RX for readers: Get treated!

Poor oral health can affect everything from your teeth to your heart, even interfere with pregnancy.

Untreated infections cause problems (photo credit: MCT)
Untreated infections cause problems
(photo credit: MCT)
I have read articles maintaining that periodontal disease can affect one’s physical health in many ways and not only result in bleeding gums and eventually tooth loss. But I wonder if this really true.
If it were really important, wouldn’t dental care for adults be included in the basket of health services? B.R., Petah Tikva Judy Siegel-Itzkovich replies: Dental care, including the treatment of periodontal disease, was not included in the basket of services – not because it isn’t very important to the health of the rest of the body but because it was regarded by the Treasury as “too expensive.”
Much research in Israel and around the world has found a direct link between bleeding gums, gum “pockets” and other signs of periodontal disease and systemic conditions ranging from cardiovascular disease and osteoporosis to diabetes and arthritis – and it can even lead to premature delivery and low birth weight of infants. Thus, even though dental care for adults is not subsidized by the government, one would be wise to get periodontal problems treated – by scaling and root planing, drug treatment and/or oral surgery – as soon as possible.
Prof. Carlos Nemcovsky, a periodontologist at Tel Aviv University’s School of Dentistry, wrote last year in the Hebrewlanguage Israeli Journal of Family Practice about the link between gum disease and systemic disorders. He explained that periodontal disease is a process of infection and inflammation involving the tissues that support the teeth in the mouth. This process results in the destruction of the bone and the periodontal collagen that attaches the teeth to the jaw. Periodontal disease is common in people over the age of 40, but it can occur at younger ages.
It begins as gingivitis, an infection that shows up as inflamed, red and bleeding gums, he wrote, and this occurs in 50 percent to 90% of the Western world’s over-40 population. The bleeding occurs when you brush your teeth or eat hard foods. This condition is usually painless, so many people dismiss it. But if untreated, it can develop into periodontitis, which affects the tissues that support the teeth and not only the gums, which recede. X-rays can show the loss of supportive ligaments and bone. If treated in time by a periodontologist, at least some of the tissue that has been destroyed can be restored. If not, the anaerobic bacteria that accumulate in gum pockets grow and thrive and release toxins.
Periodontal infections show evidence of leaking into the bloodstream. In turn, heart disease can result from the development of plaque in the blood vessels (atherogenesis), Nemcovsky noted. There is a two-way interaction here. Uncontrolled diabetes can worsen periodontal disease, and chronic periodontal infection and inflammation can cause a deterioration of the blood’s sugar-insulin balance; this is especially true in smokers.
While there is no clear proof yet, it is believed that osteoporosis (bone-thinning in the spine and limbs) can result from periodontal disease, while bonethinning can be a risk factor for periodontal disease as well.
There is solid evidence that the toxins in the mouth that enter the bloodstream in general can cause uterine infections and interfere with pregnancy, causing preterm birth. Doctors increasingly urge women who plan to become pregnant or are in the early stages to visit a dentist and treat gum infections as soon as possible.
Hospital patients in internal medicine and intensive care units very often suffer from poor oral health, which leads to a risk of bacterial infections that can cause respiratory problems and even pneumonia.
The TAU specialist said that autoimmune reactions may result in people who have genetic tendencies, and this can lead to rheumatic disease and damage to the joints.
Pancreatic cancer and chronic kidney disease may be connected to periodontal disease. A link between gum disorders and Alzheimer’s disease is suspected, but it has not been proven. Even though there is only statistical evidence between gum disease and some other systemic diseases, Nemcovsky concludes, treatment of periodontal disorders is strongly recommended for the general population and especially for those with chronic diseases. The Health Ministry would be wise to take note.
A friend sent me an item widely published on the Internet that presented the many “benefits” of surrounding oneself with fresh onions, as well as some “risks” from leaving them cut and unused. It is claimed that placing bowls of onions around can prevent one from getting the flu and to have powerful antibacterial and antiseptic properties. I was also told that since onions absorb bacteria and thus are “so good” at preventing us from getting colds and flu, we shouldn't eat an onion that has been sitting for a time after it has been cut open. It is not safe even to put sliced, uncooked onion in a zip-lock bag and eat it after refrigeration, it said. The item claimed it is dangerous to cut an onion and cook it the next day, even after putting it in a plastic bag and in the refrigerator, because it becomes “highly poisonous” for even a single night and creates toxic bacteria, which may cause adverse stomach infections because of excess bile secretions and even food poisoning.

It seemed rather far-fetched to me. Is there any truth to this?
H.H., New Jersey
Dr. Menachem Oberbaum, director of the Center for Integrative Complementary Medicine at Jerusalem’s Shaare Zedek Medical Center, replies: The only one who will benefit from this “approach” is the greengrocer. I can’t understand how an adult can take this nonsense seriously.
Rx for Readers welcomes queries from readers about medical problems. Experts will answer those we find most interesting.

Write Rx for Readers, The Jerusalem Post, POB 81, Jerusalem 91000, fax your question to Judy Siegel-Itzkovich at (02) 538-9527, or e-mail it to [email protected], giving your initials, age and place of residence.