According to a report commissioned by the European Federation of Periodontology (EFP), 4.9 percent of global healthcare expenditure is allocated to treat preventable oral diseases such as gum inflammation, cavities, and tooth loss. A preventive approach to oral disease management can bring significant savings to societies, especially when interventions are targeted at economically vulnerable populations.

The "Time to put your money where your mouth is: addressing inequalities in oral health" report by the Economist Impact reveals that the combined prevalence of cavities and severe gum inflammation, periodontitis, has already exceeded the combined global prevalence of non-communicable diseases (NCDs) like mental health disorders, cardiovascular diseases, diabetes, chronic respiratory diseases, and cancers.

Preventive oral care saves money

The report introduces a new cost calculation model for oral disease prevention and treatment, estimating that preventable oral diseases consume approximately $357 billion annually from global healthcare budgets.

Preventable oral diseases affect too many people worldwide. Tooth decay affects over two billion individuals globally, while severe gum inflammation impacts over one billion people. Hence, the EFP report underscores the urgent need to improve global oral health.

Reducing risk factors threatening oral health, such as sugary diets, tobacco, and alcohol consumption, is recommended not only to reduce oral diseases but also to improve overall health and prevent non-communicable diseases.

The scientific evidence linking oral infections to overall health is growing continuously, emphasizing the importance of utilizing this knowledge more extensively among healthcare professionals.

For instance, a recent doctoral thesis from the University of Turku reveals that poor oral hygiene increases the risk of severe head and neck infections requiring hospitalization. The study's findings suggest that investments in oral health and dental care can reduce infection-related costs, complications, and even mortality.

The EFP emphasizes the clear link between oral and overall health, stressing the importance of prioritizing oral health in healthcare budgets and policies.

The report also introduces a framework detailing the progression of cavities from healthy teeth to severely decayed teeth, presenting preventive measures such as maintaining oral hygiene with fluoride toothpaste and implementing local fluoride treatments to prevent or slow down cavity development.

Lumoral: Support for Mechanical Brushing

Efficient oral self-care is crucial for preventing and treating cavities and gum diseases. However, as people age, maintaining oral hygiene can become challenging due to declining vision, memory, or motor skills.

The Lumoral method serves as a targeted solution against microscopic plaque in the mouth, enhancing the effectiveness of mechanical tooth brushing and interdental cleaning. Lumoral treatment eliminates Streptococcus mutans bacteria responsible for tooth decay and gingivitis bacteria.

Endorsed by dentists and the Dental Hygienists' Association in Finland, Lumoral is suitable for maintaining oral health, as well as treating and preventing oral diseases at home. Lumoral slows plaque formation and significantly reduces the amount of bacteria causing periodontitis on tooth surfaces and along the gum line.

Existing studies support Lumoral's efficacy, showing that while even the most effective electric toothbrushes remove only about 65% of harmful bacteria from teeth, Lumoral eliminates over 99% of biofilm bacteria.

Sources:

1. Pakarinen S, Saarela RKT, Välimaa H, et al. Home-applied dual-light photodynamic therapy in the treatment of stable chronic periodontitis (HOPE-CP)—three-month interim results. Dent J (Basel). 2022;10(11):206. doi:10.3390/dj10110206
2. https://www.suuhygienistiliitto.fi/suomen-suuhygienistiliitto-suosittelee-lumoralia/
3. Aggarwal N, Gupta S, Grover R, Sadana G, Bansal K. Plaque removal efficacy of different toothbrushes: a comparative study. Int J Clin Pediatr Dent. 2019;12(5):385-390. doi:10.5005/jp-journals-10005-1669 
4. https://www.efp.org/publications/special-publications/the-burden-of-caries-and-periodontitis/

Maintaining good oral hygiene and oral health is paramount for overall well-being. When it comes to older individuals, proper dental care goes beyond just addressing oral issues; it also plays a critical role in managing underlying health conditions.

Periodontal disease (periodontitis) affects up to two thirds of people over 65. The condition is even more common in people with diabetes.

- Clean mouths, teeth and dentures are a priority in the oral care of older people, as they prevent both decay and various types of oral infections. Inflammation of the gums is thought to be linked to the risk of heart attack, among other things, says Tommi Pätilä, a cardiac and organ transplant surgeon at the New Children's Hospital in Helsinki.

Oral health is known to predispose to more than 200 chronic diseases, including lung disease and rheumatic diseases. According to researchers, severe gum disease, periodontitis, can increase the risk of developing even dementia or milder form of memory loss. The results of a study published in the Journal of the American Geriatrics Society show that the risk was about a fifth higher if a patient had poor dental health.

- Simple measures, such as regular brushing and cleaning of gaps between teeth and regular dental check-ups, can help prevent the onset of gum disease while minimising the risk of oral bacteria or their structures entering the bloodstream and spreading to other parts of the body, says Pätilä.

