“The terms oral health and general health should not be interpreted as separate entities. Oral health is integral to general health: oral health means more than healthy teeth and you cannot be healthy without oral health.” —Donna Shalala, Secretary of Health and Human Services, in Oral Health America: A Report of the Surgeon General, 2000

I could not think of a better way to begin this article than to underscore the effect of oral health on general health. But just how does the former Secretary’s statement correlate to overall health and longevity? Healthy people live longer and the quality of their lives is far superior. There are a number of factors related to the study of health and longevity that almost everyone will recognize. Some of the more common factors include:

1. Healthy diet

2. Intelligent nutritional supplementation

3. Healthy lifestyle

4. Elimination of harmful substances, such as tobacco, alcohol, and drugs

5. Stress reduction

6. Exercise

7. A healthy emotional, spiritual and mental life

Every serious proponent of optimal health understands the relationship between these factors and overall health and longevity; without a doubt, they are all important. However, I suggest that there is another factor missing from this list, one that also plays an often overlooked but substantial role in health and healing. This factor is dental disease and its harmful effect on the overall health of the body.

With that in mind, this article will focus on:

• How dental /oral disease, mercury amalgam fillings, and non-compatible dental materials can affect one’s overall health;

• Why these issues are so important in regard to health and longevity; and

• How physicians and other health professionals can help their patients recognize the

importance of this issue.

You will also discover that if dental disease, with its related oral health issues, is not acknowledged as an obstacle to achieving overall health, any efforts to accurately diagnose and treat disease, improve health, and extend life, will be less effective, and will fall short of the desired goals.

Background

A number of oral health issues can negatively affect systemic health. All but one of the issues listed are the direct result of dental disease, in one form or another. These oral health issues can be divided into two distinct, but overlapping categories.

1. Dental/oral disease. The most important of these in regard to their impact on general health are:

a. Periodontal (gum) disease;

b. Infected root canals;

c. Cavitations (infected extraction sites); and

d. Other diseases of the oral cavity, such as oral cancer

2. Mercury amalgam fillings, non-compatible dental materials and fluoride. All of these dental/oral issues can affect overall health and ultimately, longevity. Their impact is determined by the seriousness of the disease, its duration, and how many of the above dental problems are active in the same person at the same time. Thus, some individuals may be dealing only with problems related to gum infections or mercury amalgam fillings, but there will be a significant number of people whose oral and overall health is being compromised by all of the above dental issues.

If you are to fully understand the impact dental disease can have on overall health, a basic understanding of it is necessary.

Dental Disease

What is commonly referred to as dental disease is actually two separate diseases: tooth decay and gum disease. You can have one without the other, or both simultaneously. The terms “gum disease” and “periodontal disease” are often used interchangeably, even though periodontal disease is a much more destructive form. Technically, gum disease is broken down into two categories: gingivitis, the initial and milder form of gum disease; and periodontitis, the more advanced and serious form that has now infected soft tissue, tooth ligaments and the surrounding jaw bone.

While the basic cause of tooth decay and gum disease is poor oral hygiene (mainly due to a lack of patient education and/or motivation) other factors are involved. Diet, smoking, vitamin deficiency, and toxic substances such as mercury can also contribute to exacerbating dental disease. Of the two diseases, gum disease, especially in its most advanced form, is much more harmful to overall health than tooth decay.

Certainly, tooth decay can have an effect on a person’s overall health. For example, it can interfere with the mastication process and thereby affect digestion. It can cause tooth loss, again affecting digestion. The main difference is that, unlike gum disease, tooth decay is not an infection that has access to the systemic body. Clearly, it can contribute to systemic health problems, but its effects on overall health are significantly less than the effects of gum disease.

By any standards, dental disease should be classified as a worldwide epidemic. Ninety percent of the population of the United States has, or has had, some form of these diseases.

It is estimated that between 30% and 50% of the population has periodontal disease, the most destructive form of dental disease (it is impossible to accurately gauge this figure, as approximately 50% of the population do not see a dentist on a regular basis).

Dental disease can cause:

• Gum disease

• Bleeding

• Abscesses;

• Tooth decay;

• Tooth loss;

• Bad breath; and

• Unsightly teeth.

