The Mouth-Body Connection®

Improve your health today

Oral Health Means Better Health for you and your family

32 Why thirty-two?

That’s how many teeth the average adult has. Of course, there are many more reasons that make staying on top of your oral health care key to your overall health.

The Mouth-Body Connection®

The Mouth-Body Connection refers to the link between oral health and overall systemic health, and the role that the harmful bacteria and inflammation in our mouths play in chronic, systemic disease. We’ve known about The Mouth-Body Connection for nearly two decades, since the Surgeon General’s Report on Oral Health in America in 2000 (and updated 2021). The mouth is the window to the rest of the body.

Let’s act on this knowledge together.

Reason 01: Inflammation 02: The 5 biggest, baddest bacteria

Reason 03: Brain Health 04: Tooth truth 05: Before you forget 06: The dental mental dilemma 07: Hard-to-pronounce bacteria

Reason 08: Heart Health 09: Talk to the mouth 10: Toothbrushing and heart health 11: Save on heart attacks 12: Regular checkups

Reason 13: Diabetic Health 14: Toothbrushing and diabetes 15: Gum disease and diabetes 16: Dentistry makes a difference 17: Spit expectations

Reason 18: Maternal Health 19: Preterm, low-weight babies 20: Preeclampsia and miscarriage 21: Healthier pregnancy 22: Hormones and your mouth

Reason 23: Cancer 24: Cancel oral cancer 25: Head and neck cancers 26: Early detection 27: Teeth, tobacco, and alcohol

Reason 28: The Economics 29: Gum disease globally 30: Preventative oral healthcare savings 31: Good financial hygiene 32: Oral health = better health

©2022 Smile Generation. All rights reserved. Smile Generation® and The Mouth-Body Connection® are registered trademarks of Pacific Dental Services®.

Inflammation is the root cause of all major diseases.

Scientists from around the world now agree that inflammation is the root cause of all major diseases: cancer, heart disease, and diabetes—even Alzheimer’s.1

– Harvard Medical School, 2020

The 5 biggest, baddest bacteria:

1. Aggregatibacter actinomycetemcomitans (Aa) 2. Porphyromonas gingivalis (Pg) 3. Tannerella forsythia (Tf) 4. Treponema denticola (Td) 5. Fusobacterium nucleatum (Fn)

The five biggest, baddest bacteria (a.k.a. periodontal pathogens) travel from the mouth throughout the body contributing to heart disease, diabetes, pregnancy complications, cancer and Alzheimer’s. Salivary diagnostic testing can measure the levels of these bad bacteria and identify your individual risk factors, putting you on the path to better health.2

Improve your health today. | Smile Generation®

What do my teeth have to do with my brain?

REASON 03

Chronic gum inflammation increases the risk of developing Alzheimer’s disease. As oral bacteria breaks into the bloodstream through the gums, it can travel to organs throughout the body, including the brain.3

The most common bacteria associated with Alzheimer’s disease and dementia, Pg, can now be identified through a simple salivary diagnostic test that you can take in the dental office.*

Ask your dentist about it today.

* The diagnostic test, sent to an external lab, measures 11 types of bacteria (a.k.a. periodontal pathogens) known to cause gum disease.

REASON 04

Tooth loss. Memory loss.

Losing more than half your teeth by age 60 may more than double your risk of Alzheimer’s disease.4

REASON 05

Before you forget.

For participants in a case study, the most common cause of tooth loss was periodontal disease occurring 20 to 30 years prior to the onset of dementia.5

– Inside Dentistry, 2015 – Journal of American Dental Association, 2007

The dental mental dilemma.

People with dementia and Alzheimer’s tend to decline in their oral hygiene. This creates a vicious cycle of periodontal disease, which leads to dementia, further declines in oral hygiene, and then worsened periodontal disease.6

Porphyromonas gingivalis

(We know. That's a lot of syllables. Trust us: That can be some really bad stuff.)

