Home / News / Tagged: general health

Poor Oral Health and Oral Dysbiosis: A Link to Systemic Diseases and Cancer

Poor Oral Health and Oral Dysbiosis: A Link to Systemic Diseases and Cancer

Scientists have discovered a significant link between poor oral health and systemic diseases, including specific cancers. This connection is centered around so-called oral dysbiosis, a condition where imbalanced oral bacteria can lead to a range of health issues. It also emphasizes the crucial role of oral hygiene in promoting overall health.

The oral cavity houses more than 700 types of bacteria. While some bacterial species are beneficial for dental and overall health, in some cases, they can play a role in the development of serious systemic illnesses.

Studies show that maintaining a balanced microbial ecosystem in the mouth is crucial for oral health and it has a significant impact on how the body responds to various diseases. Dysbiosis, or an imbalanced oral microbiome, or ecosystem, can lead to various health issues ranging from common dental problems like cavities and gum disease to severe conditions such as heart disease, Alzheimer’s disease, and diabetes. [1, 2]

Recent studies have revealed that oral dysbiosis may even be involved in the development of life-threatening digestive cancers. Digestive cancers include cancers located in the esophagus, stomach, liver, pancreas, colon, and rectum. Their incidence and related mortality are increasing worldwide, with the majority of new cases of digestive cancers (63%) and related deaths (65%) occurring in Asia, followed by Europe and North America. [3].  

Scientists believe that many digestive cancer forms are influenced by various environmental factors that can be potentially changed. These include tobacco smoking, diet, alcohol consumption, and obesity. Some recent evidence also suggests a role of the human oral microbiota in the development of digestive cancers. Fusobacterium nucleatum is one bacteria species found commonly in the mouth, which is a key member of colorectal cancer-associated bacteria. However, many other oral pathogens can play a role in the development of cancer as well. [4,5]

Exposing the oral bacteria-pancreatic cancer link

One study published in the British Journal of Cancer (BJC) reported that Trepenoma denticola (Td), the bacteria responsible for periodontitis, may cause pancreatic cancer [6,7]. Pancreatic cancer is one of the deadliest forms of cancer caused by the abnormal and uncontrolled growth of cells in the pancreas – a large gland that is part of the digestive system. Around half of all new cases are diagnosed in people aged 75 or over. [8]

–  The Treponema bacterium can enter the bloodstream through inflamed gums and spread to other parts of the body. If left untreated and undiagnosed, periodontal disease contributes to the development and spread of cancer and cancer deaths – not only from oral cancer, but especially pancreatic cancer, explains Timo Sorsa, Professor of Oral and Maxillofacial Diseases at the University of Helsinki, findings of the study.

Professor Sorsa points out that Treponema bacterium shares a specific enzyme with some cancer types in the gut. This enzyme is called Treponema denticola chymotrypsin-like proteinase – or dentilisin – and it is usually found in the mouth, where it is known to contribute to severe gum disease (periodontitis). However, this same enzyme has also been observed in malignant and life-threatening tumors. [6,7].

In the oral cavity, dentilisin not only contributes to gum disease but also triggers other enzymes that promote cancer. These enzymes are called matrix metalloproteinases (MMPs), and they break down the material between cells and cell membranes, making it easier for cancer to invade healthy tissue. This connection raises concerns about potential health issues related to dentilisin in the oral cavity, Prof. Sorsa stresses.

The BJC study from 2017 was the first to show that virulence factors from gum disease bacteria could spread from the mouth to other parts of the body and take part in central mechanisms of cancer-related tissue destruction.

Since then, supplementary research has supported the study’s findings.  One report released in the International Journal of Cancer – also by Prof. Sorsa’s team – examined registry data for over 10 years on over 68,000 adults in Finland who had made a primary dental healthcare visit. This revealed that periodontitis was associated with a 33% increased risk for overall cancer mortality. The mortality risk associated with gum disease among individuals with pancreatic cancer was far higher, with a more than twofold increased risk, the study shows [7].

From fast diagnosis to a quick onset of treatment 

The links revealed so far between oral bacteria and cancer developments have inspired Prof. Sorsa’s team to search ways to help prevent cancerous developments. One potential solution is to detect gum infections in their initial stages through early diagnosis. By quickly identifying gum disease with a chair-side aMMP-8 rapid test, researchers believe that we might be able to prevent certain cancers because it allows for faster treatment of the underlying issue: gum inflammation. The test makes invisible visible, points out Prof. Sorsa. [9,10]

– Out of all MMP enzymes, especially active MMP-8 enzyme has been found to be elevated in patients suffering from gum disease leading to periodontal connective tissue destruction, Prof. Sorsa explains his team’s findings.

