The systemic oral health connection: Biofilms

Abstract

Frequently, periodontal health and it's associated oral biofilm has not been addressed in those patients who have systemic health issues, especially those who are not responding to medical treatment via their physician. Oral biofilm may be present in the periodontal sulcus in the absence of clinical disease of periodontal disease (bleeding on probing, gingival inflammation) and periodontal reaction is dependent on the patient's immune response to the associated bacterial and their byproducts. Increasing evidence has been emerging the past decade connecting oral biofilm with systemic conditions, either initiating them or complicating those medical conditions. The patient's health needs to be thought of as a whole-body system with connections that may originate in the oral cavity and have distant affects throughout the body. To maximize total health, a coordination in healthcare needs to be a symbiosis between the physician and dentist to eliminate the oral biofilm and aid in prevention of systemic disease or minimize those effects to improve the patient's overall health and quality of life. Various areas of systemic health have been associated with the bacteria and their byproducts in the oral biofilm. Those include cardiovascular disease, chronic kidney disease, diabetes, pulmonary disease, prostate cancer, colon cancer, pancreatic cancer, pre-term pregnancy, erectile dysfunction Alzheimer's disease and Rheumatoid arthritis. This article will discuss oral biofilm, its affects systemically and review the medical conditions associated with the oral systemic connection with an extensive review of the literature.

Association between Chronic Gingivitis and Cancer: A Retrospective Cohort Study of 19,782 Outpatients from the United Kingdom

“…As pointed out, chronic gingivitis is a condition characterized by inflammation of the gums that can last for a prolonged period of time. It is caused by the buildup of plaque on the teeth, which can lead to the formation of bacterial colonies that produce toxins that irritate the gums [ 36 , 37 ]. Chronic inflammation and damage to the cells in the gums were suggested to increase the risk for oral cancer development.…”

A Meta-analysis Comparing Toothbrush Technologies on Gingivitis and Plaque

“…2 Effective toothbrushing removes dental plaque 3 to prevent and reverse gingivitis, thereby reducing the risk of periodontitis, which has been associated with systemic conditions such as cardiovascular disease, diabetes, and Alzheimer's disease. 4 Therefore, for the individual, removing plaque and preventing gingivitis have the potential to improve not only oral health but also whole-body health. For society, a cost-benefit analysis 5 established that the economic burden of periodontitis is mitigated better by a strategy of prevention than of treatment.…”

Comparative analysis of microbial composition and functional characteristics in dental plaque and saliva of oral cancer patients

“…The oral diseases caused by dysbiosis in the oral microbiota (such as periodontitis) are associated with various systemic disorders [ 11 ]. Oral bacteria and their metabolic products enter the bloodstream, increasing oral and systemic inflammation through the release of toxins or microbial by-products [ 12 , 13 ]. Much research has reported the associated risk of periodontal disease and systemic diseases such as cardiovascular disease, diabetes, respiratory infections, and adverse pregnancy outcomes, with a 19% increased risk in cardiovascular diseases and an elevated risk of gaining the critical COVID-19 infection [ 14 , 15 ].…”