Decades ago science recognized the connection between periodontal infection and the rest of the body. Unfortunately, the mechanisms weren’t clearly understood. We mistakenly took our lead from the most absurd places without paying attention to the reasons why, and the reasons why are probably the most important problem to address in just about everything!
What we thought
We also had no real basis for dental visits. It wasn’t too long ago that people went to the dentist when something hurt, so creating a process or correct frequency needed some guidance. Oddly, that guidance came from an ad jingle for tooth powder. Yes, we used to brush our teeth with powder. And yes, it was a marketing jingle that led us to the 6 month cleaning. Brusha brusha brusha with Ipana Tooth Powder and see your dentist twice a year. Catchy.
The initial concept of gum infection was focused on the buildup or hard deposits on the sides of teeth. Much like a barnacle on a pier, the calculus or tartar that is stuck to the sides of teeth is rough and hard to keep clean. The idea was if we remove those barnacles, the teeth would be smoother, and so they would be cleaner. Our basic focus was on scraping the sides of the teeth and removing those little deposits. We created tools to do ‘Scaling and Root Planing’ where we would scrape the side of the tooth smooth and remove those hard barnacles and with the smoother tooth, we assumed bad stuff would just slip off. The body is much more complicated and elegant than that…
What we know
It turns out that for a lot of people, 6 months is a pretty good timeline. The whole game is about controlling biofilm and the slime layer of bacteria that accumulates below the gum line and on the teeth. Depending on your particular immune system, twice a year is great to keep you healthy. A few people do well once a year. Gum infection is entirely tied into our immune system and the bacterial infection is, obviously, bacterially driven. The infection and healing follows bacterial timelines, and it is their timeline we need to be using. There are people with a host of systemic diseases who really should get their teeth cleaned once a month to keep their mouth healthy. Keeping the mouth healthy also turns out to be critically important in keeping the body healthy!
Bacteria is the criminal and the tartar or calculus buildup is simply a place for that bacteria to hide. The rest of the story is about how those bacteria infect the tissues around our teeth. The longer it stays, the more potent and aggressive it becomes. It also marinates into the tissues and irritates the gums and the bone that holds our teeth in. If left infected, the body initiates a host response to fight off the infection. That would be fine if it was all internal, then it could win that battle. However, since the source of the bacteria is actually between the teeth and gums, the body simply stays infected and is chronically trying to fight a war that it can’t win!
What it means
The body is a complex and sophisticated organism with many protective mechanisms. First among them is our ability to fight off infections and protect ourselves from bacterial, viral, and fungal threats. When we get sick, our whole body responds with the inflammatory immune response. If we get a cold, our whole body responds. If we smoke or abuse alcohol, our whole body responds. The same thing happens with a splinter. A small area of infection is battled locally at the area of the infection or splinter, but also throughout the entire body. Gum health is also important as gum infection is the same full body issue.
The surface area of the gum tissue around your teeth is about the same as the length of your forearm, and if it is infected, then it’s not just a small infection. Our body jumps into the battle locally and you get a lot of inflammation in the gums. We call this gingivitis. Once it starts causing bone loss, we call it periodontitis. The reason we measure gum tissue pocket depths is to catch things early when the first 4mm pockets show up. When most of the numbers are three or smaller and there are a few 4s, it is likely there is simply inflammation in the tissue. That’s another way of saying there’s a mild chronic infection. Not good, but lots of room to get worse. If there is bleeding or pus, it is definitive for significant infection. If there are a lot of 4+ measurements, it is also a clear sign if significant infection.
The issue is with any case of chronic infection, our body throws all in to fight it, and isn’t ready to fight the next thing that happens. The cold or flu or coronavirus. All of these opportunistic infections aggressively attack people whose natural immune system is already challenged. The key to staying healthy is protecting your immune system, so one of the most important things we can do is take whatever simple steps there are to keep ourselves healthy.
The good news
Fortunately, for most of us, the steps to staying healthy are pretty simple. For eons, we have known that food is medicine. If we usually eat garbage like a happy meal, it shouldn’t be terribly surprising that our body isn’t in tiptop shape. If we usually eat fresh food with a lot of colorful vegetables and a bit of protein and a bit of carbs, then we can expect to feel better. Sleep is also mission-critical. We need 8+ hours of great sleep. Both the quantity and the quality of sleep makes a huge difference in keeping healthy. You should take about 15 minutes to fall asleep and you shouldn’t wake up until the morning. When you do wake up, you should feel rested, and you should feel good all day. If you are snoring loudly enough to have people complain, you are almost certainly not getting the right quality of sleep, even if the quantity is right. It’s the same issue for people who fall asleep while they are laying their heads down. If you are asleep in less than 5 minutes, you probably have some issues in getting quality, restful and restorative sleep.
One of the most powerful things we can do to keep our immune system strong is to eliminate chronic infections. Estimates are that about 80% of American adults have some level of periodontal infection, which means pretty much all of us. If you have chronic infection in your gums, one of the best things you can do for your own health is to address it. Not just to keep the teeth, but to keep you from getting the flu or worse, COVID.
Obviously being careful to not get exposed to the virus is smart, but if you are a smoker or have chronic gingivitis or aren’t getting good sleep or are otherwise putting yourself in a position to get sick, those are simple easy fixes! If you are past due for your hygiene visit, make that call today. It may keep you from catching the flu, or worse!