Research shows that oral bacteria Porphyromonas gingivalis (Pg), the main pathogen in chronic gum disease, has been identified in the brain of Alzheimer’s disease patients.7

– Science Advances, 2021

Want to know your oral health numbers? Ask your dentist about salivary diagnostic exams.

Can dental problems affect my heart?

REASON 08

Research has shown that people with periodontal (gum) disease are two to three times more likely to suffer from a heart attack or other serious cardiovascular issue.8

– Harvard University, 2019

The most common bacteria associated with heart disease (Aa, Pg, Tf, Td, and Fn) can now be identified through a simple salivary diagnostic test that you can take in the dental office.*

Ask your dentist about it today.

* The diagnostic test, sent to an external lab, measures 11 types of bacteria (a.k.a. periodontal pathogens) known to cause gum disease.

Improve your health today. | Smile Generation®

REASON 09

Your mouth has something to say your heart needs to hear.

(Actually, two things.)

1) 50% of heart attacks may be triggered by an infection found in the mouth. 2) Studies show the adverse effects on your heart from gum disease are due to five high-risk oral bacteria (a.k.a. the five biggest, baddest bacteria we told you about earlier). 9

Circulation, 2013 Postgraduate Medical Journal, 2016

A healthier heart and smile in just two minutes a day?

Yes, please!

A study presented at the American Heart Association’s Scientific Sessions in 2018 showed that brushing your teeth with fluoride toothpaste twice a day for at least two minutes could lower the risk of developing cardiovascular disease.10

11

Spend on dental cleanings. Save on heart care costs.

Patients with heart disease who received dental services spent 31.1% less on healthcare costs. Additionally, heart disease patients who completed periodontal treatment and maintenance saw a 28.6% reduction in annual hospitalizations.11

Regular dental checkups for a healthier heart.

A study out of Sweden suggests that “dental screening programs including regular check-ups and education on proper dental hygiene may help to prevent first and subsequent heart events.” 12 (In other words, see your dentist.)

How can healthy gums reduce the risk of diabetes?

REASON 13

Chronic gum disease may cause your blood sugar level to rise, which makes diabetes more difficult to manage. Regular dental cleanings can help improve blood sugar control.13 But findings on the following pages show how oral health can help reduce the risk of developing diabetes in the first place.

The five bad bacteria are associated with insulin resistance, prediabetes and diabetes, and can now be identified through a simple salivary diagnostic test that you can take in the dental office.*

Ask your dentist about it today.

* The diagnostic test, sent to an external lab, measures 11 types of bacteria (a.k.a. periodontal pathogens) known to cause gum disease.

More brushing. Less diabetes?

Researchers in Europe found that brushing teeth three times a day or more is linked to an 8% lower risk of developing diabetes. Additionally, just having periodontal disease is associated with a 9% increased risk of developing diabetes. For people missing 15 or more teeth, this risk increases to 21%.14

15

Did you know?

A recent study found that nearly one in five people with severe gum disease had Type 2 diabetes and didn’t know it.15

– American Diabetes Association, 2017

A difference in managing diabetes.

Researchers in Spain found that diabetic patients who received advanced oral treatment and other oral health interventions were able to maintain better blood sugar levels than those who received basic dental care.16

Expect more from your spit.

Some oral conditions are more common in people with diabetes, such as dry mouth. Saliva protects teeth from cavities. If not enough saliva is being produced, the food, drink or bacteria in your mouth won’t get washed away as easily. Plus, it can cause further tooth decay, soreness or infections. 17

– American Diabetes Assosciation

Can my gum health affect my pregnancy?

REASON 18

Almost 20% of the pre-term, low-weight births occurring each year might be attributable to periodontal disease.18 –

Journal of the American Dental Association

Elevated levels of Fn are associated with pregnancy complications and can now be identified through a simple salivary diagnostic test that you can take in the dental office.* Ask your dentist about it today. * The diagnostic test, sent to an external lab, measures 11 types of bacteria (a.k.a. periodontal pathogens) known to cause gum disease.

