Oral Health: Much More than the Mouth

Can we all agree at this point in our lives that we know we’re supposed to brush our teeth twice a day? These days, there are lots of options in the oral care space, but they’re not all created equal, and that matters. If not properly maintained, oral health can impact your heart, pancreas, lungs, and sexual health.

My oral health can impact my sexual health?

Yes, it can. Research shows that poor oral hygiene and gum disease (periodontal disease) are linked to several serious health conditions that are more prevalent in men, including erectile dysfunction and poor prostate health.

1. Heart Disease:

• Gum disease (gingivitis and periodontitis) has been linked to an increased risk of cardiovascular disease. Men with gum disease are up to 49% more likely to develop heart disease than those with healthy gums.
• The inflammation caused by periodontal disease allows bacteria to enter the bloodstream, potentially leading to atherosclerosis (hardening of the arteries), which increases the risk of heart attack and stroke.

2. Erectile Dysfunction (ED):

• There is a growing body of evidence linking gum disease to erectile dysfunction. Men with chronic periodontitis (severe gum disease) are 2.28 times more likely to have erectile dysfunction compared to those with good oral health.
• Inflammation caused by oral bacteria from gum disease can damage the blood vessels, leading to impaired blood flow, which is crucial for erectile function.

3. Prostate Health:

• Poor oral health may also be connected to prostate health. Inflammation from gum disease can influence the prostate gland, which produces some of the fluid in semen.
• Some research suggests that men with prostate inflammation or prostatitis may also experience worsened gum disease and higher levels of prostate-specific antigen (PSA), a marker of prostate inflammation or cancer.

4. Diabetes:

• There is a bidirectional relationship between diabetes and periodontal disease. Men with type 2 diabetes are more likely to develop gum disease, and severe gum disease can worsen blood sugar control, leading to complications in managing diabetes.

5. Respiratory Health:

• Oral bacteria can be inhaled into the lungs, potentially causing or exacerbating respiratory infections like pneumonia or worsening conditions such as chronic obstructive pulmonary disease (COPD).

6. Cancer Risk:

• Men with severe periodontal disease have been found to have a 14% increased risk of developing cancer compared to those without gum disease. Studies have shown that men with a history of periodontal disease are at a higher risk of developing cancers of the mouth, esophagus, prostate, and pancreas.

Low testosterone has also been linked to a higher risk of gum disease and tooth loss, possibly due to its influence on bone density and inflammation. If you have low T, be cognizant of your oral health habits.

So, what does a good oral health routine look like?

Flossing

Most dentists tell you to floss once daily, which is considered best practice. A good habit is to floss at night, before brushing, to remove any food bits you picked up over the day. Physical floss is better than a waterpik or interdental brushes as floss can get under the gums, but if you have braces or some other dental work that makes using floss difficult, using a waterpik or brush is better than not using anything.

Brushing

Next in the oral health hygiene routing is the main act: brushing. Research shows that 2 minutes is best and that most people underestimate the time they spend brushing. It’s also important to note that more is not always better; research has shown that brushing over 3 minutes doesn’t give additional gains. Electric toothbrushes can be beneficial, as most have built-in timers to ensure you hit that 2-minute mark. Electric toothbrushes can also be helpful if you are an aggressive brusher. Aggressive brushing can erode gum tissue, and like cartilage and heart muscle, gum tissue doesn’t regrow once you’ve lost it. Periodontal grafting, the process of cutting and relocating a tiny bit of gum tissue, is expensive and can be painful. That electric toothbrush may seem like a splurge until you’re staring down an expensive dental bill.

When it comes to what goes on your brush, you have more options than ever. The general consensus is that traditional baking soda and charcoal-based products are too abrasive for teeth and can do more harm than good by wearing down enamel, which leads to additional staining and sensitivity.

For preventing cavities, the FDA’s OTC drugs mostly rely on fluoride compounds as active ingredients. These are commonly found in over-the-counter toothpaste and mouth rinses. The key fluoride compounds approved by the FDA for cavity prevention include:

1. Sodium Fluoride (NaF)

• Concentration: Typically between 0.02% and 0.15% in toothpaste
• Use: One of the most common active ingredients in toothpaste and mouth rinses for cavity prevention.

2. Sodium Monofluorophosphate (MFP)

• Concentration: Usually around 0.76% in toothpaste
• Use: Another widely used fluoride compound in toothpaste. It offers similar cavity-preventing benefits as sodium fluoride.

3. Stannous Fluoride (SnF₂)

• Concentration: Typically around 0.4% in toothpaste
• Use: Known not only for preventing cavities but also for providing additional benefits like reducing gingivitis and tooth sensitivity.

These fluoride compounds work by strengthening tooth enamel which makes it more resistant to acid attacks from bacteria in the mouth.

As an OTC drug, products containing these fluoride compounds must follow specific labeling requirements set by the FDA, including directions for use, warnings, and claims about cavity prevention.

There’s also a new(ish) ingredient popping up in more products in the US callednano-hydroxyapatite (nHA).

Like ear thermometers and home insulation, nano-hydroxyapatite was first developed in the 1970s by NASA researchers. The initial goal was to help astronauts combat the loss of bone density they experienced during extended periods in space due to the lack of gravity. Hydroxyapatite, the mineral form of calcium apatite, is a naturally occurring component of human bones and teeth, and the nano version was designed to mimic this mineral structure on a microscopic scale for potential use in bone regeneration and other medical applications.

By the late 1980s and early 1990s, researchers began exploring its use in dental care, particularly for repairing tooth enamel, which is also composed of hydroxyapatite. The nano form, with its much smaller particle size, was found to be particularly effective at bonding with enamel, making it suitable for use in oral care products like toothpaste to promote remineralization and repair. Today, nano-hydroxyapatite is widely used in Japan and Europe as an alternative to fluoride in toothpaste and other dental products. In the US, it is not regulated as an OTC drug, so its labeling will look different compared to the fluoride products referenced above.

What science currently tells us about nano-hydroxyapatite:

• Enamel Repair: Works by filling in microscopic cracks and repairing damaged enamel. It mimics the natural structure of enamel, helping to restore its integrity.
• Cavity Prevention: Some studies indicate that nHA might be comparable to fluoride in its ability to prevent demineralization and promote remineralization, although long-term data is still limited compared to fluoride.
• Safety Profile: Considered safe and biocompatible, with no known toxicity or systemic side effects. Because it is a naturally occurring component of teeth and bones, it is often considered more suitable for individuals who prefer to avoid fluoride.
• Additional Benefits: Noted for its ability to reduce tooth sensitivity by occluding exposed dentinal tubules and for providing a cosmetic benefit by making teeth appear smoother and shinier.

Mouthwash

Mouthwash is an optional part of oral hygiene. Some formulations provide benefits to people who suffer from dry mouth. Unless advised by a dentist or oral surgeon, steer clear of any mouthwash that states it ‘kills 99% of bacteria’. Recent studies show that one week of use with this type of mouthwash can disrupt your oral microbiome. A better option is simply brushing your tongue for a few seconds at the end of your routine as this can help remove any lingering bits that cause bad breath without disrupting the good bacteria you want to be there.

Closing It Out

It is estimated that roughly 35% of the population has untreated dental decay. In addition to creating other health conditions, dental issues can also impact your confidence and self-esteem. Spending just 5 minutes a day, 2 in the morning and 3 at night, can significantly improve your physical, mental, and financial health.

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