Periodontitis, or severe gingivitis, is a common disease that is estimated to affect as many as half of the global population – often without any symptoms at all. Early detection of these diseases is important because it allows for intervention and treatment before irreversible damage occurs. Traditional methods like check-ups and X-rays might, however, miss early signs of these diseases since they often show symptoms in later stages. Using biomarkers like aMMP-8, clinicians can spot subtle inflammation and tissue damage, allowing them to start treatment before the disease becomes visible.

–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. The test complements the diagnosis, follow-up, and maintenance treatment of periodontitis and peri-implantitis, explains Prof. Sorsa. 

Advanced approaches for treating oral diseases

Periodontal and peri-implant diseases are conditions that affect the supporting structures of teeth and dental implants and can lead to tooth loss if left untreated. Gum infections can develop for various reasons. One key factor is the buildup of bacterial plaque, also known as biofilm, on the surfaces of teeth due to inadequate oral hygiene. [9]  

When discussing new treatment options and prevention of periodontitis, Prof. Sorsa emphasizes modern antibacterial methods for better oral hygiene and efficient plaque removal in periodontitis treatment and prevention. Also, research reveals that antibacterial photodynamic therapy (aPDT) is a promising approach to treat bacterial infections – even ones that do not respond well to antibiotics [12].

Lumoral treatment is the first aPDT treatment device designed for home use. It has been developed by Finnish scientists as a drug-free alternative for treating and preventing severe gum disease.

– Poor oral health is linked to over 200 chronic diseases. Lumoral is a product that enhances oral hygiene when used regularly at home, and research suggests that it can also enhance the effectiveness of professional dental care. What's more, it may reduce the need for conventional medications like antibiotics and chlorhexidine in the treatment of gum disease, according to Tommi Pätilä, a cardiac and organ transplant surgeon at the New Children's Hospital in Helsinki.

– Based on a light-activated antibacterial effect, Lumoral slows down plaque formation and significantly reduces the burden of harmful bacteria in the mouth, Pätilä explains further.

The product is suitable for patients of all ages, but it is particularly recommended for those with a history of problems with common oral diseases, tooth decay, and gum disease [9].

The crucial role of oral hygiene in cancer care

Brushing and flossing on a regular basis is key to maintaining a healthy mouth by removing dental plaque from the surfaces of teeth and interdental spaces. However, it is not always enough. Good oral hygiene requires adequate motor and mental skills. On the other hand, even when brushing teeth perfectly, studies show that even the most effective electric toothbrush only removes about 65% of harmful oral bacteria from the mouth [13].

– The key to overall well-being is good oral hygiene. For cancer patients, this is all the more important because they must maintain a high-calorie diet in order to fight the disease, notes Prof.  Dr. Tuomas Waltimo from the University of Basel.

Prof. Waltimo also acts as a private dentist at a clinic that offers dental services to patients with special dental needs, for example patients undergoing cancer treatments. He reminds that cancer treatments often bring along side-effects that can require special attention. Mucositis, as one example, can lead to generalised infection and even be life-threatening.

Mucositis is the painful inflammation and ulceration of the mucous membranes lining the digestive tract. It can occur anywhere along the gastrointestinal (GI) tract, but oral mucositis refers to the inflammation and ulceration that occurs specifically in the mouth. Maintaining good oral hygiene habits is a prerequisite for treating oral mucositis. Lumoral supports regular mechanical dental hygiene, helps achieve gum health, and prevents inflammation when regular dental hygiene is insufficient. 

– Good oral hygiene is of paramount importance also in the management of oral mucositis. Initial findings suggest Lumoral treatment might help prevent and potentially treat oral mucositis, but this hypothesis requires further scientific research to confirm. We are, therefore, starting a new PhD study examining the topic at the University of Helsinki, Prof. Waltimo says.

******

November is Stomach Cancer Awareness Month, and the goals of stomach cancer awareness primarily include: Raising public awareness and supporting educational efforts about stomach cancer, including risk factors, prevention, and early detection.