Reduce the number of preterm, low-weight babies by 80%.

Treating periodontal disease prior to the second trimester has been shown to reduce the number of pre-term, low-weight babies by 80%.19

– Journal of Periodontology, 2002

REASON 20

40% of pregnant women

have some form of periodontal disease, which may also contribute to preeclampsia and miscarriage. 20

– Journal of Periodontology, 2004

REASON 21

Healthier pregnancy. Healthy savings.

Pregnant patients who completed periodontal treatment and maintenance saved $2,433 in annual medical costs. 21

Hormones can wreak havoc on your gums.

Hormone changes occur during pregnancy and later during menopause. The hormone levels increase the blood flow to the gums, making the tissue swollen and more susceptible to plaque and, consequently, gum disease.22

Is there a connection between cancer and gum health?

REASON 23

According to the Centers for Disease Control and Prevention, cancer is the second leading cause of death in the United States, exceeded only by heart disease. Better oral care and treatment promises to help eliminate cancer-causing microbes in the mouth .23

The most common bacteria associated with cancer (Aa, Pg, Tf, Td, and Fn) can now be identified through a simple salivary diagnostic test that you can take in the dental office.*

Ask your dentist about it today. * The diagnostic test, sent to an external lab, measures 11 types of bacteria (a.k.a. periodontal pathogens) known to cause gum disease.

Cancel oral cancer with advanced, proven technology.

Oral cancer kills about one person per hour, 24 hours a day.24 Oral cancer screenings accompanied with devices like VELscope® can help with early identification of abnormalities not visible to the naked eye.

$4.5 billion is spent each year in the U.S. on treatment of head and neck cancers.

– Oral Cancer Foundation

Early detection with salivary diagnostics.*

A study published in 2022 linked gum disease with an increased risk of colorectal cancer—all the more reason for salivary diagnostic testing, which analyzes saliva to identify biomarkers for systemic cancers and other conditions.26

* The diagnostic test, sent to an external lab, measures 11 types of bacteria (a.k.a. periodontal pathogens) known to cause gum disease.

REASON 27

Tobacco, alcohol and poor oral hygiene—oh my!

Several case-control studies have found tobacco, alcohol, and poor oral hygiene contribute to tooth loss which is associated with a higher cancer risk.27

REASON 29

Gum disease is the sixthmost prevalent health condition worldwide.

It accounts for more years lost to disability than any other condition, and has been linked to more than 50 non-communicable diseases. 29

–The Economist Intelligence Unit, 2021

REASON 30

The savings resulting from preventative oral healthcare from 2016 to 2025 are estimated at over

$63

billion.30 REASON 31

– Avalere Health Research Study, 2016

The estimated cost of treating periodontal disease from 2016 to 2025 is

$7.2 billion. 31

– Avalere Health Research Study, 2016

Oral health means better health.

REASON 32

The link is clear. The question should be clear, too: now that you know, what will you do? Simple. Brush, floss and schedule an appointment with your dentist.32

– The Mayo Clinic, 2022

Hold the mayo, please.

Preventive dental care is strongly associated with significant savings for patients with diabetes or coronary artery disease. 32

– The Mayo Clinic, 2022

It’s time we talked about more than your teeth.

What’s on your mind about what’s in your mouth? Bad breath? Good news. There’s help for that. Swollen gums? Bleeding gums? Sensitive teeth? Loose teeth? Bite not right? These are all signs that are telling you something important. And so are we.

The five baddest bacteria are busy in your body and you know what that means? It’s time for The Inflammation Conversation.

The Inflammation Conversation:

Reason 1

Watson, S. (2020, June 15). All about inflammation. Harvard Health Publishing, Harvard Medical School. https://www.health.harvard.edu/staying-healthy/ all-about-inflammation/

Reason 2

American Academy of Periodontology. (2015, June 23). More Than a Quarter of U.S. Adults are Dishonest with Dentists about How Often They Floss Their Teeth [Press release]. https://new-media-release.com/aap/love_the_gums_ youre_with/

National Institutes of Health. Oral Health in America: Advances and Challenges. Bethesda, MD: US Department of Health and Human Services, National Institutes of Health, National Institute of Dental and Craniofacial Research, 2021.

