Diseases of the oral cavity, as well as other systemic diseases that have an impact on oral health, can affect an individual's ability to eat and hence affect his/her nutritional status. On the other hand, if the nutritional status of an individual is compromised, it may negatively influence his/her oral health development. It may also impact the severity of oral diseases as well as their rate of recovery.
A variety of medical conditions such as diabetes, heart disease, HIV, and adverse outcomes of pregnancy have associations with oral health (1, 2). In addition, the nutritional status of an individual also impacts oral health. In fact, a two-way interaction between nutrition and oral health has been observed. The position statement of the American Dietetic Association states that "nutrition is an integral component of oral health" (2).
The associations between nutritional and medical status, and oral health have highlighted an important connection between dental and systemic health.
Oral Health & Diabetes
Poorly controlled or uncontrolled diabetes results in high blood sugar levels as well as increased amounts of sugar in saliva. This can lead to complications that put an individual at increased risk of oral conditions (2, 3) such as:
- Xerostomia (dry mouth)
- Periodontal disease
- Dental caries
- Gingivitis
- Infections
- Candidiasis
- Burning mouth syndrome
Dry mouth can lead to difficulty in chewing, tasting and swallowing - these problems can adversely affect nutrient intake. Young persons with diabetes may have a higher incidence of dental caries due to reduced flow of saliva (a consequence of dry mouth). Keeping blood sugar levels in control helps prevent complications arising from dry mouth (3).
The relationship between diabetes and periodontal disease is two-way. While poorly controlled diabetes raises the susceptibility to periodontal disease, having periodontal disease increases the difficulty of achieving good blood glucose control in people with diabetes (1, 2).
Procedures such as dental surgery or fitting of dentures require adequate control of blood sugar in order to be successful (2).
Oral Health & Heart Disease
Research has indicated a potential link between oral infections and risk of heart disease (1).
Oral infection-causing microorganisms may infect blood vessels that can result in inflammation and injury. This can lead to development of atherosclerotic plaques (1).
Oral Health & HIV
People afflicted with HIV can have several oral complications (2). These include:
- Oral-pharyngeal fungal infections - may result in burning mouth, mouth pain, and difficulty in swallowing
- Oral viral diseases - can result in mouth ulcers
- Oral candidiasis - can lead to pain during chewing, sucking, and ingestion of food
- Kaposi's sarcoma (cancerous growth in oral cavity)
These conditions not only compromise oral health but also overall health by compromising nutrient intake. As nutritional status worsens, so do these conditions, thereby creating a vicious cycle of ill health.
Oral Health & Adverse Outcomes of Pregnancy
An area of active research is the suggestion of an association between the presence of oral infectious bacteria and the risk of preterm births (1).
The outcome of pregnancy may also be affected by periodontal disease as a result of toxins produced by periodontal bacteria in the mother's oral cavity that can affect the fetus. In addition, as part of the mother's response to the oral infection there is constant release of factors by the maternal immune system that may potentially affect growth of fetus and delivery (1).
Thus, we see that in several instances oral health can serve as an indicator of general health.
References:
- U.S. Department of Health and Human Services. Oral Health in America: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, National Institute of Dental and Craniofacial Research, National Institutes of Health, 2000.
- American Dietetic Association. (2003). Position of the American Dietetic Association : Oral health and nutrition. JADA, 103, 615-625.
- Vernillo, A. T. (2001). Diabetes mellitus: Relevance to dental treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 91, 263-270.