Dental disease can also generate a great deal of stress. It can create fear and anxiety, pain, and discomfort. It can also be very expensive, especially when the cost of treatment is added up over a lifetime.

As destructive and costly as dental disease is, most people, including dentists and physicians, have somehow managed to convince themselves that its health damaging effects are limited to the teeth and gums. I believe this is because most people tend to think that the mouth is not actually a part of the body . . . or it is somehow “outside of the body”.

I also feel that there is a serious communication gap between the medical and dental professions. This gap, in effect, means that vital information on the oral and overall health of the patient is not normally shared between the two professions. Whatever the reason, the result is that most people, including the majority of health professionals, do not understand the seriousness of this disease and its impact on overall health.

Dental Disease and Its Effects on Overall Health

The fact is, dental disease is not just a minor ailment of the gums and teeth and it can no longer be omitted from the subject of health and longevity. It is a disease of the body that happens to begin in the mouth. If left unchecked it can contribute to, or exacerbate, other more harmful diseases that can seriously affect the quality of life and actually shorten life expectancy. Because of its proven relationship to overall health, health professionals must make every effort to understand this relationship and play a role in providing patients with the basic information they need to address the issue of dental disease. This will be discussed in detail at the end of this article.

Recent scientific studies clearly demonstrate the harmful role gum disease plays in serious and life-threatening diseases. For example, moderate-to-severe gum disease can:

• Increase the risk of heart attack by as much as 25%

• Increase the risk of stroke by a factor of 10

• Increase the severity of diabetes

• Contribute to low pre-term birth weights

• Contribute to respiratory disease

• Interfere with proper digestion

• Play a role in osteoporosis

• Severely stress the immune system

• Lower resistance to other infections

• Actually reduce life expectancy

How Dental Disease Does Its Damage

Various forms of dental disease result in active and long lasting infections, which have been implicated in diminished overall systemic health. Specific infections related to dental disease can contribute to problems such as periapical abscesses (root canals) and cavitations of the jaws. However, the most serious damage to overall health results from the more advanced forms of gum disease. Every health practitioner understands that the body is negatively affected by infection of any kind, regardless of where it is located. Of course, the more serious the infection, and the longer it is present, the greater its potential for affecting systemic health. Infection can also seriously stress the immune system and diminish that system’s ability to deal with other infections and diseases. Its effect on the immune system is directly related to the extent, type, and duration of the infection.

It is important to understand that periodontal disease does not just involve soft tissue. When left unchecked, gum disease will continue to progress until it ultimately infects the underlying bone structure. When this occurs, the periodontal pocket becomes a safe haven for bacteria that continues to destroy more and more bone and soft tissue. The result is that the circulatory system will then be constantly exposed to numerous strains of virulent bacteria and their toxins.

It has been estimated that the infected area in a mild form of gum disease, if laid out flat, would cover an area the size of a postcard. In the case of moderate-to-severe gum disease, the total infected area could cover an area the size of a standard sheet of paper. If this infected area were in the neck (or any other part of the body), any competent health professional would consider this to be a serious infection and suggest immediate treatment.

Yet, this condition is present, and left untreated, in tens of millions of people in the U.S. alone. The extent and severity of an infection is, of course, important, but so is its duration. In the aforementioned example, such an infection is now chronic and would be active 24 hours a day, 365 days per year, for as long as the periodontal disease was present. It is also a progressive disease, increasing in severity over time. Unfortunately, the infection could be present for many years. As a health professional I know it will not be difficult to imagine the stress this type of infection places on the immune system.

Another factor in dental infection is that it may not always be obvious, and even when symptoms are present, the patient will not provide his or her health professional with this information. Often, there is no pain or overt symptoms. It is an insidious disease and, if left unchecked, will continue to destroy both tissue and bone. But whether it remains hidden or not, this infection poses a serious threat to overall health, to treating any health issue, and ultimately to longevity.

Dental Disease and Its Relationship to Other Diseases

An increasing number of studies demonstrate the relationship between dental disease and other diseases of the body. The following section will provide documentation that conclusively links dental disease to other systemic diseases.

