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The Relationship of Oral Health to Overall Health and Longevity

 

by Tom McGuire, D.D.S. 
            
“The terms oral health and general health should not be interpreted as separate entities. Oral health is integral to general health: oral health means more than healthy teeth and you cannot be healthy without oral health,”
—Donna Shalala, Secretary of Health and Human Services in Oral Health  America: A Report of the Surgeon General, 2000.
 
I couldn’t think of a better way to begin this booklet than to underscore the effect of oral health on overall health. But just how does her statement about oral health correlate to health and longevity? It does because healthy people live longer and the quality of their lives is far superior. There are a number of commonly known factors related to the study of health and longevity that almost everyone will recognize. Some of the more common factors include:
 
1. Healthy diet;
2. Intelligent nutritional supplementation;
3. Healthy lifestyle;
4. Elimination of harmful substances, such as tobacco, alcohol, and drugs;
5. Stress reduction;
6. Exercise; and
7. A healthy emotional and mental life.
 
Every proponent of optimal health understands the relationship between these factors and health and longevity; without a doubt, they are all important. However, I suggest that there is another factor missing from this list, one that also plays an overlooked but significant role in overall health. This factor is dental disease and its harmful effect on the health of the body.
 
With that in mind, this booklet will focus on:
• How dental /oral disease, amalgam fillings, and dental materials can affect one’s overall health;
• Why these issues are so important in regard to health and longevity; and
• How physicians and other health professionals can help their clients recognize the importance of this issue.
 
You will also discover that if dental disease, and other related oral health issues, are not acknowledged as an obstacle to achieving overall health, any efforts to accurately diagnosis a disease or illness, treat the problem, improve health, and extend life; will be less effective; and will often fall short of the desired goals. As you will see, dental problems can effect many serious diseases and illnesses, ranging from heart attack and stroke to idiopathic diseases, such as Meniere’s and chronic fatigue syndrome.

Background
A number of oral health issues can negatively affect general health. All but one of the oral health problems listed below are the direct result of dental disease, in one form or another. These oral health issues can be divided into two distinct, but overlapping categories.
 
1. Dental/Oral disease. The most important of these in regard to their impact on general health are:
                        a. Periodontal (gum) disease;
                        b. Infected root canals;
                        c. Cavitations (infected extraction sites); and
                        d. Other diseases of the oral cavity, such as oral cancer.
 
2. Amalgam fillings, fluoride, and non-compatible dental materials
 
All of these dental/oral issues can affect your general health and, ultimately, longevity. Their impact is determined by the seriousness of the related oral health problem(s), its duration, and how many of the above dental issues are active at the same time. Thus, some individuals may be dealing only with problems related to gum infections or amalgam fillings, some with both problems, but there will be a significant number of people whose health is compromised by all of these dental issues. 
 
Before I enter into the substantive area of this booklet, I feel it will be useful to provide some background information about dental disease and offer some insights into why it’s role in overall health is often been overlooked.
 
Dental Disease
What is commonly referred to as dental disease is actually two separate diseases: tooth decay and gum disease. You can have one without the other or both simultaneously. The terms “gum disease” and “periodontal disease” are often used interchangeably, even though periodontal disease is much more destructive form of the disease. Technically, gum disease is broken down into two categories: gingivitis, the initial and milder form of gum disease, and periodontitis, the more advanced and serious form that has infected both the soft tissue and the surrounding bone.
 
While the basic cause of tooth decay and gum disease is poor oral hygiene (due to a lack of patient education and/or motivation) other factors are involved. Diet, smoking, vitamin deficiency, and toxic substances such as mercury can also contribute to dental disease. Of the two diseases, gum disease, especially in its most advanced form, is the most harmful to general health.
 
Certainly, tooth decay can affect one’s health. It can prevent proper chewing and thereby affect digestion. It can also cause tooth loss, again affecting digestion. Clearly, it can contribute to systemic health problems, but its effects on overall health are considerably less than the effects of gum disease.
 
Both forms of dental disease are so prevalent that it is an epidemic by any standard. Ninety percent of the population has, or has had, some form of these diseases. It is estimated that between 30 and 50% of the population has periodontitis, the most destructive form of dental disease (it is difficult to effectively gauge the percentage, as approximately 50% of the population do not see a dentist on a regular basis). Dental disease can cause:
 
• Gum disease;
• Bleeding;
• Abscesses;
• Tooth decay;
• Tooth loss;
• Bad breath; and
• Unsightly teeth.
 
Dental disease can also generate a great deal of stress. It can create fear and anxiety, pain, and discomfort. It can also be very expensive, especially when the cost of treatment is added up over a lifetime.
 
As destructive and costly as dental disease is, most people, including dentists and physicians, have somehow managed to convince themselves that its damaging effects are limited to the teeth and gums. I believe this is because most people tend to think that the mouth is not actually a part of the body . . . or it is some how ‘outside of the body’.
 
I also feel that there is a communication gap between the medical and dental professions. This gap, in effect, means that vital information on the overall health of the patient is not normally shared between the two professions. But whatever the reason, the result is that most people, including health professionals, do not understand the seriousness of dental disease and its impact on overall health. Yet, it should be obvious to any health professional that infection (especially a serious and long-lasting—chronic—infection) in any part of the body will always negatively affect the entire body.
           
Dental Disease and Its Effects on Overall Health
Because of its affect on the entire body, dental disease can no longer be omitted from the subject of health and longevity. Dental disease is not just a minor ailment of the gums and teeth. It is a disease of the body that happens to begin in the mouth. If left unchecked, it can contribute to other more harmful diseases that can seriously affect the quality of life and actually shorten life expectancy. This means that physicians must play a more active role in educating their patients about the role dental disease plays in their overall health and why they need to eliminate dental disease and restore their mouths to a healthy and functional state.
 
