The Mouth-Body Connection: How Oral Health Impacts Overall Longevity
Recent scientific research highlights the profound connection between oral health and chronic systemic diseases, driving calls for better integration between medicine and dentistry.
The eyes may be a window to the soul, but the mouth can reveal just as much about a person's health and the diseases that influence how we age.
To better understand these connections, scientists are investigating how issues starting in the mouth may contribute to chronic inflammation in other areas of the body. In particular, they are examining how bacteria originating from unhealthy gums, and the immune response they trigger, may contribute to conditions including heart disease, diabetes, cognitive decline, arthritis, respiratory illnesses, and chronic liver diseases.
Bridging the Medical Divide
The evolving research in this field poses a challenge for the healthcare system due to the traditional separation between medicine and dentistry—two fields that for years have operated separately regarding training, medical record management, and insurance systems. "Traditionally, dentists were not trained to think about whole-body health in the context of the mouth, and physicians were not trained to see oral health as a first step on the path to overall health," said Dr. Jessica Lederhausen, a dentist and author of the book Oral, which explores the impact of lifestyle on oral health.
But this situation is beginning to change. Dental schools, which already teach how diseases like diabetes affect the mouth, are now placing greater emphasis on how oral cavity diseases may impact the rest of the body. Leaders in medical training have called on medical schools to better integrate oral health into physician training.
At Harvard School of Dental Medicine, researchers within the Initiative to Integrate Oral Health and Medicine are investigating how oral health policy and the healthcare system's structure can better support "treating the whole person," as described by initiative director Dr. Lisa Simon, who is both a dentist and a primary care physician.
The Link to Longevity
The deepening understanding of the connection between oral health and bodily health is also leading to the development of new diagnostic tools, prevention strategies, and treatments. Simultaneously, calls to expand insurance coverage for preventive dental care are growing, particularly for older adults who are at the highest risk.
According to the U.S. Centers for Disease Control and Prevention (CDC), nearly half of adults aged 30 and older suffer from periodontitis, a severe gum disease involving bone loss around the teeth. Federal data also shows that the prevalence of the disease increases with age, with close to 60% of those 65 and older suffering from it to some degree.
A review published in 2023 in the journal Biogerontology concluded that oral health plays a significant role in achieving "exceptional longevity," partly due to its link to inflammation. Studies among those 65 and older also found that oral cavity diseases, including gum disease, cavities, and tooth loss, are still responsible for a significant portion of the years people live with disability.
The Role of Plaque and Microbiome
At the center of research today is the oral microbiome, a community of hundreds of types of bacteria, fungi, and other microorganisms living in the oral cavity. Most are part of a healthy ecosystem, but some can thrive below the gumline, cause inflammation, and lead to diseases like gingivitis and periodontitis.
One of the main challenges is dental plaque, a protective layer known as biofilm that helps bacteria attach to teeth and makes them more resistant to removal by saliva, mouthwash, and certain antimicrobial agents. When plaque accumulates, it can harden into tartar and trigger chronic gum inflammation.
Researchers like Dr. George Hajishengallis, a professor at the University of Pennsylvania School of Dental Medicine specializing in microbiology and immunology, note that plaque can release bacteria or their byproducts into the bloodstream. While the immune system typically clears them quickly, periodontitis can weaken the body's normal defense barriers, allowing bacteria to repeatedly enter the bloodstream.
Technological Innovations and AI
A recent report published in the Journal of Periodontology predicts that technologies such as artificial intelligence, saliva-based diagnostic tests, and sensor-based monitoring will enable earlier detection and personalized treatment. Sensors, for instance, could be placed in the oral cavity to monitor it in real-time, continuously tracking changes in the oral environment.
Oral health experts are also turning to artificial intelligence to analyze the growing volume of data collected from patients' mouths. A team of researchers from the ADA Forsyth Institute in Massachusetts is using AI as part of a federally funded five-year project aimed at assisting in the development of smart filling materials and decoding dental X-rays.
Overcoming Barriers in Healthcare Systems
One of the primary challenges remains the lack of insurance coverage for dental care among adults aged 65 and older, according to Dr. Frank A. Scannapieco, a professor at the University at Buffalo School of Dental Medicine.
At the same time, efforts are underway to overcome an administrative barrier working behind the scenes between physicians and dentists: medical record systems. In many cases, the two types of providers use different digital systems to store vital patient information, and these systems are unable to communicate with each other.
Efforts by companies like PDS Health are working to bridge this gap by enabling physicians and dentists to collaborate through a shared patient record, allowing patients to view both their medical and oral health information in a single portal, marking a step forward in comprehensive patient care.
