Know the Importance of Maintaining Dental & Oral Hygiene and Health

Did you know that the health of your teeth and mouth is a reflection of your health in general or in other words, problems in your oral cavity greatly affect the health of your body? So protect yourself by learning more about the relationship between oral health and your general health. According to Professor Saymour from the Sir John Walsh Research Institute, University of Otago, New Zeland states that "You cannot have good general health without having good oral health, because the oral cavity is part of your body"

The theory regarding the relationship between oral health and public health was first stated by a scientist named William Hunter in 1911, namely a theory called " focal infection ". According to data from the Human Oral Microbiome Database (HOMD) there are more than 700 species of microorganisms found in our oral cavity. Data on the species of microorganisms were taken from the oral cavity of healthy patients and conditions with infections, such as cavities ( caries ), infection of the supporting tissues of the teeth (periodontal infection), infection of the root canal of the tooth (endodontic infection) and oral cancer. According to some studies there are about 100 systemic diseases and 500 types of drugs that have a relationship with the state of our oral cavity. The following are some common (systemic) infections originating from oral infections.

Figure 3. Infectious conditions in the oral cavity (dental caries/ caries , inflammation of the supporting tissues of the teeth/ periodontitis , soft tissue infections/ mucosa diseases, and oral cancer/ oral cancer. 4 )

Cardiovascular Disease (Heart)

Inflammation of the tooth supporting tissue (periodontitis) has a risk factor for coronary heart disease. The results of the study also stated that periodontitis is closely related to the causes of cerebrovascular disease (stroke) and other cardiovascular diseases. Every year cardiovascular disease is the highest cause of death in the United States, which is 32-50%. The causes of cardiovascular disease are generally associated with general conditions such as high cholesterol levels, hypertension, diabetes and smoking. Other factors associated with cardiovascular disease are the presence of chronic inflammation, metastatic infection and vascular injury due to endotoxins produced by bacteria in the oral cavity. This mechanism is caused because in patients with periodontitis or with low levels of oral hygiene it can cause a condition known as bacteremia (bacteria in the blood, especially Streptococcus viridans bacteria). Bacteremia can cause chronic inflammation in the blood vessels which triggers several biomolecular responses in the body such as proinflammatory cytokine responses such as C-Reactive protein, TNFa (Tumor necrosis factor a), Interleukin 1b and Interleukin 6. Some of these responses can cause atherogenesis (abnormalities blood vessel walls due to injury) which can result in the accumulation of plaque (thrombus) on the surface of blood vessels so that blood flow becomes obstructed thereby increasing the risk of stroke and heart attack (due to ischemia).

Lung Disease (Pneumonia)

One of the lung diseases is pneumonia. Pneumonia is an inflammatory lung disease that can be caused by fungal, bacterial, viral and parasitic infections. The oral cavity is a place for bacteria to enter the lungs through the trachea, the aggregation of various types of bacteria can form plaques in the respiratory tract such as Staphylococcus aureus, Pseudomonas aeruginosa, Porphyromonas gingivalis and Agregibacter actinomycetemcomitans. Oral bacteria can secrete several types of enzymes that can help adhere to the surface of the mucous lining of the respiratory tract. So that it will make the respiratory tract become obstructed. Several studies have stated that the treatment of endotracheal intubation increases the risk of bacterial infection through the oral cavity to the upper respiratory area. Patients with treatment using a ventilator will increase the risk of death if they have poor oral hygiene conditions.

Kidney illness

Kidney infections caused by bacteria originating from the oral cavity are glomerular nephropathies. The kidney infection is caused by Streptococcus bacteria originating from abscesses from dental infections and chronic infections of the supporting tissues of the teeth (periodontitis). This kidney infection can also occur due to the result of excessive IgA type antibody products originating from the immune system due to this chronic abscess. The excess IgA type antibodies enter the blood vessel circulation and attach to the glomerulus which can further damage kidney function, this condition is referred to as IgA Nephropathy.

Digestive Diseases (Gastrointestinal/GI)

The oral cavity is the first line of the process of destroying food in the body before it enters the digestive system. Digestive diseases are generally always associated with infections originating from the oral cavity. The bacteria that causes digestive tract diseases such as chronic gastritis, peptic ulcer, duodenal ulcer, gastric tumors, and lymphoma is Helitobacter pylori. H. Pylori is a bacterium that can be found in dental plaque and saliva.

Arthritis (Rheumatoid Arthritis)

Arthritis is an inflammation of the synovial membrane in the joints which can interfere with the work function of the joints. In general, arthritis can be caused by several factors, such as autoimmune, hormones, food, infection, smoking and the interaction of antigens and antibodies. Inflammation of the tooth supporting tissues can trigger an inflammatory response from the immune system (T and B lymphocytes, neutrophils and monocytes) by releasing products in the form of cytokines which can cause joint inflammation. Several studies have stated that there is DNA of oral bacteria in serum and synovial fluid samples in arthritis patients. These bacteria include P. gingivalis, P. intermedia, B. forsythus.

Abnormalities in cases of pregnancy

The most common cases of childbirth are babies with low birth weight (LBW). Periodontitis is a risk factor that can cause abnormalities in cases of pregnancy such as low birth weight. This is due to the spread of bacteria, the spread of inflammatory response products, the immune response of the fetus and mother (feto-maternal) to oral bacteria. The spread of bacteria starts from the blood circulation (bacterimia) and then enters the amniotic fluid (amnion) and infects the placental membrane (chorioamniotic). Several types of bacteria that can cause inflammation include Bergeyella, Eikenella, F. nucleatum and P. gingivalis. In addition, these bacteria can infect the mother's uterus (uterus), causing inflammation which triggers the emergence of cytokine products or metalloprotease synthesis processes which also activate neutrophils which can cause premature birth.

Conclusion

The spread of infections caused by oral bacteria to various organs in the body through blood vessels (bacteriemia) is something that should not be underestimated. From some of the research data above, it is stated that oral bacteria are a risk factor for abnormalities in our body's function systems. Therefore, keep in mind that maintaining oral hygiene and health is the most important thing in maintaining overall general health.

Article written by drg. Ciptadhi Tri Oka Binartha, M.Kes (Dental Specialist at EMC Pekayon Hospital).