For example, recent scientific studies clearly demonstrate the direct and harmful role gum disease plays in many serious and life-threatening diseases. For example, moderate-to-severe gum disease can:
 
• Increase the risk of heart attack by as much as 25%;
• Increase the risk of stroke by a factor of 10;
• Increase the severity of diabetes;
• Contribute to low pre-term birth weights;
• Contribute to respiratory disease;
• Interfere with proper digestion;
• Play a role in osteoporosis;
• Severely stress the immune system;
• Lower resistance to other infections; and
• Actually reduce life expectancy.
 
But because of its damaging effect on the immune system it can also contribute, make worse, or trigger many diseases and health issues, including such idiopathic (medical term applied to diseases of unknown cause) diseases as Meniere’s, chronic fatigue syndrome (CFIDS) and fibromyalgia.
 
How Dental Disease Does Its Damage
Various forms of dental disease result in infection, which will always affect overall systemic health—to one degree or another. Specific infections directly related to dental disease can contribute to problems such as periapical abscesses (infections of the dental nerve and surround bone) and cavitations of the jaws (infections left when a tooth was extracted).
 
 
However, the most serious damage done by dental disease is caused by the more advanced form of gum disease. Every health practitioner understands that the body is negatively affected by infection of any kind. The more serious the infection, and the longer it is present, the greater its potential for damaging overall health. Any infection stresses the immune system. The extent of its effect on that system is directly related to the extent, type, and duration, and location of the infection.
 
It is also important to understand that periodontal disease does not just involve the soft tissue of the mouth. If left unchecked, gum disease will progress until the underlying bone structure of the jaws is infected. As the periodontal pocket continues to deepen it becomes a haven for many types of harmful bacteria. Over time, the bacterial infection continues to expand, exposing the circulatory system to ever increasing numbers of virulent bacteria and their toxins. Remember, this is the same blood that travels throughout the entire body and as such, it can carry the bacteria and its toxins to other parts of the body, including the heart, lungs, kidneys and liver.
 
Looking at it from another perspective will help you to better understand the extent and seriousness of this oral infection. It has been estimated that in a mild form of gum disease, if laid out flat, the total infected area would be about the size of a postcard. In the case of moderate-to-severe gum disease, the total infected area could cover an area the size of a standard sheet of paper. Now, imagine if this infected area was then transferred from the mouth to the neck (or any other part of your body). If any competent health professional saw this amount of infection in any part of the body he or she would consider this to be a very serious infection and suggest immediate treatment. Yet, this type of infection is present, and left untreated, in hundreds of millions of people in the USA and worldwide.
 
The extent, location and severity of an infection is, of course, important, but so is its duration. In the aforementioned example, such a gum infection would be considered to be both acute and chronic. Meaning it was serious and would be active 24 hours a day, 365 days per year; for as long as the gum disease was present. Unfortunately, for tens of millions of people, this infection could be present for many, many years—progressively getting worse. It should no longer be difficult to imagine the stress this infection places on the immune system.
 
Another important fact to consider is that dental infection may not always be obvious or easily identified. Often, there is no pain or overt symptoms. It is an insidious disease and, if left untreated, will continue to destroy both gum tissue and the underlying bone. But whether you are consciously aware of it or not, this infection poses a serious threat to your overall health.
 
Dental Disease and Its Relationship to Other Diseases
An increasing number of studies demonstrate the relationship between dental disease and other diseases of the body. I’ve provided a brief description of the etiology (underlying cause) of dental disease and its damaging effects. The following section will provide documentation that conclusively links dental disease to other serious and life-threatening diseases.
 
Cardiovascular Disease
 
Heart Attack
Coronary heart disease results when arteries are narrowed or blocked by plaque. Plaque usually consists of cholesterol, blood clotting proteins, calcium and other substances. This narrowing is often referred to as atherosclerosis. When this takes place in the arteries leading to and around the heart, the result is coronary heart disease. Over time, the blood supply to the heart muscle can be severely reduced or blocked, depriving the heart of the oxygen it needs, resulting in a heart attack. Basically, coronary heart disease precedes a heart attack and anything that contributes to it could contribute to a heart attack. What is significant here is that a number of studies directly link gum disease to coronary heart disease and heart attack.
 
In one study, researchers found a relationship between dental disease and the risk of dying. The study is noteworthy for a number of reasons. It was conducted in the United States and included 9,760 subjects, making the study (at that time) the largest of its kind. In addition, several important discoveries resulted from this study.
 
The study concluded that those with periodontitis (the more advanced form of gum disease) had a 25% increased risk of coronary heart disease compared to those with minimal periodontal disease. It is interesting to note that in this study, decay (dental caries) was not observed to be a factor in coronary heart disease. In men under 50, periodontal disease was an even stronger risk factor in coronary heart disease. In this group, men with periodontitis had nearly twice the risk of coronary heart disease than men who had little or no periodontal disease. In the total population (men and women of all ages) the degree of dental debris (dental plaque) and calculus (tartar), as reflected in the oral hygiene index, was a stronger risk factor for coronary heart disease than was the severity of periodontal disease.
 
In regard to longevity, the most noteworthy finding was that periodontal disease and poor oral hygiene were stronger indicators of premature death than of coronary heart disease. Young men who had a maximum oral hygiene index of 6 had a three to four times higher risk of dying than those who had a hygiene index of 0 (the higher the number the more serious was the gum disease). In addition, young men with periodontitis had a nearly threefold increased risk of death from coronary heart disease and about a 50% increased risk of admission to hospital for coronary heart disease then those without it.
 
When compared to subjects with little or no periodontal disease, individuals with gingivitis (the less severe form of periodontal disease) had an approximately 23% higher risk of premature death. Those with periodontitis, or no teeth, had about a 50% higher risk of dying. From a health standpoint, these findings could be significant because gingivitis is far more common than the more severe form of the disease. But left un-treated, gingivitis will quickly lead to the more severe form of gum disease.
 
Another Study
Another study, K. J. Matilla explored the relationship between oral health and heart attack. It also examined the role of chronic bacterial infections as risk factors for coronary heart disease and the association between poor dental health and acute myocardial infarction (heart attack). The selected patients had worse dental health than controls matched for age and sex. The study showed that the relationship between dental health and heart attack remained significant even after adjustment for age, social class, hypertension, serum lipid and lipoprotein concentrations, smoking, presence of diabetes, and serum C peptide concentration (which reflects resistance to insulin).
 