Reason 3

Chen, C., Wu, Y. & Chang, Y. (2017). Association between chronic periodontitis and the risk of Alzheimer’s disease: a retrospective, population-based, matched-co hort study. Alzheimer's Research & Therapy, 9(56). https://doi.org/10.1186/ s13195-017-0282-6

Reason 4 & 5

Stein, P., Desrosiers, M., Donegan, S., et al. (2007). Tooth loss, dementia and neuropathology in the Nun Study. Journal of the American Dental Association, 138(10), 1314-1322. https://jada.ada.org/article/S0002-8177(14)63215-3/ fulltext

Reason 6

Shaik, M., Ahmad, S., Gan, S., et al. (2014). How do periodontal infections affect the onset and progression of Alzheimer’s disease? CNS & Neurological Disorders Drug Targets, 13(3), 460-466. https://doi.org/10.2174/18715273113126660152

Reason 7

Dominy, S., Lynch, C., Ermini, F., et al. (2019). Porphyromonas gingivalis in Alzheimer's disease brains: Evidence for disease causation and treatment with small-molecule inhibitors. Science Advances, 5(1). https://doi.org/10.1126/ sciadv.aau3333

Reason 8

Gum disease and heart disease: The common thread. (2021, February 15). Harvard Health Publishing, Harvard Medical School. https://www.health.harvard.edu/ heart-health/gum-disease-and-heart-disease-the-common-thread

Reason 9

Pessi, T., Karhunen, V., Karjalainen, P., et al. (2013). Bacterial signatures in thrombosis aspirates of patients with myocardial infarction. Circulation, 127(11), 1219-1228. https://doi.org/10.1161/circulationaha.112.001254

Bale, B. et al. (2016, Nov.). High-risk periodontal pathogens contribute to the pathogenesis of atherosclerosis. Postgraduate Medical Journal, 93(1098). 215-220 https://pmj.bmj.com/content/93/1098/215

Reason 10

Matsui, S., Higashi, Y., Hashimoto, H., et al. (2018, Nov.). Abstract 12781: Associ ation of Poor Tooth Brushing Behavior With Cardiovascular Outcome: Two-Year Follow-Up Prospective Observational Study. Circulation, 138(Suppl_1). https:// www.ahajournals.org/doi/10.1161/circ.138.suppl_1.12781

Reason 11

Mugiishi, M. (2018, September). HMSA: Integrating oral health for total health [Conference presentation]. Harvard School of Dental Medicine 2018 Leadership Forum, Boston, MA, United States. https://oralhealth.hsdm.harvard.edu/files/ oralhealth/files/mark_mugiishi.pdf

United Concordia Dental. (2014). The Mouth: The Missing Piece to Overall Wellness and Lower Medical Costs [White paper]. www.unitedconcordia.com/ docs/united concordia oral health whitepaper.pdf

Reason 12

European Society of Cardiology. (2021, Aug. 25). Gum disease linked with new onset heart disease [Press release]. https://www.escardio.org/The-ESC/ Press-Office/Press-releases/Gum-disease-linked-with-new-onset-heartdisease

Reason 13

Diabetes and dental care: Guide to a healthy mouth. (2020, Nov. 3). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/diabetes/in-depth/diabetes/ art-20043848

Reason 14

Chang, Y., Lee, J., Lee, K. et al. (2020). Improved oral hygiene is associated with decreased risk of new-onset diabetes: a nationwide population-based cohort study. Diabetologia, 63, 924–933. https://doi.org/10.1007/s00125-020-05112-9

