The mouth provides another window into overall health. That’s what inspired New York University’s College of Dentistry to team up with its College of Nursing to check patients at the university’s free dental clinic for other health-related issues. More than 60% of the patients referred from the dental clinic met the criteria for hypertension, and 30% had diabetes or pre-diabetes. “The tooth pain brings them in. Diabetes and hypertension are often silent diseases,” says Edwidge Thomas, the nursing school’s director of clinical practice affairs.
In rarer cases, gums can bleed and become inflamed from leukemia. Bulimia can leave telltale acid marks on the backs of teeth — and missing teeth can be a sign of poor nutrition, advanced gum disease or long-term drug use.
Some body signs are more statistical correlations than causal relationships. Short leg length has been linked to a higher risk for diabetes, atherosclerosis and heart disease, which could all be due to poor nutrition in utero or early childhood. Several studies have found that the shorter a man’s index finger in relation to his ring finger, the more aggressive he’s likely to be. One possible explanation is exposure to testosterone in the womb, but so far, that remains more a curiosity than a clue
The American Academy of Pediatric Dentistry (AAPD), the recognized leader in pediatric oral health, announced new oral health guidelines for expectant mothers and infants. The guidelines call for all pregnant women to receive counseling and oral healthcare during pregnancy, and also that infants receive an oral health risk assessment and oral care by their first birthday. These steps will contribute to optimal oral health for both mom and baby.
“There is evidence associating periodontal disease and increased risk of preterm birth and low-birth weight,” said AAPD’s Immediate Past-President Dr. Beverly Largent. A recently published study found significant differences between women treated for periodontal disease and those who were not treated. The findings suggest that incorporating periodontal care may result in improved pregnancy outcomes.
“Because premature births have become the number one obstetric problem in the United States, we felt the need to provide more guidance about necessary oral care for expectant moms, in addition to promoting oral health as a key part of pregnant women’s overall health,” said Dr. Largent.
The guidelines are based on studies that suggest that proper dental care during the perinatal period may help prevent preterm and low-birth weight babies and is an important aspect of overall health for pregnant women – allowing them to enter delivery in optimal health. Many women, however, are unaware of the implications poor oral health can have on themselves and their babies and often don’t seek oral care during pregnancy.
Additionally, mothers with poor oral health may be at greater risk of infecting their children with the bacteria that causes cavities, increasing their children’s caries risk at an early age. Because cavities in infants are preventable, determining which mothers are at the highest risk improves opportunities for preventive intervention.
“Every expectant mother should receive a comprehensive oral health evaluation and risk assessment,” said Dr. Largent. “Dental treatment is safe throughout pregnancy, and this is a time when expectant mothers need to be screened for oral risks, counseled on proper oral hygiene and receive necessary dental treatment.”
The updated guidelines also address proper oral care for infants and toddlers, the age group most susceptible to early childhood caries (ECC), which is an infectious but preventable disease that causes tooth decay and potentially more serious health issues. When left untreated, ECC can affect speech and communication, eating and dietary nutrition, sleeping, learning, playing, and quality of life – even into adulthood. The guidelines outline how simple changes in a mother’s oral hygiene, diet, use of topical fluoride and sharing of eating utensils can significantly reduce a child’s risk for ECC.
Overview of the new AAPD Oral Health Guidelines for expectant mothers and infants:
Oral Hygiene: Tooth brushing and flossing on a daily basis are important for the parent to reduce bacterial plaque, which research has linked to preterm, low-birth weight babies.
Diet: Dietary education for the parents, including the potential effect of foods and beverages on their oral health, helps maintain good dental care.
Fluoride: Using a fluoridated toothpaste approved by the American Dental Association and rinsing every night with an alcohol-free, over-the-counter mouth rinse containing 0.05% sodium fluoride have been suggested to help reduce plaque levels.
Caries removal: Routine professional dental care for the parents can help keep their oral health in optimal condition.
Delay of colonization: Education of the parents, especially mothers, on sharing utensils, food and cups can help prevent the transmission of cavity-causing bacteria.
Xylitol gum: Recent evidence suggests the use of xylitol chewing gum (four pieces per day by the mother) can decrease a child’s caries rate.