The study concluded that bacterial endotoxin or similar factors may be related to myocardial infarction and poor dental health and could not be excluded as causative factors.
 
Heart Attack and Tooth Loss
A study by K. Paunio showed a relationship between missing teeth and coronary heart disease. I find this significant because both periodontal disease and decay can cause tooth loss. While some studies have shown that decay is not a direct risk factor in heart attack, it can and does cause tooth loss, which has been demonstrated to be a secondary factor in heart attack.
 
Stroke
Dental infections have also been associated with stroke. A study by J. Syrjänen showed a relationship between dental infections and a bacterial infection associated with cerebral infarction (stroke) in males. Another study demonstrated that preceding infection is an important risk factor for stroke, even when controlled for other established common risk factors, such as high blood pressure, smoking and alcohol use.
 
All dental and periodontal infections are of bacterial origin. The causative organisms include a number of harmful bacteria. Dental procedures can cause transient bacteremia (presence of bacteria in the blood), but even chewing can induce increased levels of bacteria in the blood in the presence of poor oral health.
 
In addition to the well-known association between abnormal levels of lipid (fat) in the blood and the narrowing and hardening of the arteries (atherosclerosis), researchers also found an association between elevated total dental index (TDI) and atherosclerosis, independent of dietary habits. This suggests that factors associated with gum disease may contribute to the cause of atherosclerosis and chronic infections could affect the development of hardening of the arteries by toxic mechanisms.
 
In a more recent study, researchers examined the relationship between stroke and chronic and recurrent infection. They found that chronic bronchial infection and poor dental health (primarily from chronic gum infection) may be associated with an increased risk for stroke (cerebrovascular ischemia). The results of this study suggest that, independent from established vascular risk factors, symptoms of recurrent or chronic bronchitis and poor dental health may be associated with stroke.
 
Gum disease and root canal infections appear as main contributors in the role of chronic dental disease. Interestingly, infections in the jaw bone resulting from an infected root canal (caused by decay) are also a factor in stroke risk. This is another example of how decay can play a role, however indirectly, in heart disease.
 
Diabetes
It has long been known that diabetes affects periodontal disease. New studies show that the reverse is also true: periodontal disease can affect diabetes.
 
In an important work by B.L. Mealy, the author cites numerous studies that indicate that the presence and severity of gum disease can increase the risk of poor glycemic control. One study clearly illustrates the relationship between gum disease and diabetes. When compared to diabetic patients with minimal gum disease, those with severe gum disease have a significantly greater prevalence of protein in the urine (proteinuria) and a greater number of cardiovascular complications. These include stroke and transient ischemic attack (TIA)—a stroke-like event lasting minutes, or hours, that occurs when the brain is deprived of oxygen-rich blood but in which the effects wear off completely after resumption of blood-flow. The study concludes that the association between disease related to diabetes and severe periodontitis in diabetic individuals requires attention and close cooperation between the physician and dentist.
 
Several other studies reported by Mealy state that treating periodontal complications implicated in diabetes may actually improve metabolic control of the underlying diabetic disease state.
 
These studies are important for at least two reasons. First, periodontal disease has been shown to affect the control of diabetes. Second, the American Heart Association now includes diabetes as a major risk factor for heart disease, ranking it with high blood pressure and smoking. Thus, we witness an unfortunate connection: diabetes is on the rise; it is a risk factor for heart disease; and periodontal disease is a risk factor in both.
 
Low Pre-term Birth Weight
The health and financial problems associated with low pre-term birth weight babies (weighing less than 2,500g at birth) are significant. One study illustrated that these infants are 40 times more likely to die in the neonatal period than normal birth weight infants. At birth, approximately 7% of all babies are in the low birth weight category, yet these babies account for two-thirds of all neonatal deaths.
 
In another significant study by Offenbacher, et al, researchers found that low birth weight is still the number one cause of infant mortality. It also causes many long-term health problems, including an increased risk of cerebral palsy, epilepsy, chronic lung disease, learning disabilities and attention deficit disorder. The cost, both financially and emotionally, of low preterm birth weight babies is tremendous. In the United States, 1 in 10 births are low birth weight babies. They account for 5 million neonatal intensive care unit hospital days per year at an annual cost of more than $5 billion. The overall cost in terms of suffering and long-term disabilities far exceeds the monetary costs of this problem.
 
The authors of this breakthrough study have provided new evidence that periodontal disease in pregnant women may be a significant risk factor for low birth preterm weight. The study suggests that 18% of all pre-term low birth weight cases may be attributable to periodontal disease. It also notes that gum disease represents a previously unrecognized and clinically important risk factor for pre-term low birth weight babies.
 
Respiratory Infections
Mealy’s evaluation of a number of studies on respiratory infections suggests that the oral cavity acts as a reservoir for bacteria that can find its way into the lungs. These studies indicate that mouth and throat bacterial colonization precedes bacterial respiratory infection. While no current studies specifically demonstrate a direct correlation, there is strong evidence that one exists.
 
There is also evidence that the gum pocket may be the source of the respiratory bacteria. A number of bacterial organisms believed to be common in infected gum pockets have been found in bacterial pneumonia. In one study, researchers isolated a number of bacterial species from a case report of pneumonia. Upon clinical examination, the author’s only significant finding was “marked periodontitis”, indicating that the bacteria originated in the gum pocket.
 
Another important study found that the substances that initiate respiratory infections most often originate from the periodontal pocket. The study showed that these organisms can produce respiratory diseases, such as pulmonary abscesses, resulting in a significant disease and even death.
 