A healthy mouth is a prerequisite for well-being

Looking after your teeth and oral health is particularly important if you have an underlying disease such as diabetes or cardiovascular disease. Preventing and treating oral infections is also necessary before surgery, Pätilä points out.

For instance, prior to prosthetic joint or flap surgery, it is imperative for a dentist to confirm the absence of asymptomatic infections within the oral cavity. Such infections could potentially serve as entry points for bacteria into the surgical site, leading to post-operative complications.

Thorough oral hygiene is the basis for the prevention and treatment of gum diseases such as periodontitis. However, effective mechanical tooth brushing and extractions are not always enough.

As we get older, oral hygiene can also become more difficult to maintain as vision, memory or hand motor skills deteriorate. Finnish researchers have developed Lumoral, a method that acts as a precision weapon against microscopic plaque in the mouth. Lumoral kills both Streptococcus mutans, the bacteria that cause tooth decay, and gingivitis bacteria.

- Lumoral retards plaque formation and significantly reduces problem-causing bacteria in the mouth. Notably, older people align well into the product's user profile, as thorough oral hygiene is so important in this age group, says Pätilä.

Tested in the treatment of peri-implantitis

Lumoral is a Finnish innovation for maintaining oral health and treating and preventing oral diseases at home. It is recommended by many dentists and the Finnish Association of Oral Hygienists.

- The device is intended primarily for people whose conventional oral hygiene does not produce desirable results. This is often the case, for example, with patients suffering from chronic periodontitis.

Lumoral has also been tested in the treatment of peri-implantitis.  Peri-implantitis is characterised by inflammation of the soft and hard tissues around the implant. It affects both the mucosa and the bone supporting the implant, leading to the gradual destruction of the skeletal structure holding the implant in place.

The pilot study involved patients diagnosed with peri-implantitis or a milder form of it. Lumoral was used by the patients as part of their dental self-care routine.

The amount of plaque and gingival bleeding around the inflamed implant was significantly reduced compared to baseline, the study found. In four out of seven patients, the inflammatory markers in the implant pocket fell to normal levels.

According to the researchers, the pilot study shows that regular, repeated antibacterial Lumoral treatment can prevent and cure inflammation of the tissue around dental implants, while promoting overall oral health.

World Heart Day, launched by the World Heart Federation (WHF), is celebrated each year on the 29th of September. The global event aims to raise awareness and encourage action for heart health.

Cardiovascular disease (CVD) is the leading cause of death in the Western world. The most common cardiovascular diseases are coronary heart disease, heart failure, and cerebrovascular disorders. More than 20.5 million people die from these diseases each year. Cardiovascular diseases affect the heart and blood vessels, leading to severe and possibly even fatal complications. However, the WHF estimates that 80% of premature deaths from the disease are preventable (1).

– By making small changes to our lifestyles, we can better manage our heart health and beat cardiovascular disease, the WHF encourages.

Such changes include actions that help improve oral health. Good oral hygiene is more than just a beautiful smile. It is essential to look after your teeth and mouth because even seemingly harmless oral conditions can put you at risk of serious diseases.

Oral pathogens are not limited to the mouth

Tommi Pätilä, a cardiac and transplant surgeon at the New Children’s Hospital (HUS), stresses that a healthy heart requires a healthy mouth and thorough daily oral hygiene. Oral biofilm bacteria are the cause of 95 percent of dental diseases.

– Simple measures such as regular brushing and cleaning of the interdental spaces and regular dental check-ups can help prevent the onset of gum disease and, at the same time, minimise the risk of bacteria or their structures in the mouth entering the bloodstream and spreading to the rest of the body, says Pätilä.

Even chewing food can spread bacteria or parts of bacteria that cause oral infections to the rest of the body through infected gums. This results in a persistent inflammatory condition within the body, which may subsequently give rise to serious health conditions, including cardiovascular disease, Pätilä notes. 

– On the other hand, sudden problems occur when live bacteria infect the heart valves, Pätilä continues.

In 2016, Pätilä operated on a severe bacterial heart valve infection and was motivated to make a difference in oral health. 

– It turned out that the cause of the patient’s severe heart infection was bacteria from the mouth. At that point, I knew something had to be done to combat the residual plaque that causes disease and plagues in peoples’ mouths despite brushing and flossing.

Pätilä is one of three Finnish researchers who have developed the antibacterial Lumoral method. Lumoral is a patented medical device that treats and prevents oral diseases at home. The Lumoral treatment can remove 99.99% of plaque bacteria from the tooth surface (2).

