Dental Health and Systemic Diseases

Some studies have shown that oral infection, especially periodontitis, are a potential contributing factor to a variety of systemic diseases. The periodontal diseases associated with 200 to more than 500 complex microflora, which may facilitate bacteremia and systemic spread of microbial toxin through the blood stream.

Researchers have found Bacteremia after dental procedures: 100% after tooth extraction, 70% after dental scaling, 20% after endodontic treatment. It is common to find oral microorganisms from the infected site in the oral cavity disseminate into the bloodstream.  Within one minute, the microorganisms from the bloodstream at the dental procedure site reach the heart, lungs, and peripheral blood system.

The proposed pathways linking oral infection to systemic systems are:
  1. Metastatic infection: transient bacteremia from dental procedures enter the blood stream allowing microorganisms to settle on a particular site and multiply
  2. Metastatic injury by bacteria toxin that can manifest a large number of pathology to the host
  3. Metastatic inflammation: Reaction between antigen and antibody forms a macromolecular compound, which can cause a variety of acute and chronic inflammation at the deposited site
Systemic diseases associated with oral infection:
  • Coronary heart diseases such as:
    • Atherosclerosis (progressive disease of medium to large arteries and thrombus formation in advanced cases), 
    • Myocardial infarction (damaging or death of heart muscle resulting from reduced blood supply due to the formation of thrombus in coronary artery)
    • Stroke (blood vessels that supply brain burst or clog by local thrombus formation). The bacteria from inflamed periodontal disease promote atherosclerosis and affect blood coagulation, contributing to the onset of stroke.

  • Infective Endocarditis - an infection of the endothelium of the heart or heart valves caused by bacteria in the blood stream lodge on damaged or abnormal heart valves or damaged heart tissue. The early bacteremia may promote thickening of valves, render the valves susceptible to late colonization and adherence with bacteria, resulting in fulminant infection to the heart valves.

  • Bacterial Pneumonia - an infection of pulmonary parenchyma caused by bacteria, fungi, parasites, and viruses. Most commonly, bacterial pneumonia results from aspiration of pathogens, colonizing on the surfaces of the oral cavity or pharyngeal mucosa, into the lower respiratory tract.  Susceptible patients with periodontal disease harbor a large number of subgingival bacteria, particularly anaerobic bacteria, these individuals are thought to be more likely to be at greater risk of having Pneumonia.

  • Low Birth Weight - oral infections increase the potential risk of having low birth weight in newborns.

  • Diabetes - Hyperglycemia due to a relative deficiency of insulin.  Periodontal disease may predispose or exacerbate the diabetic condition.