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. 

In 2020, Espoo-based Koite Health launched Lumoral, a revolutionary device for oral health care at home. Today, on Sept. 21. 2023, the company launches a share issue via Invesdor's crowdfunding platform to support its strong growth. At the same time, there will be a directed share issue for interested institutional investors.

Koite Health Oy has so far been owned by three founders, well-known Finnish and foreign angel investors in the healthcare sector and the Pharmacy Pension Fund in Finland. Now the general public has the opportunity to become an owner in the success story of a Finnish growth company.

Lumoral is a clinically proven and CE-marked medical device for oral health that has already experienced strong growth in popularity in Finland. The company has already sold more than 10,000 units in Finland and Sweden in three years and gained strong support from the experts.   Since the spring, Lumoral has also been available in other European countries. Sales of the device are now growing strongly in markets such as Germany, Italy and the UK. New partners and distributors will be announced before the end of the year. The company's ambition is to bring the unique benefits of Lumoral to users and patients across Europe and, with future partners, to expand into the US and Asian markets.

Lumoral contributes to human well-being

Lumoral has a direct impact on human well-being. More than half of the Finnish population suffers from some degree of gingivitis. The situation is no better elsewhere. According to last November's WHO's Global Oral Health Status Report, nearly half of the world's population suffers from some form of oral disease, and the number of oral diseases has increased by one billion cases worldwide over the past 30 years.

Koite Health's health technology product offers the opportunity to prevent oral diseases and treat their severe forms .

Koite Health Oy's Board of Directors also includes Timo Hildén, who made a name for himself as CEO of the publicly traded Revenio Group Oyj.  Mr. Hildén was instrumental in building the growth story of Revenio, known for its ophthalmometer technology, and the company's market value increased by almost during his tenure.

Make sure you are part of the Finnish healthcare technology success story. Invest in a company that has already revolutionized home oral health care in Finland and around the world.

Click here to become a Lumoral shareholder.                                            

About Koite Health

Koite Health is a Finnish health technology company whose patented dual light therapy innovation has revolutionized oral health care for Finns. The company's expert team consists of experienced physicians and technologists. Founders Sakari Nikinmaa, Tommi Pätilä and Juha Rantala established Koite Health in September 2018 as part of a project funded by Business Finland and Aalto University.

The seafarer's role in the maritime industry is highly crucial: the world's nearly two million seafarers, who help transport 90% of the world's total global trade, keep the wheels of the global economy turning. However, maritime work can be physically and mentally challenging and threaten seafarers' general and oral health.

Mrs Päivi Miilunpalo, an occupational health and seafarers' doctor, has worked for more than ten years as an occupational physician at the Turku Maritime Health Centre, where she is responsible for Finnish seafarers' health care, occupational health care and medical examinations of seafarers. She is also a senior medical doctor at the Institute of Occupational Health (TTL), caring for seafarers' health issues nationwide.

Mrs Miilunpalo stresses that the oral health of seafarers is a significant problem in the shipping industry on an international scale. Seafarers live on ships in international maritime areas for months, with limited access to medical treatment if, for example, dental problems occur during a long voyage.

– Oral health problems are one of the main reasons seafarers in international shipping must be moved off ships and out of care. That is why good oral health and preventive dental care are so important for maritime workers. If a serious tooth infection or a severe toothache strikes in the middle of the ocean, everyone can imagine from their own experience how terrible the situation can be.

Seafarers are at risk of oral disease

Research shows seafarers are at risk of various oral health problems. The main risk factors for oral diseases are related to seafarers' oral hygiene and eating habits, as well as the frequent use of tobacco products and alcohol.

In particular, the eating habits of seafarers during long sea voyages can threaten their oral health. Meanwhile, extended working hours and lack of physical activity often lead to the high consumption of coffee and sugary drinks, frequent snacking and a high carbohydrate diet. All these factors combined increase the risk of tooth decay and even the risk of developing severe gum diseases, such as periodontitis, if oral hygiene routines are not ideal.

Studies show tooth decay poses an even greater risk for seafarers than the general population. A toothache can be difficult to treat with the medicines found in the medical kits on board. However, severe pain can adversely affect seafarers' performance, disturb their concentration and even pose a safety risk on board.

On the other hand, dental care systems and the quality of care in foreign ports can be very different from what seafarers are used to at home. Therefore, seafarers must take good care of their oral health and have regular dental check-ups, especially before embarking.

Anticipation is also important in the maritime sector

Proactive health care and disease prevention are essential for workers in the maritime sector. Since working at sea always results in delayed access to treatment, illnesses with an increased risk of sudden worsening can even prevent a person from entering the sector.

– This system must be taken into account when applying for a career in the maritime sector. If you fall ill at sea, access to treatment is inevitably delayed. Sometimes, these delays can be critical to a person's health, even life, stresses Mrs Miilunpalo.

According to Miilunpalo, seafarers' occupational health checks include assessing their fitness to work on ships. Only a licensed seafarer's doctor is entitled to carry out the initial examination of a seafarer in Finland, as in many other countries. A valid medical certificate is required before entering the profession or commencing related studies.

The initial examination is carried out in a particular maritime health centre in Finland, but a seafarer's doctor can also carry out renewals of the seafarer's certificate outside the marine health centre.

In terms of improving the oral health of seafarers, more oral hygiene education is needed to enable them to manage their oral health in a better way. Life at sea, under challenging circumstances, is not without stress, so it is important that seafarers are given complete information about correct oral hygiene protocols and dental hygiene and the advantages of keeping a healthy mouth.

Poor oral hygiene has also been linked to other health issues, including cardiovascular disease, respiratory disease, and rheumatoid arthritis. Thus, improving the oral health of seafarers is so crucial.

Regular oral health checks needed

In Finland, the City of Helsinki maintains health services for seafarers. These services also include oral health care. However, according to Mrs Miilunpalo, seafarers do not have an invitation system for regular dental check-ups. Thus, access to oral health care for seafarers is the same compared to other population groups.

In Finland, approved seafarers' doctors are, however, increasingly checking into their patients' mouths during regular health examinations. Although an oral examination done by an occupational health physician is not equivalent to a comprehensive assessment of oral health conducted by a dentist, it is an essential step as there is also growing scientific evidence of a link between oral health and general health.

Especially for people with long-term illnesses, taking care of their oral and dental health is essential for their general health and even for treating their disease.

– If you have chronic inflammation in your mouth, it can have a systemic effect on your general health. Thus, it is so vital that seafarer's doctors refer their patients to dental treatments as soon as possible when oral problems arise.

Regular dental visits are essential because they help identify signs and symptoms of oral problems early.

Timely intervention is key

According to Mrs Miilunpalo, the aim of statutory health checks of seafarers is to ensure that risk factors for them can be addressed in a timely manner.

– We aim to emphasise the importance of preventive health care. If a person already has an illness, we want to keep it under control so that it does not prevent them from continuing to work on board.

According to Mrs Miilunpalo, increasing use of drugs among young people is an unfortunate phenomenon in the maritime sector, also in Finland.

– Over the past ten years, I have increasingly encountered young people with a drug problem in the initial screening of seafarers. Substance abuse is also reflected in oral health.

Indeed, statistics show that drug experimentation and use has increased in Finland. According to a population survey conducted by the National Institute for Health and Welfare (THL) in 2018, 24% of Finns aged 15-69 have tried cannabis at some point in their lives. Drug experimentation and use has become particularly common among young adults aged 25-34, which is also reflected in the oral health of young people. Drugs such as cannabis, amphetamines and opioids dry out the mouth, making people prone to oral diseases such as tooth decay, gingivitis and periodontitis.