced oral microbiome plays an essential role in our overall health.

There are more than 700 species of bacteria in the mouth, and most of them are GOOD bacteria. But… there are around 10-15 types of bacteria that are pathogenic or BAD bacteria.

When your oral microbiome becomes imbalanced, it increases your risk of oral infectious diseases, like gum disease, also known as Periodontal Disease.

Periodontal Disease

When your oral microbiome becomes imbalanced, it increases your risk of oral infectious diseases, like gum disease, also known as Periodontal Disease.

  • When the bacteria in your mouth interacts with sugars it forms a sticky plaque on your teeth.

  • Plaque that hardens becomes Tartar and it sits on your gum line, filled with bacteria where it irritates and inflames the gum tissues around the base of your teeth.

Pockets develop between the gum and teeth that fill with plaque and bacteria which can cause serious infections.

According to the National Study For Oral Health 2017-2018, 30.1% of the Australian adult population have moderate to severe periodontitis, which has increased to 47.2% in adults over 30 years of age.

Importance of Oral Health

Aside from the aesthetic effects, a more important reason why Dentists want our patients to have good oral health.
The state of your oral health is an important indicator of your overall health.

“The mouth is by far the greatest portal of
entrance of germ life into the body.”

Charles Mayo MD 1915

Oral Health

There is substantial research available that correlates periodontitis (gum disease) and systemic diseases ranging from diabetes to cardiovascular diseases and many others.

The Oral Systemic Connection

Your overall oral health indicates potential complications for other inflammatory diseases.

Microscopic Analysis

A microscopic view – Healthy compared with Disease

Healthy – Bacteria in a healthy mouth

Disease – Pathogenic Bacteria in an unhealthy mouth

VIP Dental Clinic Biofilm Sampling Service

VIP Dental Clinic offers a service that enables us to assess the risk of the patient using The Larkin Protocol.

During your initial or regular oral health check-up, we take a small sample of biofilm and analyse it under a microscope.

We display the sample on a big screen monitor to show the patient what their biofilm looks like and what groups of bacteria, parasites, and
cells a present.

The sampling process

It only takes a moment to take the biofilm sample using a small probe.

The process of taking the sample is unlikely to cause discomfort.

Once the sample has been analysed, an oral exam summary is provided which includes the results of your risk assessment along with a treatment recommendation.

Maintaining Good Oral Health

The plaque that causes gum disease can’t be removed by brushing and flossing alone. It requires regular
professional cleaning by a Dentist.

At VIP Dental Clinic, we have invested in AIRFLOW®, an innovative Swiss, state-of-the-art technology that removes the
plaque from your teeth without needing to scrape with metal instruments.

Instead, the AIRFLOW® system uses a mixture of air, warm water, and fine powder to clean your teeth which makes it feel more like a day spa for your mouth. This technology is highly effective in disrupting the mature biofilm which
traditional methods fail to do so.

The sampling process

Guided Biofilm Therapy consists of treatment protocols based
on individual diagnosis and risk assessment to achieve
optimal results.

GBT follows the European Federation of Periodontology recommendations on Professional Mechanical plaque removal and Oral hygiene instructions for home care.

Guided biofilm therapy was developed in cooperation with highly respected and experienced periodontists, cardiologists,
and dental hygienists.

How we can help you maintain good oral health

Bacterial Disruption Therapy is a new concept in the management of oral dysbiosis:

A combination of different protocols to combat pathogenic bacteria and disrupt unhealthy biofilm.

It is the first targeted microbiological approach that utilizes the most advanced tools to achieve a solution to prevent and treat periodontal disease because of its systemic implications and the prevention of mucositis and periimplantitis,
the most serious emerging dental problems.

Preventive Dentistry

We aim to identify potential risks early and then work with the patient to design a personalised prevention plan to maintain good oral hygiene.

The benefits of preventive dentistry are reduced risk of Cavities, Gingivitis, Periodontitis, and other dental problems. This, in turn, can reduce your risk of secondary problems caused by poor oral health.

Resources

Referral letter for all Practitioners to refer to VIP Dental Clinic Miranda.

Periodontal diseases and cardiovascular diseases are widespread non-communicable diseases that have a significant impact on health and quality of life. Periodontal diseases (gingivitis and periodontitis) are probably the most common disease of mankind¹: about 80% of people aged over 35 suffer from them and severe periodontitis is the sixth most prevalent disease worldwide, affecting about 800 million people (about 10% of the global population).² If untreated, periodontitis causes tooth loss and is associated with poorer nutrition, speech, self-confidence, and a lower quality of life.