Osteoporosis
Researchers at the University of Buffalo, led by Jean Wactawski-Wende, reported that most people diagnosed with periodontal disease may be at a higher risk of underlying osteoporosis. This study, conducted in 1995 and published in the Journal of Periodontology, is the first large-scale assessment of the relationship between bone metabolism and oral health. The authors reported that if the relationship remains strong in further studies, it is possible that a routine dental X-ray could be used to screen for bone loss. In addition, dentists could provide education and treatment for gum disease that could combat oral bone and tooth loss and possibly reduce the extent of osteporosis.
 
This landmark study is important because both osteoporosis and periodontal disease are serious public health concerns for tens of millions of North Americans. Osteoporosis affects more than 20 million people in the U.S. and accounts for nearly 2 million fractures a year.
 
Gastrointestinal Disorders
To date, the most significant relationship between dental disease and gastrointestinal disorders is from tooth loss. The edentulous (without teeth) patient, is the most vulnerable to gastrointestinal and other related problems.
 
However, one study showed that those with dentures are also subject to numerous health problems, directly related to their inability to properly chew their food. This study concluded that most of the subjects showed a low chewing (masticatory) performance classification. These subjects took more medication for gastrointestinal disorders than those with a higher chewing performance. Poor chewing was also associated with a decrease in vitamin A and fiber intake, which was mainly the result of lower intakes of fruits and vegetables. This condition seemed more likely to affect women in the study. In the edentulous person, with a deficient chewing performance, reduced consumption of fiber-rich foods that are hard to chew could provoke gastrointestinal disturbances and affect overall health.
 
Research indicates that changes in food preferences and subsequent nutrient/vitamin deficiencies are associated with tooth loss. One study provided a sound basis for why the denture wearer does not achieve the necessary breakdown of food substances. The research indicated that the chewing efficiency of those wearing dentures was about one-sixth that of a person with natural teeth. In addition, evidence suggests that nutritional deficiencies, regardless of their cause, are associated with impaired immune responses. One obvious conclusion is that a person with dentures would need to chew his or her food 6 times as long as a person with natural teeth.
 
In another important study, researchers collected dietary intake data about the food and nutrient intake of 49,501 male health professionals. The results showed that toothless participants consumed fewer vegetables and less fiber and carotene, and had higher cholesterol, saturated fat, and calories than participants with 25 or more teeth. They concluded that these factors could increase the risks of cancer and cardiovascular disease.
 
I would again like to point out that the vast majority of tooth loss is caused by dental disease, either decay or periodontal disease. It is true that once the teeth have been removed, periodontal disease, and its resultant infection, will be eliminated. But as the above studies point out, the problems facing edentulous individuals do not end with the elimination of periodontal infection. In fact, they face an entirely new set of health problems.
 
Immune System
Health professionals understand that infection stresses the immune system. It is also obvious that the more serious the infection and the longer it persists, the more the immune system is affected. At some point, the immune system can become so compromised that its ability to resist additional infections and diseases could be seriously diminished. This weakness could put the various body systems at risk and create a domino effect in regard to diseases and infections.
 
We also know that when the immune system is compromised any health problem directly or indirectly related to it will be negatively affected. It is obvious that dental infections, especially periodontal disease, periapical abscesses and cavitations, have a deleterious affect on the immune system and would jeopardize the successful treatment of any medical treatment for any immune related disease.
 
Source of Information
Space does not allow me the option of adequately covering the cause of and the prevention of dental disease. There is much more to learn about this subject if you hope to free yourself from this disease, including how to use your preventive dental tools and how to effectively utilize the dentist and dental hygienist to support your efforts. The information you need to accomplish your goals can be found in Tooth Fitness: Your Guide to Healthy Teeth. You can purchase this book and access other important information about oral health and its relationship to overall health on my website: www.dentatlwellness4u.com.
 
Other Dental Issues Affecting Health and Longevity
Infections are not the only dental issues confronting individuals who wish to free themselves of existing disease, improve their health and extend their lives. Nor is oral infection the only dental issue that the physician and other health professionals must consider. A number of other dental issues can increase the risk and severity of other, more serious diseases. They are:
 
1. Fillings (amalgam/silver amalgam) containing mercury;
2. Failed root canals;
3. Infected extraction sites (cavitations);
4. Signs and symptoms of other diseases; and
5. Sensitivity to dental materials.
 
Amalgam Fillings and the Mercury Issue
Mercury is the most toxic, naturally occurring metal on this planet. It is a potent poison, more toxic than arsenic, and even one molecule in the body will do it harm. Research indicates that even minute levels of mercury can have negative health consequences, which can vary from person to person depending on a number of factors. Because of its extreme toxicity, there is no doubt in my mind that mercury can cause, contribute, or make worse every health problem we face. Symptoms of mercury poisoning can range from mild to severe, and it can be fatal in acute doses.
 
There are a number of ways we can be exposed to mercury, but amalgam fillings are the greatest source of mercury exposure for those with these fillings. While acute mercury poisoning is rare, every person with amalgam fillings is being subjected to chronic mercury poisoning, to one degree or another.
 
Each medium-sized amalgam filling contains about 50% elemental mercury, or about 1,000 milligrams of mercury. Numerous studies have proven that mercury vapor is released from amalgam fillings. Up to 80% of that vapor is absorbed by the lungs and passes into the blood. >From there it is transported throughout the body, including the brain and central nervous system.
 
When mercury from amalgam fillings (or other heavy metals) enter the body and accumulate faster than the body can remove them, they will gradually build up until early symptoms of chronic mercury poisoning are expressed. In the filling, mercury is in its elemental state. However, when elemental mercury is released from the filling, bacteria can change it in the mouth and intestine to an even more toxic (100 times as toxic) form of organic mercury, called methyl mercury.
 
Toxic levels of mercury are measured in micrograms. This is an extremely small amount. For example, one microgram is equal to one-millionth of a gram (28.4 grams equals 1 ounce). Depending on the number of amalgam fillings present, measurements of mercury vapor in the mouth can range from between 20 and 400mcg/m3 (microgram of mercury per cubic meter of air) or more. The World Health Organization (WHO) has recognized a time-weighted average (TWA) for occupational exposure to mercury vapor at 25 mcg/m3. If set higher it believes that those individuals most sensitive to mercury toxicity are the young, the elderly, the fetus and nursing baby.
 