Prevention and early diagnosis pays off

– In contrast to commonly held beliefs, a toothbrush is only capable of eliminating approximately 60% of oral biofilm. It's no surprise then that cavities and gingivitis stand as the most prevalent diseases worldwide. If we want to improve oral health outcomes, we need to tackle the plaque left behind by tooth brushing, says Timo Sorsa, Professor of Oral and Maxillofacial Diseases at the University of Helsinki.

In Finland, it is estimated that up to two out of three people over 30 suffer from periodontitis. This common gum disease can lead to tooth loss if left untreated – but it is also linked to severe heart events. According to a study, individuals with periodontal disease are 30% more likely to experience a first heart attack compared to their healthy counterparts of the same age (3).

According to another study published in the Journal of Periodontology, people with periodontal disease were almost twice as likely to develop coronary artery disease (CAD) than those with healthy gums (4). 

Meanwhile, a 2020 European Journal of Preventive Cardiology report found that poor oral health was associated with an increased risk of cardiovascular disease, particularly among those with gum disease (5).

Professor Sorsa stresses that periodontal disease prevention is vital to maintaining a patient’s oral and overall health.

– Untreated periodontitis leads to low-grade inflammation that affects the whole body, contributing to conditions like cardiovascular disease, diabetes, Alzheimer's disease, and potentially even cancer.

Periodontitis revealed in minutes

According to Professor Sorsa, in the long term, the prevention and rapid diagnosis of periodontal disease benefit the patient, public health, and the economy. This is also possible with the new modern diagnostic and treatment methods available that are revolutionising the whole field of dentistry.

Professor Sorsa’s extensive research career has long focused on developing an immunological rapid test for active matrix metalloproteinase-8 (aMMP-8). The quick test can detect whether a person’s gum tissue is undergoing periodontal breakdown before it is visually apparent. 

The test can be performed by a healthcare professional or the consumer independently at home – similar to the COVID-19 antigen test or the traditional rapid pregnancy test (6).

–The aMMP-8 rapid test can measure and assess active periodontal adhesive tissue loss and the risk of its progression within five minutes in the dental chair non-invasively, i.e. without disturbing the tissue under examination. The test complements the diagnosis, follow-up, and maintenance treatment of periodontitis and peri-implantitis, says Professor Sorsa.

When discussing new treatment methods and prevention of periodontitis, he highlights Lumoral therapy. He calls Lumoral a drug-free alternative for treating and preventing severe gum disease. 

– Lumoral enhances the effect of the toothbrush, and studies show that it also significantly improves the results of professional oral care. At the same time, the device can potentially reduce the need to use drugs traditionally used to treat gum disease, such as antibiotics and chlorhexidine.

Based on photodynamic therapy, a light-activated antibacterial effect, Lumoral slows down plaque formation and significantly reduces the burden of harmful bacteria in the mouth. The product’s user profile is suitable for all ages, but it is particularly recommended for those with a history of problems with common oral diseases, tooth decay, and gum disease (2).

References:

1. https://world-heart-federation.org/news/deaths-from-cardiovascular-disease-surged-60-globally-over-the-last-30-years-report/
2. Pakarinen, S., Saarela, R. K. T., Välimaa, H., Heikkinen, A. M., Kankuri, E., Noponen, M., Alapulli, H., Tervahartiala, T., Räisänen, I. T., Sorsa, T., & Pätilä, T. (2022). Home-Applied Dual-Light Photodynamic Therapy in the Treatment of Stable Chronic Periodontitis (HOPE-CP) Three-Month Interim Results. Dentistry Journal, 10(11), [206]. https://doi.org/10.3390/dj10110206
3. Rydén L, Buhlin K, Ekstrand E, de Faire U, Gustafsson A, Holmer J, Kjellström B, Lindahl B, Norhammar A, Nygren Å, Näsman P, Rathnayake N, Svenungsson E, Klinge B: Periodontitis Increases the Risk of a First Myocardial Infarction. A Report From the PAROKRANK Study. 13.1.2016 Circulation. 2016;133:576–583 https://doi.org/10.1161/CIRCULATIONAHA.115.020324
4. Nesarhoseini V, Khosravi M. Periodontitis as a risk factor in non-diabetic patients with coronary artery disease. ARYA Atheroscler. 2010 Fall;6(3):106-11. PMID: 22577425; PMCID: PMC3347825.
5. Pirkko J Pussinen, Eija Könönen, Oral health: A modifiable risk factor for cardiovascular diseases or a confounded association?, European Journal of Preventive Cardiology, Volume 23, Issue 8, 1 May 2016, Pages 834–838, https://doi.org/10.1177/2047487316636506
6. Sorsa, T., Lähteenmäki, H., Pärnänen, P., Tervahartiala, T., Mäkitie, A. Pätilä, T. &   Räisänen, I. T., (2022). Aktiivisen MMP-8:n vieritestaus ja pikadiagnostiikka, Suomen Hammaslääkärilehti 2022; 14: 26–33.