Reason 15

Teeuw, W., Kosho, M., Poland, D., et al. (2017). Periodontitis as a possible early sign of diabetes mellitus. BMJ Open Diabetes Research and Care, 5 http://dx.doi.org/10.1136/bmjdrc-2016-000326

Reason 16

Mauri-Obradors, E., Merlos, A., Estrugo-Devesa, A. et al. (2017). Benefits of non-surgical periodontal treatment in patients with type 2 diabetes mellitus and chronic periodontitis: A randomized controlled trial. Journal of Clinical Periodontology, 45(3). 345-353. https://doi.org/10.1111/jcpe.12858

Reason 17

Diabetes and Oral Health. (n.d.). Diabetes.org. https://www.diabetes.org/ diabetes/keeping-your-mouth-healthy

Reason 18

McGaw, T. (2002). Periodontal Disease and Preterm Delivery of Low-BirthWeight Infants. The Journal of the Canadian Dental Association, 68(3), 165-169. http://www.cda-adc.ca/jcda/vol-68/issue-3/165.pdf

Reason 19

López, N., Smith, P., Gutierrez, J. (2002, Aug.). Periodontal therapy may reduce the risk of preterm low birth weight in women with periodontal disease: a randomized controlled trial. Journal of Periodontology, 73(8), 911-24. https:// pubmed.ncbi.nlm.nih.gov/12211502/

Reason 20

Lieff, S., Boggess, K., Murtha, A., et al. (2004, Jan.). The oral conditions and pregnancy study: periodontal status of a cohort of pregnant women. Journal of Periodontology, 75(1), 116-126. https://doi.org/10.1902/jop.2004.75.1.116

Reason 21

United Concordia Dental. (2014). The Mouth: The Missing Piece to Overall Wellness and Lower Medical Costs [White paper]. www.unitedconcordia.com/ docs/united concordia oral health whitepaper.pdf

Reason 22

Hormones and Dental Health: What Every Woman Needs to Know. (n.d.). Mouth Healthy. https://www.mouthhealthy.org/en/az-topics/h/hormones

Reason 23

Murpy, S., Kochanek, K., Xu, J., Arias, E. (2021, Dec.). Mortality in the United States, 2020 (Report No. 427). Centers for Disease Control and Prevention, National Center for Health Statistics, U.S. Department of Health and Human Services.

Meurman, J.(2010, Aug.). Oral microbiota and cancer. Journal of Oral Microbiology, 2(5195). https://doi.org/10.3402/jom.v2i0.5195

Reason 24 & 25

Oral Cancer Facts. (n.d.). The Oral Cancer Foundation. https://oralcancerfoundation.org/facts

Reason 26

Janati, A., et al. (2022, Jan. 26). Periodontal disease as a risk factor for sporadic colorectal cancer: results from COLDENT study. Cancer Causes & Control, 33. 463-472. https://doi.org/10.1007/s10552-021-01541-y

Reason 27

Nagpal, R., Yamashiro, Y., Izumi, Y. (2015). The two-way association of periodontal infection with systemic disorders: An overview. Mediators of Inflammation, 2015(793898). http://dx.doi.org/10.1155/2015/793898

Reason 28

United Concordia Dental. (2014). The Mouth: The Missing Piece to Overall Wellness and Lower Medical Costs [White paper]. www.unitedconcordia.com/ docs/united concordia oral health whitepaper.pdf

Reason 29

The Economist Intelligence Unit. (2021). Time to take gum disease seriously: The societal and economic impact of periodontitis [White paper]. https://impact. economist.com/perspectives/sites/default/files/eiu-efp-oralb-gum-disease.pdf

Reason 30 & 31

Avalere Health. (2016, Jan. 4). Evaluation of Cost Savings Associated with Periodontal Disease Treatment Benefits [White paper]. https://oralhealth.hsdm. harvard.edu/files/oralhealth/files/avalere_health_estimated_impact_of_ medicare_periodontal_coverage.pdf

Reason 32

Oral health: A window to your overall health. (2021, Oct. 28). Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/dental/ art-20047475