 *****

References:

  1.   Maier, T. Oral Microbiome in Health and Disease: Maintaining a Healthy, Balanced Ecosystem and Reversing Dysbiosis. Microorganisms 2023, 11, 1453. https://doi.org/10.3390/microorganisms11061453
  2.   Silva DNdA, Casarin M, Monajemzadeh S, Bezerra BdB, Lux R and Pirih FQ (2022) The Microbiome in Periodontitis and Diabetes. Front. Oral. Health 3:859209. doi: 10.3389/froh.2022.859209
  3.     https://dceg.cancer.gov/news-events/news/2020/global-burden-gastro
  4.   Pignatelli, P.; Nuccio, F.; Piattelli, A.; Curia, M.C. The Role of Fusobacterium nucleatum in Oral and Colorectal Carcinogenesis. Microorganisms 2023, 11, 2358. https://doi.org/10.3390/microorganisms11092358
  5.   Reitano E, de'Angelis N, Gavriilidis P, Gaiani F, Memeo R, Inchingolo R, Bianchi G, de'Angelis GL, Carra MC. Oral Bacterial Microbiota in Digestive Cancer Patients: A Systematic Review. Microorganisms. 2021 Dec 14;9(12):2585. doi: 10.3390/microorganisms9122585. PMID: 34946186; PMCID: PMC8707512.
  6.   Nieminen, M., Listyarifah, D., Hagström, J. et al. Treponema denticola chymotrypsin-like proteinase may contribute to orodigestive carcinogenesis through immunomodulation. Br J Cancer 118, 428–434 (2018). https://doi.org/10.1038/bjc.2017.409
  7.   Heikkilä, P., But, A., Sorsa, T. and Haukka, J. (2018), Periodontitis and cancer mortality: Register-based cohort study of 68,273 adults in 10-year follow-up. Int. J. Cancer, 142: 2244-2253. https://doi.org/10.1002/ijc.31254
  8.     https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/pancreatic-cancer/
  9.   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. Home-Applied Dual-Light Photodynamic Therapy in the Treatment of Stable Chronic Periodontitis (HOPE-CP)—Three-Month Interim Results. Dent. J. 2022, 10, 206. http://hdl.handle.net/10138/350606
  10. Sorsa T, Gursoy UK, Nwhator S, Hernandez M, Tervahartiala T, Leppilahti J, Gursoy M, Könönen E, Emingil G, Pussinen PJ, Mäntylä P. Analysis of matrix metalloproteinases, especially MMP-8, in gingival creviclular fluid, mouthrinse and saliva for monitoring periodontal diseases. Periodontol 2000. 2016 Feb;70(1):142-63. doi: 10.1111/prd.12101. PMID: 26662488.
  11. Sorsa T, Nwhator SO, Sakellari D, Grigoriadis A, Umeizudike KA, Brandt E, Keskin M, Tervahartiala T, Pärnänen P, Gupta S, Mohindra R, Bostanci N, Buduneli N, Räisänen IT. aMMP-8 Oral Fluid PoC Test in Relation to Oral and Systemic Diseases. Front Oral Health. 2022 Jun 10;3:897115. doi: 10.3389/froh.2022.897115. PMID: 35757444; PMCID: PMC9226345.
  12. Liu Y, Qin R, Zaat SAJ, Breukink E, Heger M. Antibacterial photodynamic therapy: overview of a promising approach to fight antibiotic-resistant bacterial infections. J Clin Transl Res. 2015 Dec 1;1(3):140-167. PMID: 30873451; PMCID: PMC6410618.
  13. 1 Neha Aggarwal, Sunil Gupta, Rashu Grover, Gunmeen Sadana, and Karan Bansal; Plaque Removal Efficacy of Different Toothbrushes: A Comparative Study, Int J Clin Pediatr Dent. 2019 Sep-Oct; 12(5): 385–390.  doi: 10.5005/jp-journals-10005-1669

 

 

 

 

The Heart of the Matter: Exploring the Link Between Oral Health and Heart Health on World Heart Day 2023

The Heart of the Matter: Exploring the Link Between Oral Health and Heart Health on World Heart Day 2023

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. 

 

A healthy mouth supports top athletes’ performance and sports goals

A healthy mouth supports top athletes’ performance and sports goals

Research shows a direct link between oral health and sports performance. Thus, Annimari Korte, a Finnish Olympic athlete, finds it disappointing that sports bodies such as her home country’s Olympic Committee do not support the oral health of competitive athletes like they support general health by paying for medical and physiotherapy services. Even though good oral health is known to improve sports performance and results. 

– Throughout the years I have represented Finland as a competitive athlete, there has been no official talk about the importance of oral health in top performances, says Annimari Korte, a top-performing hurdler.

Annimari believes insufficient information is the most significant reason official sporting organisations do not support their athletes' oral health more visibly.