The Agency for Toxic Substances and Disease Registry (ATSDR) takes the most prudent and realistic approach to mercury vapor exposure. After a lengthy study it established a minimal risk level (MRL) of 0.2 mcg/m3 of air. According to the agency, this is the upper limit to which a person can be continuously exposed to without exhibiting any observable effects. This makes the most sense because anyone with amalgam fillings is being exposed to varying amounts of mercury vapor 24 hours a day, 365 days a year. As you can readily see, in many people with amalgam fillings the amount of mercury they are being exposed to daily can exceed the safe levels established by many regulatory agencies.
 
Mercury is classified as a neurotoxin and the toxicity of mercury is undisputed. Chronic mercury poisoning can impair the blood and cardiovascular system. It can cause genetic mutations and can interfere with, or overload, the natural detoxification pathways of the liver, kidneys, skin, and bowel. It can impair the function of the nervous, endocrine, enzymatic, gastrointestinal, reproductive, and urinary systems. It can increase allergic reactions and act as a harmful antibiotic, killing both good and harmful bacteria in the gut. Mercury can also cause a great deal of tissue damage by creating an abundance of free radicals, suspected to be one of the underlying causes of all degenerative diseases.
 
One study indicated that mercury can interfere with leukocytes. It also showed how it could not only compromise the body’s natural defenses, but also promote tissue injury via the local production of oxygen free radicals. Another study demonstrated that mercury can inactivate neutrophils. These important immune system components are responsible for killing fungi inside the body (blood and soft tissue). Mercury toxicity was also shown to inhibit their ability to kill Candida.
 
But mercury can also have devastating secondary effects on the body by depleting it of the important antioxidants the body needs to not only remove mercury and other heavy metals, but to fight free radicals and other toxins. This happens because each atom of mercury that is removed from the body requires an escort of 1 to 2 molecules of glutathione (the body’s most abundant and important antioxidant for removing mercury and other heavy metals). As you can see, over time, more and more glutathione is lost, creating a deficiency of it and an increase in mercury being stored in the body. This indirect, or secondary, effect of mercury is devastating to the immune system and can seriously reduce the body’s ability to deal with other diseases.
           
Yet, not everyone with amalgam fillings shows signs or has obvious symptoms of mercury toxicity. Mostly, this is related to the number of fillings, the length of time the fillings have been in the mouth, the health of the individual, and the body’s ability to naturally rid itself of mercury. I believe that if you now have—even if you haven’t yet shown any symptoms of chronic mercury poisoning—the chances are very good that more and more mercury is being stored in your body. There is no doubt in my mind that chronic mercury poisoning can be the most important oral health issue to consider when treating any health problem. Of course, there are hundreds of millions of people who have both mercury amalgam fillings and gum disease; the combination of which could dramatically weaken the body’s ability to deal effectively deal with all other health issues.
 
Sources
There are many sources of mercury exposure, including food (mostly mercury contaminated fish), air, water, cosmetics, medications, and industrial occupations. However, according to the World Health Organization, the single biggest contributor of mercury to the body is amalgam fillings.
 
Symptoms
A wide variety of symptoms are related to mercury toxicity. Because mercury can be stored in virtually every cell, organ, and tissue (particularly the brain, kidneys, and central nervous system) of the body, its range of symptoms are vast. Of course, other health issues could contribute to these symptoms, or even cause them; clearly, no single symptom is specific to mercury poisoning. But it is also important to realize that mercury related symptoms are directly proportionate to the number of fillings you have and the length of time they have been in the teeth. Although this is a long list, I feel it important to include it here. You can use this as a checklist (see Figure 1) when determining whether or not you may have mercury related symptoms. (The symptoms listed are those commonly related to the direct effects of chronic mercury poisoning. Because of its secondary effects this list could be much longer.)
 
 
Figure 1.
1. Neurological/mental

a. Slurred speech

b. Memory loss                                                          
c. Learning disorders
d. Lack of concentration

e. Fine tremor

 

2. Heart

a. Rapid heart rate

b. Irregular heartbeat

c. Pain in chest

 

3. Head Area                                                              
a. Dizziness
b. Ringing in ears
c. Faintness
d. Insomnia

 

4. Energy Levels

a. Chronic tiredness

b. Apathy

c. Restlessness

 

5. Emotions
a. Mood swings
b. Fits of rage
c. Fear and nervousness
d. Anxiety
e. Depression
f. Aggressiveness
g. Confusion

 

6. Digestive System

a. Loss of appetite

b. Diarrhea/constipation

c. Loss of weight

d. Nausea/vomiting

e. Cramping

 

7. Oral/throat
a. Chronic coughing
b. Bleeding gums
c. Bone loss
d. Metallic taste

e. Inflammation of the gums

f. Bad Breath
g. Ulcers of oral cavity
h. Mouth inflammation
i. Sore throat

 

8. Muscles & Joints

a. Muscle aches

b. Joint aches

c. Stiffness

 

9. Nose
a. Inflammation of the nose
b. Sinusitis
c. Excessive mucus formation
d. Stuffy nose
e. Frequent illnesses

f. Sense of smell loss

g. Genital discharge

h. Unspecified allergies

i. Excessive perspiration

j. Anemia

k. Kidney disease

l. Candida

 

10. Other

a. Hair loss

b. Water retention

c. Vision problems

d. Skin problems

 

11. Lungs                                                      
a. Asthma/bronchitis
b. Shortness of breath

c. Chest congestion

d. Shallow respiration

 

Amalgam Controversy
The controversy about dental amalgams that you may have heard about has absolutely nothing to do with the toxicity of mercury; rather, it is about whether or not mercury is released from an amalgam filling in quantities great enough to cause health problems. It is scientifically known that any amount of mercury in the body will cause harm and the more that is present the more harm will be caused. We also know without a doubt that mercury is released from amalgam fillings. In spite of that fact, the ADA continues to say that no one with these fillings need worry because not enough is released to cause any health problems; except those who are allergic to mercury.
 
