Healthy teeth for a healthy heart?

Một nụ cười không những có thể làm mềm lòng một khuôn mặt lạnh lùng băng giá, mà còn cho thấy sức khỏe của một con người.
Nhiều công trình nghiên cứu cho thấy mối quan hệ giữa sức khỏe răng miệng và sức khỏe toàn diện , đáng kể nhất là mối liên quan của bệnh về nướu răng và bệnh tim mạch, dẫn đến đột quỵ.
Gởi các bạn một bài viết liên quan đến đề tài này.
by Jenny Pogson

There's no denying the importance of maintaining healthy teeth and gums. But does your oral health also affect your general health?

Published 19/06/2012

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As a child, you learn that brushing and flossing your teeth is essential if you want to avoid tooth decay and have healthy gums.
But could keeping your gums healthy also help to reduce your risk of having a heart attack?
The idea of a link between oral health and the heart has been around for a century. But it's only been in the last 20 years that some health professionals have taken this link seriously enough to recommend dental care as a way of reducing your risk of heart disease.
They believe that there is a connection between serious gum disease and atherosclerosis, which causes heart disease. (Atherosclerosis is the build-up of fatty deposits on the lining of artery walls that can lead to blood clots, it's also known as hardening of the arteries.)
But to date the evidence supporting this idea has always been controversial. So the American Heart Association (AHA) decided to review the existing research to see what the data suggests.
The Association's review concluded while a link was "biologically plausible", there was no clear evidence that gum disease causes heart disease, or that treating gum disease would have any effect on those with a heart condition.
However, the review did find gaps in the understanding of the interaction between gum disease and heart disease, and called for more research.

More research

Professor Malcolm West, professor of medicine at the University of Queensland and consultant cardiologist at Brisbane's Prince Charles Hospital, agrees there needs to be more research before we have a definitive answer.
"The potential link between the two hasn't been clarified as much as people would like and we're left with this question mark," West says.
"They're both two very common problems. It's something you could accept as being related but trying to prove it has been very difficult."
One of the problems with linking the two conditions is that they have many of the same risk factors, West says.
If you smoke, have poor nutrition, diabetes, or are from a lower socio-economic background then you are at higher risk of developing gum disease, but these factors also contribute to heart disease.
"So when trying to say one thing causes another, to try to eliminate how those other risk factors are interfering is quite difficult," West says.

Possible explanation

Gum disease generally refers to gingivitis, inflammation of the gums, and the more severe periodontitis, a serious infection that can lead to destruction of the bone and gums that hold teeth in place.
Two main theories are thought to explain how gum disease could contribute to coronary heart disease, West says.
One proposes that organisms, which grow between your teeth and cause plaque to build-up, can enter the bloodstream when your gum starts bleeding, which happens easily if you have gum disease. Once in the blood stream, these organisms attach to pre-existing fatty deposits in coronary arteries (those that supply blood to the heart). This leads to inflammation, which may cause blood clots that can decrease blood flow to the heart and cause a heart attack.
Support for this idea comes from research that's shown organisms that exist in the mouth, such as Porphryomonas gingivivalis, are also found in these deposits.
The second theory proposes these bacteria cause the body to develop antibodies that attack receptors on the cells lining blood vessels and cause an inflammatory reaction. This inflammation may play a role in the further development of fatty deposits lining the artery walls that can cause blockages.
We already know that people with certain heart conditions, such as abnormal heart valves or certain congenital heart defects, are at a higher risk of developing an infection of the heart (known as infective endocarditis) after receiving certain dental treatments. This is why some people are given antibiotics before they go to the dentist. (NPS has an excellent fact sheet on Preventing Infections of the Heart).

Other conditions linked to gum disease

But it's not just heart disease that's been linked to gum disease.
"There's an ever expanding list of conditions that have been investigated in relation to gum disease," says Associate Professor Ivan Darby, head of Population Oral Health and Periodontics at the University of Melbourne.
For example, there's a suggestion that if you've got gum disease it might predispose you or increase your risk of developing diabetes, because of the persistent infection in your body.
Another is the link between preterm birth or low birth weight and gum disease, Darby says.
"The original suggestion was that women that had preterm birth had more gum disease than those who went to full term. Some studies say yes and some say no, so it really is inconclusive. But probably like heart disease, having gum disease in addition to other factors adds to your risk," he says.
Research has also shown the mouth can act as reservoir for the bacteria Helicobacter pylori, a known cause of stomach ulcers.
Plaque in the mouth also acts as reservoir for lung bacteria. People with gum disease, who have tubes inserted to help them breathe while having medical treatment, are more likely to get lung infections than those without gum disease. It's believed the bacteria from the mouth can travel down the tube to the lungs, Darby says.
There is also emerging research on the link between gum disease and infertility, as well as erectile dysfunction, he says.

How to prevent gum disease

While maintaining good oral hygiene will reduce your chances of getting gum disease, Darby says, there are also genetic factors involved.
"Some forms [of gum disease] do run in families. So if your mum and dad lost their teeth early and your brothers and sisters have got problems then you might also get it," Darby says.
The best way to prevent gum disease is to stop the plaque getting underneath the gum first place.
You'll reduce your chances of getting gum disease if you:

• brush your teeth twice a day for two minutes.
• use dental floss to clean in between your teeth.
• avoid smoking.
• pay special attention to oral hygiene if you're taking medications, as some increase your risk of gum disease.
• have regular dental check-ups, especially if you are pregnant or have diabetes as these conditions increase your risk of gum disease.