Periodontal diseases and diabetes are both chronic diseases that become more common as people get older. About 80% of people aged over 35 suffer from some kind of gum complaint and about 7% of the population suffers from diabetes, although in many cases this goes undiagnosed.
There are strong associations between the two diseases. Indeed, there is a two-way (bidirectional) relationship between periodontal disease and diabetes. This means that people with periodontitis have a higher risk of diabetes and patients with diabetes are three times more likely to develop periodontal disease.

Abstract
Trichomonas tenax (T. tenax) and Entamoeba gingivalis (E. gingivalis) are two oral protozoan parasites that are universal and found in patients with poor oral hygiene, as well as chronic and periodontal diseases. This study was conducted to assess the efficacy of some parameters, such as age, gender, education, residency, smoking, and dental cleaning routines, on the incidence of these parasites in the oral cavity of the patients participating in this study. A total of 230 individuals with chronic diseases, 97 of whom were patients (44 females and 53 males) participated in the present study. Dental plaque and saliva samples were collected from each patient and examined under light microscopy with Giemsa staining. Out of 230 dental plaque samples, 60 (26.08%) samples
were positive for E. gingivalis, while 37 (16.08%) cases were positive for T. tenax. Diabetic patients showed high E. gingivalis percentage (n=12; 20%) (P=0.000*). However, thyroid disorders showed a low percentage. Hypertensive patients showed a high percentage for T. tenax (n=6; 16.21%) (P=0.000*), while tuberculosis patients showed the lowest percentage. Patients with hypertension, smoking, heart disease, and diabetes showed statistical significance for the presence of these parasites. Equally, patients older than 30 years have shown a higher rate of infection. According to the findings, E. gingivalis was detected in 58.33% and 41.66% of the urban and rural populations, respectively. Furthermore, T. tenax was detected in 81.08% and 18.91% of the urban and rural populations, respectively. Parasitic contagions were comparatively popular in patients with chronic and periodontal illness.

Background—Several epidemiological studies have suggested periodontitis as a risk factor for coronary heart disease (CHD), but results have been inconsistent.
Methods and Results—We evaluated the association between clinical and radiographic measures of periodontitis, edentulism, and incident CHD (angina, myocardial infarction, or fatal CHD) among 1203 men in the VA Normative Aging and Dental Longitudinal Studies who were followed up with triennial comprehensive medical and dental examinations up to 35 years (median 24 years). Cox proportional hazards models with time-varying effects of exposure and potential confounders were fit. We found a significant dose-dependent association between periodontitis and CHD incidence among men <60 years of age (hazard ratio 2.12, 95% confidence interval 1.26 to 3.60 comparing highest versus lowest category of radiographic bone loss, P for trend=0.02), independent of age, body mass index, smoking, alcohol intake, diabetes mellitus, fasting glucose, total cholesterol, high-density lipoprotein cholesterol, triglycerides, hypertension, systolic and diastolic blood pressure, education, marital status, income, and occupation. No association was found among men >60 years of age. Similar results were found when the sum of probing pocket depths was used as a measure of periodontitis. Among men >=60 years of age, edentulous men tended to have a higher risk of CHD than dentate men in the lowest bone loss (hazard ratio 1.61, 95% confidence interval 0.95 to 2.73) and lowest pocket depth (hazard ratio 1.72, 95% confidence interval 1.03 to 2.85) categories, independent of confounders.
Conclusions—Chronic periodontitis is associated with incidence of CHD among younger men, independent of established cardiovascular risk factors. (Circulation. 2008;117:1668-1674.)

ABSTRACT
Periodontal disease (PD) is generated by microorganisms. These microbes can enter the general circulation causing a bacteraemia. The result can be adverse systemic effects, which could promote conditions such as cardiovascular disease. Level A evidence supports that PD is independently associated with arterial disease. PD is a common chronic condition affecting the majority of
Americans 30 years of age and older. Atherosclerosis remains the largest cause of death and disability. Studies indicate that the adverse cardiovascular effects from PD are due to a few putative or high-risk bacteria: Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola or Fusobacterium nucleatum. There are three accepted
essential elements in the pathogenesis of atherosclerosis: lipoprotein serum concentration, endothelial permeability, and binding of lipoproteins in the arterial intima. There is scientific evidence that PD caused by high-risk pathogens can influence the pathogenesis triad in an adverse manner. With this appreciation, it is reasonable to state PD, due to high-risk pathogens, is a contributory cause of atherosclerosis. Distinguishing this type of PD as causal provides a significant opportunity to reduce arterial disease.

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