They are as wrong today as they were 150 years ago. In a majority of those with amalgam fillings, it is impossible for the body to remove all of the mercury it is exposed to from them and other sources of mercury. That which cannot be removed accumulates in the body and over time it can cause innumerable health problems to tens of millions of people. This booklet does not allow me the space to explain the many variables that play a role in determining the numerous long-term effects of the mercury released from amalgam fillings. But it should provide enough information for you to acknowledge that mercury could be a major factor in nearly every health problem we know of. If you would like to explore this subject in more detail, I suggest you read A Mouth Full of Poison: The Truth about Mercury Amalgam Fillings and Your Complete Guide to Mercury Detoxification: How to Safely Remove Mercury from Your Teeth and Body. These books are available at www.dentalwellness4u.com.
 
Galvanic Effect of Dental Fillings
Dental fillings have also been shown to exert a galvanic effect in the mouth when two dissimilar fillings (i.e., gold and amalgam fillings) are present. This battery-like effect has been shown to corrode to the less noble filling material, notably amalgams. As the other metal components of amalgam are pulled out of the filling, mercury vapor can be released. The severity of this action depends on the number of fillings present and their relationship to each other.
 
In addition, the current that is generated in this process is thought to interfere with energy flow along acupuncture meridians. The belief is that the resultant current blockage can eventually affect the organs along the corresponding acupuncture meridian. Anyone who is utilizing acupuncture as part of their treatment regime should consider them. I also believe that Meniere’s suffers should consider this effect as a potential symptom trigger.
 
Root Canals
The idea that a root canal can cause health problems is not new. In the 1930s and 40s, Dr. Weston Price dealt with this subject in two classic books, Dental Infections-Oral and Systemic, Volume I, and Dental Infections and the Degenerative Diseases. The subject of root canals and their relation to general health is also thoroughly examined in Dr. George Meining’s book, Root Canal Cover-up.
 
This concept is called the “focal infection theory.” It is based on the fact that traditional root canal therapy cannot guarantee that the tooth’s root canal, and the thousands of tubules that radiate out from the canal, can always be effectively sterilized by root canal treatment. The theory proposes that an infection existing in one part of the body (in this case the root canal and chamber) can be transferred, via the circulatory system, to other parts of the body, where they can initiate an entirely new infection. It is believed that such an infection, resulting from an infected root canal, can migrate and infect the kidneys, the heart, intestines, and other sites. Some researchers claim that health problems resulting from root canals rank in severity right behind mercury/amalgam fillings.
 
In 1998, approximately 60 million root canals were performed. While I do not believe that every root canal will be a source of focal infection, I do believe it must be considered when attempting to diagnose an illness or symptom. The root canals that I consider to be at risk are those whose infection has spread to the bone surrounding the root tip. Looking to the mouth as a source of chronic infection is especially important when the source of a health problem is elusive or an accurate diagnosis that fits the symptoms cannot be made.
 
Cavitations
Cavitation is a relatively new dental term. It refers to the destruction of bone in the area where a tooth has been extracted. One of the most common problems that can result from a cavitation is a neuralgia inducing cavitational osteonecrosis (NICO). According to experts, if the tooth is not removed properly, incomplete healing can take place, leaving a hole or spongy place inside the jawbone. In some cases, particles of the periodontal membrane, along with bacteria, can be left behind, becoming a breeding ground for bacteria and their toxins. Studies indicate that the bacterial waste products can be extremely potent. Cavitations are also believed to contribute to focal infections. They can have an impact on systemic health and could cause various levels of stress.
 
Signs and Symptoms of Other Diseases
Diseases whose early signs and symptoms appear in the mouth can affect the patient’s health and life expectancy. Of these, oral cancer is of primary concern. More than 30,000 people are diagnosed with oral cancer each year. If the cancer is caught early, the five-year survival rate is 90%. If it isn’t caught early, the survival rate drops to 50%. While most dentists include this in their oral examination you cannot afford to take it for granted. Always remind the dentist or hygienist to include this examination. 
 
There are as many as 25 diseases of the body whose early signs and symptoms can be seen in the oral cavity. The early detection of any of these diseases increases the possibility of successful treatment, and may extend or even save lives. Some of the more serious diseases that first show signs in the oral cavity, lips, or tongue, include leukemia, hemophilia, Kaposi’s sarcoma, malignant melanoma, syphilis, diabetes, squamous cell carcinoma, myoblastoma, tuberculosis, epilepsy, and hemangioma. My book, Tooth Fitness: Your Guide to Healthy Teeth, includes an educational chapter about patient oral self-examination and its importance to dental and overall health.
 
Sensitivity to Dental Materials
Sensitivity to dental materials may not be a serious problem for many people. But for those who are allergic to any one of the hundreds of different metals, compounds, chemicals, and products used in dentistry, these materials present a potentially serious health hazard. If you have allergies, regardless of their source, your health practitioner may look at every potential source of the allergy except for the mouth. If you he or she is unable to track down the culprit, I recommend that you be tested for potential allergic reaction to dental materials. Information about this test can be found at www.ccrlab.com, the website for Clifford Consulting and Research.
 
Fluoride
Although it poses a potentially serious health hazard, the subject of fluoride is not within the scope of this booklet. It does relate to teeth, but is not really a dental health issue. I see it as a public health issue, as the greatest single source of fluoride is delivered to the individual via the municipal water systems. Regardless of how it is delivered, fluoride is a poison, and increasing evidence suggests it can create, or contribute, to numerous health problems. I also suggest asking your health professional to evaluate you for potential fluoride toxicity when doing a complete health assessment. This would be particularly important if he or she can’t establish a diagnosis that fits your symptoms. Thus those with idiopathic diseases should take this into consideration.
 
It should be noted that today people are exposed to greater quantities of fluoride than 25 years ago. At that time, the major source of fluoride exposure was fluoridated water. Today, it is also found in mouthwash, toothpaste, rinses, and tablets. Some evidence shows that fluorosis has caused dental fluorosis (unsightly stained and pitted enamel) in children in areas where the water isn’t even fluoridated. No one knows how much fluoride each individual is getting. Fluoride toxicity is definitely something to watch for, especially in communities where the water is fluoridated.
 
