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oral health month: stomach cancer, stroke, problems with pregnancy all linked to poor oral health

the connection between disease and the health of our mouths makes taking care of our teeth critical, say experts.

by robin roberts

published apr 27, 2023

last updated feb 02, 2024

5 minute read

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5 minute read

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there are a lot of reasons to take care of your teeth, including helping to prevent cancer. getty

a routine trip to the dentist office could reveal more than a cavity or two. in fact, your dentist could take one look at your not-so-pearly whites and spot a potentially life-threatening condition. according to the canadian dental association (cda), gum disease is the most common dental problem dentists see, and seven out of 10 canadians will have it at some point in their lives. when plaque sticks to the edge of your gums and is not removed through brushing and flossing, it hardens into tartar. this can cause bacterial infection, called gingivitis. it’s not painful, but you’ll notice your gums getting a little swollen and they may bleed when you brush or floss. left untreated, gingivitis can lead to the more serious periodontitis, and you could risk losing a tooth or two. bacteria can also seep into the bloodstream, spreading to various organs where it could wreak potentially deadly havoc.

gum disease can affect your overall health

researchers have discovered a possible association between poor oral health and certain diseases, like diabetes, heart disease, crohn’s disease, respiratory diseases, cancer, and stroke. and while there is a “common denominator,” says dr. ryan noh, assistant professor of the undergraduate program in periodontics at the university of toronto’s faculty of dentistry, he cautions that the evidence is not quite there yet.

still, he acknowledges the risk of bacteria found in the spaces between teeth getting into the bloodstream.

“for instance, it has been demonstrated that periodontal bacteria can directly invade walls of vessels and influence the formation and progression of atheroma plaque [the fatty material that builds up in the arteries, which could lead to heart attack or stroke],” says noh.“both atherosclerotic cardiovascular disease [described by the nih as a narrowing of the arteries] and periodontitis share many common risk factors, such as smoking, inadequate oral hygiene, diabetes mellitus, and obesity, [but] it is hard to definitively conclude that periodontitis is a primary causal factor for acvd.”

however, we should still be aware of the risk.

studies show link between periodontitis and stroke, diabetes and kidney disease

in 2020, european and american researchers found enough evidence to support associations between severe periodontitis and cardiovascular disease and stroke as well as kidney disease, chronic obstructive pulmonary disease and diabetes. researchers at the mayo clinic have found that certain mouth bacteria can invade the lungs, causing pneumonia and other respiratory diseases. but this is found mainly in patients who are hospitalized or in nursing homes, and in those who are unable to floss or brush on their own.

like noh, iona leong, associate professor at the university of toronto’s faculty of medicine and researcher of oral pathology, including oral cancers, also notes the possibility that mouth bacteria ends up in the bloodstream.

“sometimes bacteria that are present in the mouth can be introduced into the bloodstream and have been linked to certain infections, such as infections of the heart valve, or in patients who have had congenital heart disease,” she says. “the evidence is there, but it’s actually quite uncommon.”

leong cautions that much of the evidence is statistical and, like noh, believes there hasn’t been proven sufficient cause and effect.

“if a patient has cardiovascular disease, chances are more likely that they may have some unhealthy lifestyle factors in general that contributed to the disease,” she says. “it’s always better to have good periodontal health regardless.”

crohn’s disease can be spotted in the mouth

leong also sees many patients with crohn’s disease.

“on occasion crohn’s is actually diagnosed when it presents in the mouth first. you can see lesions in the mouth that warrant investigation,” she says. “when adults get frequent and persistent canker sores it may be a sign of an underlying systemic disease such as crohn’s, the inflammatory bowel diseases, celiac disease, hiv infection, autoimmune disease, and of anemia, especially iron deficiency anemia, vitamin b12 deficiency.”

what about cancer?

according to the canadian cancer society, oral cavity cancer is included in the general category of head and neck cancer — a diagnosis that about 7,500 canadians receive each year, with 2,100 dying from it. smoking or chewing tobacco, heavy alcohol use, and being infected with the human papillomavirus (hpv) also increase the risk of oral cancer.

but despite the hpv link to oral cancer, leong says that many people become infected with hpv and never develop oropharyngeal cancer, [which occurs] at the back part of the mouth, noting that the virus doesn’t have a strong role in cancer of the mouth, although it does in areas closer to the throat.

researchers at harvard’s t.h. chan school of public health also found that those with longstanding gum disease have a 52 per cent higher risk of developing stomach cancer and a 43 per cent higher risk of esophageal cancer. studies by medical journal the lancet also found higher risks of total cancer incidence as a result of poor oral health.

some diseases make gum disease worse

on the flip side, some diseases and conditions can cause or exacerbate gum disease, particularly hiv/aids, autoimmune diseases such as celiac, and diabetes. (however, most people with hiv/aids are being treated with antiretroviral therapy, which reduces the risk of oral problems.)

the role that diabetes plays in gum disease, according to noh, has to do with high blood sugar levels which, in turn, affect inflammatory responses and wound healing, contributing to more severe gum disease.

diabetic patients with good glycemic control have reduced prevalence and severity of periodontitis compared to those with poorly controlled diabetes, he says, adding that effective periodontal treatment is potentially associated with improved glycemic control.

how gum disease affects pregnancy

noh says many of his patients worry about the possibility of maternal periodontal disease leading to low birthweight and pre-term births.

“the concern comes from oral micro-organisms that can potentially directly and/or indirectly impact the fetal-placental unit,” he says. “this is biologically plausible, but further well-designed studies are still required. i emphasize that non-surgical periodontal treatment [regular exams and cleaning] is safe, and contributes to the overall wellbeing and oral health of the pregnant mother.”

in fact, the centers for disease control reports that between 60 and 75 per cent of pregnant women have gingivitis, and that periodontal disease, which may be aggravated by changing hormones, has been associated with poor pregnancy outcomes. research also notes that pregnant women who have cavity-causing bacteria can transmit it from their mouth to their baby’s. the cdc acknowledges, however, that the connection between poor oral health and adverse pregnancies is not fully understood.

the bottom line for preventing any of these possible scary outcomes is to put a little effort into the front end: brush your chompers twice a day using a soft-bristled toothbrush, floss at least once a day, limit sugary food and drinks, and see your dentist for routine check-ups and cleanings.

for more tips on practicing good oral health, check out the canadian dental association.

robin roberts is a vancouver-based writer.

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robin roberts

oral health month: stomach cancer, stroke, problems with pregnancy all linked to poor oral health

the connection between disease and the health of our mouths makes taking care of our teeth critical, say experts.

gum disease can affect your overall health

can you 'catch' stress? this toronto researcher says yes

is ignoring your teeth bad for your brain?

studies show link between periodontitis and stroke, diabetes and kidney disease

crohn’s disease can be spotted in the mouth

some diseases make gum disease worse

how gum disease affects pregnancy

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oral health month: stomach cancer, stroke, problems with pregnancy all linked to poor oral health

the connection between disease and the health of our mouths makes taking care of our teeth critical, say experts.

gum disease can affect your overall health

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