Links Between Oral and General Health
The Mouth as Early Warning System
Problems in the mouth can signal trouble in other parts of the body. AIDS and
osteoporosis are examples.
- Mouth lesions and other oral conditions may be the first sign of HIV
infection, and are used to determine the stage of infection and to follow its
progression to AIDS.
- Studies in post-menopausal women suggest that bone loss in the lower jaw may
precede the skeletal bone loss seen in osteoporosis.
Saliva As a Diagnostic Tool
Saliva, like blood and urine, can be used to detect and measure many compounds
in the body. Saliva collection has the advantage of being noninvasive.
- Many medications as well as alcohol, nicotine, cocaine, opiates, and other
drugs can be detected and measured in saliva. Hormones and environmental toxins
can also be measured in saliva.
- Saliva can be used to detect antibodies against viruses such as HIV and
hepatitis A and B, as well as antibodies against bacteria like Helicobacter
pylori, which causes peptic ulcers.
- Saliva could potentially replace blood testing for diagnosis and monitoring
of diseases such as diabetes, Parkinson's disease, alcoholic cirrhosis, and many
The Mouth As Source of Infection
The human mouth is home to
millions of microorganisms, most of them harmless. Under certain conditions,
however, some can cause oral infections such as tooth decay or gum disease. Oral
bacteria may also enter the bloodstream if normal protective barriers in the
mouth are breached. This can happen as a result of dental treatment or even
tooth brushing and flossing.
In people with healthy immune systems, the influx of oral bacteria into the
bloodstream is harmless. If the immune system is weakened by disease or medical
treatments, however, oral bacteria can cause infection in other parts of the
body. Infective endocarditis and oral complications of cancer treatments are
- Infective endocarditis results when oral bacteria enter the bloodstream and
stick to the lining of diseased heart valves.
- Harsh cancer treatments that damage mouth tissues can open the door to
debilitating oral infections as well as systemic infections resulting from the
spread of oral microorganisms. Besides cancer patients, others at increased risk
for general infections caused by oral bacteria include hospitalized patients
unable to practice oral hygiene, patients taking medications that reduce saliva
flow, and those taking antibiotics that alter the balance of microorganisms in
Oral Infections As Risk Factors
Recent studies point to associations
between oral infections -- primarily gum infections -- and diabetes; heart
disease; stroke; and preterm, low-weight births. To date, there is not enough
evidence to conclude that oral infections cause these serious health problems.
Research is under way to determine if the associations are causal or
- Gum infections have been called "the sixth complication of diabetes," because
people with diabetes are more likely to have periodontal disease. Researchers
are exploring a possible two-way connection between the conditions to see if
treating gum disease improves diabetic control.
- Recent studies point to an increased risk of heart disease and stroke in
people with gum infections; the risk increases with the severity of the oral
infection. However, there is not yet enough evidence to establish oral infection
as an independent risk factor for heart disease or stroke.
- Some studies have found that mothers of preterm, low birth weight infants
tend to have more severe gum disease than mothers of normal birth weight babies.
More research is needed to determine if gum infections do indeed contribute to
babies being born too soon and too small.
For more information, contact:
Centers for Disease Control and Prevention
National Center for Chronic
Disease Prevention and Health Promotion
Division of Oral Health, MS F-10
4770 Buford Highway, NE
Atlanta, GA 30341
National Institute of Dental and Craniofacial Research
National Institutes of Health
Building 45, Room 4AS-19
45 Center Drive MSC 6400
Bethesda, MD 20892-6400
Sources: U.S. Centers for Disease Control and Prevention, http://www.cdc.govLast Editorial Review: 6/26/2008