Topical fluoride applied at the dental office has been shown to effectively reduce decay in individuals whose teeth are susceptible to it. I don’t have a problem with this form of application as it is controlled and little, if any, will be ingested. The key to fluoride toxicity is that it has to enter the body and thus topical application of it, done properly, prevents that occurrence. But I do have a concern about high fluoride concentrations applied to the teeth of young children without adequate protection against ingestion. There have been documented cases of fluoride toxicity when very young children swallowed an excessive amount of topical fluoride gel.
 
Idiopathic Diseases
I previously mentioned the relationship of oral health to diseases that are idiopathic, or those we don’t know, or are uncertain, of their cause.
 
In a very real sense the idiopathic (unknown) aspect makes it imperative that those that are dealing with any idiopathic disease or illness MUST consider every health problem as a potential cause or contributor of their problem. I say this because any of them, or any combination of them, could be a contributing factor. The only way to actually know which ones may be involved in an idiopathic health issue is to eliminate each of them and let the body tell you what role it has played. As oral health is in my area of expertise, I have listed those oral health issues that I KNOW have an effect, some very serious such as amalgam fillings/chronic mercury poisoning and gum disease. But all oral health issues must be evaluated and dealt with.
 
I will take Meniere’s Syndrome/Disease as an example. There are a number of symptoms that, when taken together, comprise Meniere’s syndrome. But not only are we not sure what caused the disease, we are just as uncertain about what trigger’s the symptoms associated with Meniere’s. Thus, there could be a genetic cause that predisposes this condition and other factors that are involved in the triggering of symptoms. We just don’t know. But what I suggest be considered is that stress, in whatever form, could easily trigger the various symptoms.
 
We know that stress takes many forms. We know that emotional, psychological and physical stress can lower the body’s resistance to disease. In short, stress makes us more vulnerable to disease. Well, the reverse is also true and all disease causes stress; some more than others but all stress the body. It would seem logical to assume that anyone with Meniere’s, or any other idiopathic disease, would want to do everything possible to eliminate every form of stress. This may be easier said than done but I believe every effort must be made if you want to reduce or eliminate any potential triggering effect.
 
It is not in my area of expertise to tell you how to deal with other avenues of stress in your life but I will encourage you to make your best effort to eliminate all oral health issues. The first step includes a complete oral health evaluation. You must know what is wrong before you can effective treat it.
 
Even if a thorough evaluation shows that a person with Meniere’s doesn’t have ANY of these oral health problems he or she will have accomplished a great deal by eliminating a number of potential triggers. That means one can move on to other health issues as a potential cause.
 
I’ve run into those that try to isolate a particular problem, such as Meniere’s or CFS, as if their major health issue doesn’t involve the rest of the body. They attempt to focus treatment solely in that one area and although they generally get some relief from that approach, if it is also related to other health issues, they can never hope to truly eliminate their problem. Plus, not doing so will still leave them vulnerable to the side effects of those other health problems in the future.
 
So while it would be truly wonderful to know a specific cause for Meniere’s, it is still in a person’s best interest to achieve optimal health. So looked at in the right way the idiopathic aspect can really become a motivating factor to identify and eliminate other health problems.
 
The two oral health issues that I believe can contribute to, cause, or trigger Meniere’s symptoms, are mercury amalgam fillings and gum disease. But because of its effect on the immune system I also believe it would be important to consider the individual’s sensitivity to dental materials and the galvanic effect of dental fillings.
 
Real Age Evaluation
It would be appropriate to end this booklet with some insightful comments about the effects of dental disease on longevity, by Dr. Michael F. Roizen. In his classic book, Real Age: Are You as Young as You Can Be? he offers a revolutionary, systematic approach to calculating the aging effect of more than 100 different health behaviors. These range from diet and medication to stress control and dental disease.
 
Dr. Rozen cited one study that showed people with gingivitis and periodontitis have a 23% to 46% higher mortality rate. Another study indicated that men under age 50, who have advanced periodontal disease, are 2.6 times more likely to die prematurely and three times more likely to die from heart disease than those who have healthy teeth and gums. Both studies considered other pertinent factors, such as smoking, alcohol, and overeating. Studies have also shown that a bacterial strain commonly found in tooth plaque has also been found in the fatty deposits that clog arteries. Other studies demonstrate that periodontal disease increases the white blood cell count, an indicator that the immune system is under increased stress.
 
Dr. Roizen concluded that dental disease and tooth loss doesn’t just make you look older, they actually make you older. Indeed, periodontal disease can make our Real Age more than 3.4 years older. Conversely, the absence of periodontal diseases makes you 6.4 years younger than the median person.
 
As a person concerned about your health it is your responsibility to do all you can to not only extend your life but to also improve its quality. This has to extent to considering the effect of your oral health on your overall health.  
 
Conclusions
The long-held belief that dental disease is a localized, minor disease that only affects the teeth and gums, has not withstood the test of time. Dental disease, and other issues related to the mouth, can and do contribute to serious health problems. They can also interfere with successful medical treatment and healing and can actually shorten life expectancy.
 
I believe that the evidence supporting the role of dental disease in systemic diseases is conclusive. As a patient, you cannot afford to overlook this relationship when seeking treatment for any disease or for attempting to extend life expectancy and improve the quality of your life. If you suffer from any of the symptoms or diseases referred to in this chapter, you must determine if periodontal disease, amalgam fillings, or another oral issue could be contributing to its cause or severity. Certainly, you want to ensure that you have at least eliminated dental disease or mercury poisoning as a possible cause of, or contributor to, your existing health problems.
 
Neglecting the issue of dental health, in my opinion, jeopardizes the success of treatment and could lead to disappointing outcomes. It could also result in great frustration for you and your health practitioner. 
 
Solutions
Discussing problems without offering solutions does not have much value. Therefore, I will offer some solutions to help you address the problems of dental disease and its effects on overall health.
 
