The Silent Killer In Your Mouth

In a funny new novel called To Rise Again at a Decent Hour, author Joshua Ferris’s narrator, Paul O’Rourke, is a depressive and obsessive Park Avenue dentist who begs his patients to floss while waxing poetic about the mouth and its connection to disease.

“The mouth is a weird place. Not quite inside and not quite out, not skin and not organ, but something in between: dark, wet … where cancer starts, where the heart is broken, where the soul might just fail to turn up …

Flossing prevents periodontal disease and can extend life up to seven years …  But then someone who never flossed a day in his life would come in, the picture of inconceivable self-neglect and unnecessary pain — rotted teeth, swollen gums, a live wire of infection running from enamel to nerve — and what I called defiance rose up in me and I would go around the next day or two saying, ‘You must floss, please floss, flossing makes all the difference.’”

Flossing makes all the difference, indeed. It’s true that you need to floss as much as possible. Food particles that reside for long periods between the gums can lead to gingivitis, the beginning of mild gum disease, a spectrum disorder that has, on the opposite side of that spectrum, serious ill health affects. Gingivitis left unchecked or not properly maintained can lead and/or contribute to many other diseases, chiefly periodontitis, or severe gum disease.

A Silent Killer

When a person has the beginnings of periodontal damage, the build-up of tartar and plaque along the gum line can cause the gums to deteriorate, creating “pockets” where food and bacteria can lodge. As more and more of those pockets of bacteria emerge, the disease can quickly worsen without intervention. For instance, untreated periodontitis can lead to bone loss, inflammation, oral and other cancers, heart disease, and even a disruption in the body’s immune system response.

In new study results published this month in the journal Cell Host & Microbe, senior author and professor at Pennsylvania School of Dental Medicine’s Department of Microbiology, George Hajishengallis, explains how periodontitis can lead to the immune system becoming imbalanced. That imbalance is known as dysbiosis, a two-part break down that can disable immune cells’ ability to kill harmful cells while preserving their ability to cause inflammation. The process, once started, becomes a cycle of ever-increasing disease.

Who’s At Risk?

The mouth is filled with bacteria. Everyone has at least mild to moderate gingivitis, which is normally kept in check with regular brushing, flossing, and periodic trips to the dentist for tooth cleaning and/or whitening.

Other risk factors include: smoking, diabetes and other diseases, like cancer and its treatment, hormonal changes, medications that cause “dry mouth” or otherwise reduce saliva production, and/or genetic susceptibility.

The symptoms of serious gum disease often begin with bad breath that cannot be controlled by frequent brushing (also often a sign of internal disease). Chronic halitosis, painful or red swollen gums, bleeding gums, painful chewing, loose or sensitive teeth or receding gum lines should send you to a dentist immediately.

To help control the scourge of gingivitis, follow your dentist’s instructions and look for toothpaste that contains triclosan, a powerful antibacterial and antifungal agent added to some toothpaste brands. While the U.S. Food and Drug Administration is still reviewing the efficacy of triclosan in other consumer products, such as soap, the use of the ingredient in toothpaste has been proven time and time again as an effective agent against gingivitis. And remember to brush your tongue! Its tiny bumps, or papillae, are often home to other sources of laden bacteria that can multiply to infect surrounding teeth and gums.