Cardiovascular Disease

Heart Attack

A number of studies link dental disease to coronary heart disease. In one study, researchers found a relationship between dental disease and mortality. The study is noteworthy for a number of reasons. It was conducted in the United States and included 9,760 subjects, making it (at that time) the largest of its kind. In addition, several important discoveries resulted from this study.

The study concluded that those with periodontitis (the more advanced form of gum disease) had a 25% increased risk of coronary heart disease compared to those with minimal periodontal disease. It is interesting to note that caries (decay) was not observed to be a factor in coronary heart disease. In men under 50, periodontal disease was an even stronger risk factor. In this group, men with periodontitis had nearly twice the risk of coronary heart disease than men who had little or no periodontal disease. In the total population (men and women of all ages) the degree of dental debris (dental plaque) and calculus (tartar), as reflected in the oral hygiene index, was a stronger risk factor for coronary heart disease than was the severity of periodontal disease.

In regard to longevity, the most noteworthy finding was that periodontal disease and poor oral hygiene were stronger indicators of total mortality than of coronary heart disease. Young men who had a maximum oral hygiene index of 6 had a three to four times higher risk of dying than those who had a hygiene index of 0. In addition, young men with periodontitis had a nearly threefold increased risk of death from coronary heart disease and about a 50% increased risk of admission to hospital for coronary heart disease.

The study also showed that the severity of periodontal disease increased the risk of total mortality more than the risk of coronary heart disease. When compared to subjects with little or no periodontal disease, individuals with gingivitis (the less severe form of periodontal disease) had an approximately 23% higher risk of death. Those with periodontitis or no teeth had about a 50% higher risk of dying. From a health standpoint, these findings could be significant because gingivitis is far more common than the more severe form of the disease.

Another study by K. J. Matilla explored the relationship between oral health and heart attacks. It also examined the role of chronic bacterial infections as risk factors for heart disease, and the association between poor dental health and acute myocardial infarction. The authors used two separate case-control series patients with acute myocardial infarction. The selected patients had worse dental health than controls matched for age and sex. The study showed that the relationship between dental health and acute myocardial infarction remained significant even after adjustment for age, social class, hypertension, serum lipid and lipoprotein concentrations, smoking, presence of diabetes, and serum C peptide concentration (which reflects resistance to insulin).

The study concluded that bacterial endotoxin or similar factors may be related to myocardial infarction and dental health and could not be excluded as causative factors. In addition, a study by K. Paunio showed a relationship between missing teeth and coronary heart disease. While some studies have shown that decay is not a direct risk factor, it can and does cause tooth loss, which has been demonstrated to be a secondary factor in heart attack. I find this significant because both periodontal disease and decay can cause tooth loss.

Stroke

Dental infections have also been associated with stroke. A study by J. Syrjänen showed a relationship between dental infections and a bacterial infection associated with cerebral infarction in males. Another study demonstrated that preceding febrile infection is an important risk factor for cerebral infarction, even when controlled for other established risk factors, such as hypertension, hypertriglyceridemia, smoking, and alcohol use.

Dental and periodontal infections are of bacterial origin. The causative organisms include streptococci, and in adult periodontal infections, mainly spriochetes and gram-negative anaerobic rods. Dental procedures, such as cleanings and periodontal surgery, can also cause transient bacteraemia; but even chewing food can induce transient bacteraemia in the presence of poor oral health.

In addition to the well-known association between dyslipidemia and atherosclerosis, researchers also found an association between elevated TDI and atherosclerosis, independent of dietary habits. This suggests that factors associated with dental disease may contribute to the etiopathogenesis of atherosclerosis. Bacterial infections are also known to cause changes that may create a predisposition to thrombosis. Chronic infections could affect the development of atherosclerosis by immunological or toxic mechanisms.

In a more recent study, researchers examined the relationship between stroke and chronic and recurrent infection. They found that chronic bronchial infection and poor dental status (primarily from chronic dental infection) may be associated with an increased risk for cerebrovascular ischemia. The results of this study suggest that, independent from established vascular risk factors, symptoms of recurrent or chronic bronchitis and poor dental status may be associated with cerebrovascular ischemia. Periodontitis and periapical lesions appear as main contributors to chronic dental disease. Interestingly, periapical lesions, normally resulting from an infected root canal (caused by decay) are also a factor in stroke risk. This is another example of how decay can play a role, however indirectly, in heart disease.