I am not suggesting that you become a dentist yet, it is vitally important to address the issue of oral health, especially since it could affect the success of any treatment you may now be undergoing.
 
Everyone understands that successful treatment hinges on making an accurate diagnosis. In order to make a truly ‘whole body’ diagnosis you, your dentist and your health professional, must know the state of your oral health.
 
My suggestion is that you make an appointment with your dentist to determine the following:
 
1.       Your total periodontal health;
2.       Whether or not you have any infected root canals;
3.       The condition of any extraction sites;
4.       Whether or not you have, or have had, amalgam fillings, including how many;
5.       Whether or not you have been examined for other diseases whose early signs and symptoms are found in the oral cavity.
 
If the results show that you have no existing oral health problems it will allow you to at least eliminate these oral health issues as a potential health risk factor. If the report shows that oral health problems exist, you will be doing yourself a service by knowing that you can now take the necessary steps necessary to deal with these oral issues. It is also imperative to understand that prevention is something that is done by you, not to you. But you can ask for the support of your dental and medical professionals. If you are willing to do your part, any treatment for your health problems will be more successful. 
 
In health,
 
Dr. Tom
 
 
Contact Information
Tom McGuire, DDS
President
The Dental Wellness Institute
321 S. Main St., # 503
Sebastopol, CA  95472
1-800-335-7755
www.dentalwellness4u.com

 
References
 
1. Frank DeStefano, et al: Dental disease and risk of coronary heart disease and mortality. British Medical Journal 306: 688-691, March 13, 1993.
 
2. KJ Mattila, et al: Association between dental health and acute myocardial infarction. British Medical Journal 298: 779-82, March 25, 1989.
 
3. K Paunio, et al: Missing teeth and ischemic heart disease in men aged 45-64 years. Eur Heart J 14 (suppl K): 54-56. 1993
 
4. J. Syrjänen, et al: Dental infections in association with cerebral infarction in young and middle-aged men. Journal of Internal Medicine 225: 179-184,    
March, 1989.
 
5. J. Syrjänen, et al: Preceding infection as an important risk factor for ischaemic brain infarction in young and middle aged patients. British Medical Journal 296: 1156-60, 1988.
 
6. Shaw JH: Causes and control of dental caries. New England Journal of Medicine 317: 996-1004, 1987.
 
7. Loesche WJ, Syed SA, Schmidt E, Morrison EC: Bacterial profiles of subgingival plaques in periodontitis. Journal of Periodontal 56: 447-56, 1985.
 
8. Jokinen MA: Bacteremia following dental extraction and its prophylaxis. Proc Finn Dent Soc 66: 73-98. 1970.
 
9.   Murray M, Moosnick F: Incidence of bactermia in patients with dental disease. J Lab Clin Med 29: 801-802. 1941.
 
10.  Mathews JD, Whittingham S, Mackay IR: Autoimmune mechanism in human vascular disease. Lancet 2: 1423-7. 1974.
 
11. Grau AJ et al: Association between acute cerebrovascular ischemia and chronic and recurrent infection. Stroke 28: 1724-1729, 1997.
 
12. Mealy BL: Influence of periodontal infections on systemic health. Periodontology 2000 21: 197-209, 1999.
 
13. Thorstensson H, et al:  Medical status and complications in relation to periodontal disease experience in insulin dependent diabetics. Journal of Clinical Periodontology 23: 194-202.
 
14. McCormick MC: The contribution of of low birth weight to infant mortality and childhood morbidity. New England Journal of Medicine 312: 82-90, 1985.
 
15. Offenbacher, S, et al: Periodontal infection as a possible risk factor for preterm low birth weight. Journal of Periodontology 67:1103-13, 1996.
 
16. Slots J, et al: Yeasts, enteric rods and pseudomonads in the subgingival flora of severe adult periodontitis. Oral Microbiol Immunol 3: 47-52, 1988.
 
17. Slots J, et al: Prevalence and antimicrobial sensitivity of Enterobacteriaceae, Pseudomonadaciae and Acinetobacter in human periodontitis. Oral Microbiol Immunol 5: 149-54, 1990.
 
18. Venkataramani A, et al: Actinobacillus actinomycetemcomitans pneumonia with possible septic embolozation. Chest 105: 645-46, 1994.
 
19. Bartlett J: Anaerobic bacterial infections of the lung. Chest 91: 901-09, 1987.
 
20. Brodeur J-M, et al: Nutrient intake and gastrointestinal disorders related to masticatory performance in the edentulous elderly. J Prosthet Dent 70: 468-73, 1993.
 
21. Carlos JP, et al: Methodological and nutritional issues in assessing the oral health of aged subjects. Am J Clin Nutr 50: 1210-18, 1989.
 
22. Kapur KK, et al: Masticatory performance and efficiency in denture wearers. J Prosthet Dent 14: 687-94, 1964.
 
23. Chandra KK: Nutritional regulation of immunity and risk of infection in old age. Immunology 67: 141-7, 1989.
 
24. Kaumudi J, et al: The impact of edentulousness on food and nutrient intake. JADA Vol. 127: 459-67, April 1996.
 
25. Woods JS: Altered porphyrin metabolism as a biomarker of mercury exposure and toxicity. J Physiol Pharmacol 74 (2): 210-15, 1996.
 
26. Contrino J, et al: Effects of mercury on human polymorphonuclear leukocyte function. Am J Pathol 132:1, 110-118, July 1988.
 
27. Perlingeiro RC, et al: Polymorphonuclear phagocytosis and killing workers exposed to inorganic mercury. Int J Immunopharmacol 16:12, 1011-17, 1994
 
28. Breiner MA: Whole Body Dentistry. Quantum Health Press, 1999.
 
29. McGuire T: Tooth Fitness: Your Guide to Healthy Teeth. St. Michael’s Press, 1994.
 
30. Yiamouyiannis J: Fluoride: The Aging Factor. Health Action Press, 1993. the information they need to access it.
 

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