Brush up on dental health


Gum disease has been linked to cancer, heart disease, diabetes and stroke, writes Michael Kelly 

WHILE MOST men would appreciate that good oral health is important for maintaining impeccably fresh breath and a pearly-white smile, there is a growing body of evidence to suggest that oral health is far more important than that.

Researchers are now focusing on the connection between oral and general health and suggesting that this connection may in fact be a two-way street.

It has already been established that poor oral health can be a sign of problems in other areas of the body - in other words, the gums and teeth effectively act as an early-warning system.

But perhaps more alarming is the fact that there is increasing evidence to suggest that poor oral health can cause illness or disease in other areas of the body.

Specifically in relation to men for example, it is believed that there could be a link between periodontal (gum) health and the occurrence of diseases such as diabetes, cancers, heart disease and strokes. Research published in the June issue of The Lancet Oncologyfor example found that men with periodontal disease may be 49 per cent more likely to develop kidney cancer and 54 per cent more likely to develop pancreatic cancer.

In addition, while there has long been a suggested connection between periodontal and cardiovascular diseases, the American Academy of Periodontologynow believes it knows why - that the extended bacterial exposure which results from the effect of chronic periodontitis may be what ultimately leads to heart disease.

There's good and bad news for men in this - the bad news is that one of the most common factors associated with poor oral health is just being a man.

The good news is that dentists do not believe there is a genetic reason for this - it is purely a result of our less-than-stellar attitude to oral health and our infrequent attendance with dentists.

That's the good news, I hear you ask? Well, at least these are things that we can work on.

Men are less likely than women to visit the dentist, and often visit only after a problem arises, rather than seeking regular, preventative care.

We are also less likely to take care of our teeth and gums between dentist visits and, as a result, are more prone to develop gum disease.

"Halitosis or bad breath can be a sign of periodontal disease," says Dr Paul O'Reilly, a dentist based in Burlington Road in Dublin and a member of the Irish Dental Association. "If your breath smells bad then the first port of call should be the general dentist and in most cases when they clean up plaque and tartar, it will get rid of the problem.

"But about 80 per cent of the population have some form of periodontal disease and about 12-17 per cent, depending on what survey you read, have advanced periodontitis."

As is the case with most areas of health, however, anecdotally at least, the attitude of men to oral health is changing.

"The general perception is that yes, men are not quite as on top of their dental health as women," says O'Reilly. "Even for something basic like tooth-brushing, women are far more likely to want to have their teeth clean, whereas men see it as a chore. But I think that is changing."

Dr Helen Walsh, a dentist at the Portobello Dental Clinic in Dublin, says that in terms of new patients, her practice now sees almost as many men as women. "Five years ago we had a much higher percentage of new female patients coming in the door so there is no question that it is changing and not before time. Younger men in particular are very aware of their dental health and in my opinion they actually prioritise dental health over their general health.

"They see having white teeth and fresh breath as a necessity, not a luxury."

O'Reilly sees a huge increase in the number of men seeking elective dental procedures for aesthetic reasons. "Men won't accept gaps or missing teeth anymore. It was very common for men to come in and say, 'oh I don't mind it at all but my wife or girlfriend is saying that I can't go out looking like this'. I used to hear that a lot but haven't heard it in years.

"There is a lot of self-referral now with men coming in and saying that they want their teeth to look better. There has been a huge increase in the number of men going for all the major aesthetic procedures such as tooth whitening, veneers and crowns."

The key dietary consideration for men to consider in terms of optimal dental health relates to sugar intake, according to Walsh. "Your mouth needs half an hour to recover from an acid attack so it's vital to look at the volume and frequency of sugar intake in the diet.

"For example, you have people who eat a bar of chocolate in little squares, taking a square now and another in half an hour. From a dental health perspective it's better to eat it all in one sitting and to eat it immediately after lunch or dinner because the additional saliva that your body produces when you are eating a meal acts as a buffer against the acid," says Walsh

The idea that immediate tooth brushing following a sneaky sugary snack will help is also a misconception, she says. "In fact you are doing more damage that way because the acid has weakened your enamel so you are brushing weakened enamel and causing additional damage. The best approach there would be to rinse the mouth with water."

O'Reilly says that men also need to watch out for the sugar content of so-called energy drinks. "You see quite an amount of dental caries or carious lesions, basically tooth decay, from these drinks because of the sugar content. There is a lot of hidden sugar in these drinks which we need to watch out for."

A key oral health issue for men is the impact of sports injuries and O'Reilly believes that the use of mouth-guards should be mandatory in all contact sports here.

"I am dealing with two to three cases a month of young guys who have lost teeth playing hurling and football. Properly fitted mouth-guards would reduce the number of broken teeth as well as serving to reduce concussions and bone fractures."