Diabetes

It has long been known that diabetes affects periodontal disease. New studies show that the reverse is also true: periodontal disease can affect diabetes. In an important work by B.L. Mealy, the author cites numerous studies that indicate that the presence and severity of periodontal disease can increase the risk of poor gylcemic control.

One study clearly illustrates the relationship between periodontal disease and diabetes. When compared to diabetic patients with minimal periodontal disease, those with severe periodontal disease have a significantly greater prevalence of proteinuria and a greater number of cardiovascular complications. These include stroke, transient ischemic attack, angina, myocardial infarct, heart failure, and intermittent claudication. The study concludes that the association between disease and severe periodontitis in diabetic individuals requires attention and close cooperation between the physician and dentist.

Several studies reported by Mealy state that treating periodontal complications implicated in diabetes may actually improve metabolic control of the underlying systemic disease state. These studies are important for at least two reasons. First, periodontal disease has been shown to affect the control of diabetes. Second, the American Heart Association now includes diabetes as a major risk factor for heart disease, ranking it with high blood pressure and smoking. Thus, we witness an unfortunate connection: diabetes is on the rise; it is a risk factor for heart disease; and periodontal disease is a risk factor in both.

Low Pre-term Birth Weight

The health and financial problems associated with low pre-term birth weight babies (weighing less than 2,500g at birth) are significant. One study illustrated that these infants are 40 times more likely to die in the neonatal period than normal birth weight infants. At birth, approximately 7% of all babies are in the low birth weight category, yet these babies account for two-thirds of all neonatal deaths.

In another significant study by Offenbacher, et al, researchers found that low birth weight is still the number one cause of infant mortality. It also causes many long-term health problems, including an increased risk of cerebral palsy, epilepsy, chronic lung disease, learning disabilities and attention deficit disorder. The cost, both financially and emotionally, of low preterm birth weight babies is tremendous. In the United States, 1 in 10 births are low birth weight babies. They account for 5 million neonatal intensive care unit hospital days per year at an annual cost of more than $5 billion. The overall cost in terms of suffering and long-term disabilities far exceeds the monetary costs of this problem.

The authors of this breakthrough study have provided new evidence that periodontal disease in pregnant women may be a significant risk factor for low birth preterm weight. The study suggests that 18% of all pre-term low birth weight cases may be attributable to periodontal disease. It also notes that periodontitis represents a previously unrecognized and clinically important risk factor for pre-term low birth weight babies.

Respiratory Infections

Mealy’s evaluation of a number of studies on respiratory infections suggests that the oral cavity acts as a reservoir for potential respiratory pathogens and that oropharyngeal colonization precedes bacterial respiratory infection. While no current studies specifically demonstrate a direct correlation, there is strong evidence that one exists.

There is also evidence that the periodontal pocket may be the source of potential respiratory pathogens. Enterobacteriaceae species have been found in plaque samples from deep periodontal pockets. Also, a number of organisms believed to be common in infected periodontal pockets have been found in bacterial pneumonia. In one study, researchers isolated Actinobacillus actinomycetemcomitans and Fusobacterium species from a case report of pneumonia. Upon clinical examination, the author’s only significant finding was “marked periodontitis.”

Another important study found that the inoculum in anaerobic respiratory infections most often originates from the periodontal pocket. The study showed that these organisms can produce respiratory diseases, such as pulmonary abscesses, with significant morbidity and mortality.

Osteoporosis

Researchers at the University of Buffalo, led by Jean Wactawski-Wende, reported that most people diagnosed with periodontal disease may be at a higher risk of underlying osteoporosis. This study, conducted in 1995 and published in the Journal of Periodontology, is the first large-scale assessment of the relationship between bone metabolism and oral health. The authors reported that if the relationship remains strong in further studies, it is possible that a routine dental X-ray could be used to screen for bone loss. In addition, dentists could provide interventions for preventing and treating osteoporosis that would also combat oral bone and tooth loss.

