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What do cardiovascular disease, rheumatoid arthritis, and diabetes have in common?

They ALL may be negatively impacted in some way by poor oral health[1]. It may seem difficult to imagine, but oral heath can negatively affect your heart, immune system and glucose control. In this article, we will describe the periodontal challenges and the impact on diabetes and rheumatoid arthritis, as well as a particular type of medication often used following surgery or due to stroke concern.

Diabetes & oral health

The relationship between periodontal disease and diabetes is unique because it seems to be ‘bidirectional’. This means that hyperglycemia (diabetes) can affect oral health, and periodontitis (gum disease) can affect glycemic control, as well as blood circulation in the gums[2]. Since people with diabetes benefit from a diet that includes fruits and vegetables, unresolved oral pain can make it difficult for them to eat healthier foods, impacting their glucose control.

Rheumatoid arthritis & oral health

Rheumatoid arthritis (RA) is an inflammatory immune disease. Our immune system is designed to help protect your body from harm. If that system doesn’t work right, it can make you sick. When someone has RA, cells from the immune system move into joints, causing inflammation, joint damage, and pain. The immune system seeks other types of inflammation

too, including gum inflammation due to periodontitis. A study by The Johns Hopkins Arthritis Center concluded that both tooth loss and gum disease are more common in people with rheumatoid arthritis inflammation due to immune response[3]. When the body responds to gum inflammation, it contributes to tooth loss. Physical pain may create difficulty for residents to participate in their oral care.

Medication & oral health

It’s worthwhile to mention how medications can impact oral health treatment. Here’s an example of how one specific medication, blood thinners, can affect oral health. One side effect of blood thinners is bleeding of the gums (even when not brushing the teeth). Other ones may include weakening, swelling, or breaking of the tissues and muscles found around the mouth area[5]. A resident’s use of blood thinners may prompt the dentist to revise the resident’s immediate oral health treatment, as well as make recommendations for the resident’s daily oral care while on the medication.

What can facility caregivers do?

First, front-line, daily caregivers know their residents, placing them in a vital role to notice oral health issues. Secondly, they should be watchful of any changes in the residents’ mouth comfort during provision of care, as well as when the resident is eating. Finally, vigilance in monitoring for possible bacterial or fungal infections is also important. Bacterial infections may cause pain, swelling in the mouth or around a tooth.

Fungal infections may cause a white coating around the tongue or inside of cheeks. If your front-line, daily caregivers notice any changes in oral health, they should not hesitate to report the concerns to their unit manager or Director of Nursing so that a dental appointment can be scheduled.

Aria dentists holistic approach

Aria Care Partners’ dentists are attuned to the unique needs of residents who have multiple co-morbidities. This leads them to take a holistic (whole body) approach in care[4] — recognizing the relationship between oral health and systemic functioning. It’s why prior to providing oral care they review residents’ medical records, condition changes, recent lab work, and current medications prior to treatment. If a facility caregiver has any questions or concerns about a resident’s oral health status, they can call 877-674-1211 to talk to an Aria specialist.

Oral Health Supporting Sources

  1. http://1. Barnett ML. The oral-systemic disease connection. An update for the practicing dentist. J Am Dent Assoc 2006;137 Suppl:5S- 6S
  2. S. Public Health Service. Oral Health in America: A Report of the Surgeon General (Executive Summary). Washington, DC: Department of Health and Human Services 2000
  4. http://Kapila YL. Oral health’s inextricable connection to systemic health: Special populations bring to bear multimodal relationships and factors connecting periodontal disease to systemic diseases and conditions. Periodontology 2000 2021;87(1):11-16.