If the eyes are windows to the soul, the mouth is a window to whole body health and fitness. Open wide for a look.
What does oral hygiene have to do with fitness? Dental decay may be a key marker of bodywide illness and reduced athletic performance. The good news is that it’s not difficult to make dramatic improvements in both oral and body health, and athletic performance, and in a very short time.
Here’s a rundown of some key factors and causes to poor oral health, and suggestions for how to improve it.
Oral Environment
Two biochemical factors significantly affect oral health, and are a clue to much more.
- Acidity of saliva. Oral pH s is a measure of acid-alkaline balance. If it’s below a neutral 7, it’s too low (too acid); it should be around 7.5 (slightly alkaline). Low oral pH is a cause of cavities at all ages because bad bacteria thrive in that environment. In addition, oral pH reflects the body’s ability to burn stored fat for energy — lower pH is associated with higher body fat. (Saliva can be assessed with pH paper, available at a pharmacy, health store, or online. Healthy range is 7.4 to 7.6, slightly higher in children.)
- Inflammation. Common oral conditions of gingivitis and periodontitis are caused by inflammation, likewise for bone loss and tooth problems. Bad bacteria in the mouth (low oral pH) contributes significantly to inflammation. Many common diseases, illness and physical injury/impairment, especially pain, also are caused by inflammation (including those ending in “-itis,” such as tendinitis, colitis, arthritis, etc.).
Dental disease is relatively easy to recognize, and a loud warning that chronic disease and physical impairment has also started throughout the body. Both low oral pH and inflammation are caused by bad foods — refined carbohydrates, including sugar (i.e., junk food).
Poor diet often leads to:
- Reduced fat-burning and increased body fat.
- Low oral pH, bad bacteria and inflammation.
- Dental cavities, gingivitis, periodontitis and bone and tooth loss.
- Diabetes, cardiovascular disease, cancer, Alzheimer’s and other common conditions.
- Physical impairment in muscles, joints, ligament and tendons and chronic pain.
As dentists and hygienists often tell us, sugar causes many oral health problems. But it’s bigger than just nibbling on candy or sweetening coffee. Sugar-containing foods and all refined carbohydrates, which turn to sugar immediately after eating, affect metabolism, reducing fat-burning and increasing body fat. Excess stored fat also promotes inflammation. There’s a reason that in the Western world about 90 percent of adults are overfat — the same prevalence as gingivitis
Poor oral and bodywide health and fitness maintains a food-mouth-body vicious cycle.
It doesn’t take much refined carbohydrate to promote these problems. The easiest place to actually see this damage is the gums. When the dentist says you have inflammation or there’s bone loss, it usually means the rest of your body is vulnerable too. Here are two of the many examples of these problems.
The Athletic Mouth
Studies show that athletes have a high prevalence of oral disease, including dental cavities, tooth erosion and periodontal disease. In addition, the associated oral inflammation can not only reduce quality of life but also is associated with reduced athletic performance. I have measured oral pH in thousands of competitive athletes and saw the relationship between low pH and reduced performance — a logical link between poor fat-burning and low endurance energy.
In a study of participants in a variety of sports at the London 2012 Olympics, oral health of athletes was found to be poor with a resulting substantial negative impact on well-being, training and performance.
Gingivitis and Alzheimer’s
Bad bacteria associated with gum disease has been found in the brains of people with Alzheimer’s disease, migrating from mouth to brain. The bacteria may promote production of amyloid beta, a component of Alzheimer’s plaques. This may be secondary to poor oral health that includes low pH and chronic inflammation.
Healthcare Debacle
Dentists have long known that the mouth is a window to whole body health, often emphasizing this to patients. However, this holistic idea may be mentioned, but the big picture is rarely considered. Healthcare is made up mostly of specialists, including dentists and health professionals in all other fields, who usually don’t work together. Recommendations for improving oral health are usually done in isolation of input from other healthcare specialists, sometimes appearing to be different or conflicting.
Instead, all healthcare practitioners should be informing us about this problem — they should all work together to send a simple, concise message to patients. How great would that be? Unfortunately, it won’t happen in our current system. But there’s still a remedy. We can manage our own health and fitness best by improving the lifestyle factors we control — food, physical activity, and stress — while using a variety of healthcare specialists as needed.
Public health officials have long known that conventional oral health education is neither effective nor efficient. Oral health products and services focus on the mouth as office cleanings, repairs, and reactive care (crowns, deep cleanings, etc.), Proactive assessments to identify the cause of these problems is also key. While the best home remedies are an electric toothbrush, water pick, and devices to clean between the teeth, consumption of refined carbohydrates can cause good care to go to waste.
Good News
Dr. Philippe Hujoel, professor of dental public health sciences at the University of Washington School of Dentistry says that the high-glycemic diet that led to dental problems short-term may in the future eventually lead to potentially serious chronic diseases. “Dental problems from poor dietary habits appear in a few weeks to a few years,” he explains. “Dental improvement can be rapid when habits are corrected.” In this case, eliminating refined carbohydrates can often improve gingivitis scores in a couple of weeks, says Hujoel.
Of course, eliminating refined carbohydrates can also quickly make dramatic changes to chronic disease indicators as well, such as high blood pressure, blood sugar, triglycerides, body fat, and endurance, in the same two-week time frame.
References
Ashley P, et al. Oral health of elite athletes and association with performance: a systematic review. Br J Sports Med. 2015;49(1). doi: 10.1136/bjsports-2014-093617.
Gray L. Dental disease may be a wake-up call that your diet is harming your body. University of Washington Health Sciences/UW Medicine. 2009. http://www.washington.edu/news/2009/07/09/diets-bad-for-teeth-are-also-bad-for-the-body/
Morimoto J, et al. Sucrose and starch intake contribute to reduced alveolar bone height in a rodent model of naturally occurring periodontitis. PLoS One. 2019; 14(3). doi: 10.1371/journal.pone.0212796.
Needleman I, et al. Oral health and impact on performance of athletes participating in the London 2012 Olympic Games: a cross-sectional study. Br J Sports Med. 2013;47(16). doi: 10.1136/bjsports-2013-092891.
Sheiham A, Watt RG. The common risk factor approach: a rational basis for promoting oral health. Community Dent Oral Epidemiol. 2000;28(6). doi.org/10.1034/j.1600-0528.2000.028006399.x.