– I hope this situation will change. Studies have shown that oral problems such as gingivitis and periodontitis have been shown to reduce performance significantly, says Annimari.

Top sport is a risk factor for oral health

Research indicates that elite sport is one of the most significant risk factors for the onset of oral diseases. According to one study, caries is found in up to 70% of competitive athletes, dental erosion in almost 40% and severe gum disease, periodontitis, in up to 15% of top athletes1.

Furthermore, studies show that the oral health of athletes appears to be poor in a wide range of sports. Various underlying medical conditions can hamper training results and impair sporting performance; oral infectious disease is no exception.

Concerns about the oral health of athletes are nothing new. For example, during the 2004 Athens Olympics, the second most requested health service for athletes after physiotherapy services was dental care2. Meanwhile, at the 2012 London Olympics, it was noted that Olympic athletes had poor oral health. Up to 55% of athletes had high caries levels, 76% had gingivitis, and 14% had periodontal disease3

One study examined the oral health of top Dutch athletes before the Rio 2016 Olympics. This study found that almost 50% of top athletes needed regular dental care and suggested that oral health screening, included in the overall preventive healthcare of elite athletes, is essential to ensure that athletes are fully healthy during competitions such as the Olympic and Paralympic Games4.

Dental Reasearch notes that oral health is not part of most sport and exercise or nutrition curricula or integrated within athlete health strategies. Consequently, the importance of good oral health is not fully understood despite the clear link between good oral health and athlete performance.

Inflammatory oral diseases such as gingivitis and periodontitis are common in top athletes. Oral diseases such as gingivitis and periodontitis have been reported to harm the performance of athletes. One reason is the pain and discomfort associated with oral diseases, making concentrating difficult and hampering training results. Links have been reported between muscle injuries and poor oral health in athletes.

There are many possible reasons for the high prevalence of inflammatory oral diseases in competitive athletes. Physical strain is one of the most important. Heavy training increases the body's stress levels, which directly affect oral health and susceptibility to the onset of various gum diseases. Physical exertion affects the composition of saliva during exercise and reduces its secretion5. Frequent oral breathing during exercise and dehydration further contribute to dry mouth. All these factors predispose to tooth decay and enamel erosion and contribute to the onset of inflammatory oral diseases.

Saliva secretion has a variety of effects on dental health. Saliva prevents decay by restoring the pH of the oral cavity from acidic to neutral after eating and by helping to restore minerals dissolved by acids to the tooth surface. Saliva also removes 2-4 grams of microbes daily from the mouth and tooth surface to the digestive tract.

Dietary choices also have a significant impact on the oral health of athletes. Rigorous training programmes require regular eating, supplemented by 'sports nutrition' such as carbohydrate gels and bars consumed during training. This strains oral health by increasing the number of daily acid attacks in the mouth.

A healthy mouth is an integral part of overall well-being

Annimari Korte held the Finnish record in the 100m hurdles 2019-2023. She has also represented Finland several times in world championships. However, she has not had an easy career, as a bout of illness forced her to take a five-year break from competition in 2012. However, the health challenges taught Annimari the importance of overall well-being, including good oral health.

According to Annimari, the Finnish Olympic Committee covers as part of its comprehensive health package visits to a doctor and physiotherapist, but not, for example, visits to a dentist or oral hygienist.

– Regular oral health professional visits would help detect oral health problems early. For example, severe and often asymptomatic periodontitis can be very detrimental to an athlete's overall health and well-being, says Korte.

– At least primary dental care should be covered for competitive athletes, as it affects their overall health and sporting performance.

Juuso Simpanen, a trail runner turned professional, echoes Korte's views on the importance of oral health for athletes aiming for the top.

– Only a fully healthy athlete can achieve top results. If your mouth is not in good shape, it will also hurt your results, says Simpanen.

As an endurance athlete, Simpanen says he eats very often to meet the high-energy demands of training.

– Consuming high amounts of energy exposes my teeth to constant acid attacks. That's why I pay special attention to my oral health. I brush my teeth morning and evening, floss and use antibacterial photodynamic Lumoral-treatment regularly, says Simpanen.

In Simpanen's opinion, support for professional athletes to maintain their oral health would be very welcome.

– At least annual dental check-ups at the dentist would be worthwhile, and why not guide athletes in using new, scientifically proven, effective dental methods? This would prevent many infections in the mouths of top athletes. This would also reduce inflammation, injuries and illnesses in athletes.

