Another Voice for the Oral-Systemic Union – Daily Flossing

Oral Systemic Union

When my patients present to my office for their periodic exam and oral hygiene services, they can expect my hygienist and I to emphasize daily flossing.  This simple preventive act yields tremendous benefits, some of which I will present in this blog.

In addition to flossing, we have been recommending the use of a Waterpik to provide excellent oral hygiene.  I have noticed flossing does not always remove enough “food film” to achieve the desired results of minimal gum inflammation.  But those patients that incorporate the Waterpik into their daily regimen realize a much healthier oral environment.

How important is a healthy mouth?  Dr. Richard Nagelberg voiced his view in a recent magazine article titled State of the Oral-Systemic Union: 2013 (http://www.dentaleconomics.com/articles/print/volume-103/issue-1/practice/state-of-the-oral-systemic-union-2013.html).  For those readers inclined to read the full article and read up on many details of inflammation such as endotoxins, interleukin proinflammatory mediators, enzymes, periodontal bacterium such as Fusobacterium nucleatum and more, they can click on the link provided.  For others I will provide a brief summary of Dr. Nagelberg’s article.

For years now there has been growing evidence that periodontal disease, or gum disease, has concerning and serious systemic effects.  These effects are more pronounced in vascular disease, atherosclerosis, and diabetes.  Dr. Nagelberg’s article focuses on atherosclerosis in this particular article, but a search of online material will reveal more research and information upon the other systemic diseases.

Inflammation is key to the development and progression of atherosclerosis and coronary heart disease.  The growing conclusion is that periodontal pathogens (bacteria) initiate the cascade of events that result in atherosclerosis and the potential for cardiovascular events (http://www.dentaleconomics.com/articles/print/volume-103/issue-1/practice/state-of-the-oral-systemic-union-2013.html).

This is the thing you should remember:  The American Heart Association has stated that there is growing evidence that periodontal disease is independently associated with arterial disease.  Atherosclerosis and periodontitis share common confounders, which means that that the observed association between periodontitis and AVD cannot be attributed solely to the recognized common risk factors (http://circ.ahajournals.org/content/125/20/2520.abstract?ijkey=67c4d8d38ebcc70d27630e2be5720f75ab649ad1&keytype2=tf_ipsecsha).  The AHA cautions, however, that periodontal disease has not yet been found to be a causative factor of atherosclerosis.  More research will be required to determine that.

The fact remains that daily flossing and use of a Waterpik is valuable for maintaining a healthy mouth, and also reducing risk factors of systemic disease such as atherosclerosis.

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