– Only a fully healthy athlete can achieve top results. If your mouth is not in good shape, it will also hurt your results, says Juuso Simpanen.

Gingivitis is a severe inflammatory disease

Athletes must get their bodies in the best possible condition to reach the top. Extensive research shows that dental and oral bacteria are linked to many chronic diseases of the body. In addition to heart disease, oral diseases are linked to lung disease, diabetes and metabolic problems in healthy people.

Periodontal disease is a long-standing inflammation of the gums. Over time, the inflammation damages the attachment tissue of the teeth, causing the collagen fibres that hold the teeth to the jawbone to break and, in the worst case, lead to tooth loss. Early signs of periodontal disease include reddened and swollen gums, bleeding of gums and bad breath.

Inflammation of the gums causes low-grade inflammation in the body, which is linked to vascular health and the performance of athletes. Oral bacteria lingering on tooth surfaces and gum pockets are spread throughout the body when teeth are brushed and food is chewed. Even asymptomatic oral conditions can affect the health of the whole body.

– Statistics show that people with a healthy mouth live longer. Each missing tooth reduces life expectancy. This is far too little talked about, says Tommi Pätilä, a specialist in cardiac and organ transplant surgery at HUS New Children's Hospital. He is one of the developers of the antibacterial Lumoral method.

According to Pätilä, it is estimated that up to two out of three people over the age of 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, a first heart attack is 30% more common in people with periodontal disease than in healthy people of the same age6.

Effective oral hygiene prevents oral disease

According to Simpanen, there is minimal discussion among athletes and sports managers about the risk factors for oral health in elite sports. However, there is good reason to do so.

– During long training sessions and intense competitions, drinking sports drinks and eating energy gels puts teeth and gums under strain. Scientific studies also show this, Simpanen admits. 

At his worst, Juuso says that in a 20-hour race, he eats or drinks something sugary every 15-20 minutes throughout the race.

– In addition, almost every week, I do one long training session of 4-8 hours, where I also practice taking energy and sports drinks like in the race.

Juuso says he takes oral health seriously. He takes care of his teeth by brushing twice daily and regularly cleaning his interdental spaces, as specialists recommended. For the last eight months, he has also regularly used a new oral care device based on antibacterial photodynamic therapy7.

– It is crucial for endurance athletes to take care of their oral health outside training and competition, as sports drinks and energy gels are consumed heavily during competition and long training sessions.

References:

  1. Merle CL, Wuestenfeld JC, Fenkse F, Wolfarth B, Haak R, Schmalz G, Ziebolz D. The Significance of Oral Inflammation in Elite Sports: A Narrative Review. Sports Med Int Open. 2022 Dec 25;6(2):E69-E79. doi: 10.1055/a-1964-8538. PMID: 36643596; PMCID: PMC9839431.
  2. Vougiouklakis, G. et al. Dental data of the Athens 2004 Olympic and Paralympic Games. Int. J. Sports Med. 29, 927–933 (2008).
  3. Opazo-García, C., Moya-Salazar, J., Chicoma-Flores, K. et al. Oral health problems in high-performance athletes at 2019 Pan American Games in Lima: a descriptive study. BDJ Open 7, 21 (2021). https://doi.org/10.1038/s41405-021-00078-1
  4. Kragt L, Moen MH, Van Den Hoogenband CR, Wolvius EB. Oral health among Dutch elite athletes prior to Rio 2016. Phys Sportsmed. 2019 May;47(2):182-188. doi: 10.1080/00913847.2018.1546105. Epub 2018 Nov 25. PMID: 30408425.
  5. Julie Gallagher, Paul Ashley, Aviva Petrie & Ian Needleman. Oral health-related behaviours reported by elite and professional athletes. British Dental Journal, 2019 DOI: 10.1038/s41415-019-0617-8  
  6. Tripodi D, Cosi A, Fulco D, D'Ercole S. The Impact of Sport Training on Oral Health in Athletes. Dent J (Basel). 2021 May 3;9(5):51. doi: 10.3390/dj9050051.
  7. 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
  8. Pakarinen S, Saarela RKT, Välimaa H, Heikkinen AM, Kankuri E, Noponen M, Alapulli H, Tervahartiala T, Räisänen IT, Sorsa T, et al. Home-Applied Dual-Light Photodynamic Therapy in the Treatment of Stable Chronic Periodontitis (HOPE-CP)—Three-Month Interim Results. Dentistry Journal. 2022; 10(11):206. https://doi.org/10.3390/dj10110206