This landmark study is important because both osteoporosis and periodontal disease are serious public health concerns for tens of millions of North Americans. Osteoporosis affects more than 20 million people in the U.S. and accounts for nearly 2 million fractures a year.

Gastrointestinal Disorders

To date, the most significant relationship between dental disease and gastrointestinal disorders is from tooth loss. The edentulous patient without dentures is the most vulnerable to gastrointestinal and other related problems. However, one study showed that those with dentures are also subject to numerous health problems, directly related to their inability to properly chew their food. This study concluded that most of the subjects showed a low masticatory performance classification. These subjects took more medication for gastrointestinal disorders than those with a higher masticatory performance. Poor chewing was also associated with a decrease in vitamin A and fiber intake, which was mainly the result of lower intakes of fruits and vegetables. This condition seemed more likely to affect women in the study. In the edentulous person with a deficient masticatory performance, reduced consumption of fiber-rich foods that are hard to chew could provoke gastrointestinal disturbances.

Research indicates that changes in food preferences and subsequent nutrient deficiencies are associated with tooth loss. One study provided a sound basis for why the denture wearer does not achieve the necessary breakdown of food substances. The research indicated that the chewing efficiency of those wearing dentures was about one-sixth that of a person with natural teeth. In addition, evidence suggests that nutritional deficiencies, regardless of their cause, are associated with impaired immune responses.

In another important study, researchers collected dietary intake data about the food and nutrient intake of 49,501 male health professionals. The results showed that edentulous participants consumed fewer vegetables and less fiber and carotene, and had higher cholesterol, saturated fat, and calories than participants with 25 or more teeth. They concluded that these factors could increase the risks of cancer and cardiovascular disease.

I would again like to point out that the vast majority of tooth loss is caused by dental disease, either decay or periodontal disease. It is true that once the teeth have been removed, periodontal disease, and its resultant infection, will have been eliminated. But as the above studies point out, the problems facing edentulous individuals do not end with the elimination of periodontal infection. In fact, they face an entirely new set of health problems.

Immune System

All health professionals understand that infection stresses the immune system. It is also obvious that the more serious the infection and the longer it persists, the more the immune system is affected. At some point, the immune system can become so compromised that its ability to resist additional infections and diseases could be seriously diminished. This depletion could put the various body systems at risk and create a domino effect in regard to other diseases, infections and illnesses. It is obvious that dental infections, especially long term periodontal disease and periapical abscesses, have a deleterious affect on the immune system and would jeopardize the successful treatment of any medical treatment.

Other Dental Issues Affecting Health and Longevity

Dental infections are not the only oral health issues confronting individuals who seek improved health and longevity. Nor are they the only problem facing the physician and other health professionals when attempting to successfully treat their patients. A number of other dental issues can increase the risk and severity of other, more serious health issues and diseases. They are:

1. Mercury amalgam/silver fillings;

2. Infected root canals;

3. Infected extraction sites (cavitations);

4. Signs and symptoms of other diseases; and

5. Sensitivity to dental materials.

Amalgam Fillings and the Mercury Issue

Mercury is the most toxic, naturally occurring substance on this planet. It is much more toxic than arsenic, lead or cadmium. It is a potent neurotoxin, not needed by the body and even one atom of it in the body will cause harm. Research indicates that even minute levels of mercury can have negative health consequences, which can vary from person to person.

Because of its extreme toxicity, there is no doubt in my mind that mercury can contribute to, or exacerbate, every health problem we face. Symptoms of mercury poisoning can range from mild to severe, and it can be fatal in acute doses. The most common cause of chronic mercury poisoning is from the release of mercury vapor from amalgam fillings.

Each medium-sized amalgam filling contains about 50% elemental mercury, or about 1,000 milligrams. Numerous studies have proven that mercury is released from amalgam fillings, both as a vapor and etched or abraded particles. When mercury (or other heavy metals) enter the body and accumulate faster than the body can detoxify and remove them, it will gradually build up until an observable toxic state is reached. This will eventually result in numerous symptoms and related health issues directly or indirectly related to chronic mercury poisoning. In the filling, mercury is in its elemental form but when it is stimulated it releases mercury vapor. In addition, bacteria can change elemental mercury in the mouth and intestine to an even more toxic (100 times as toxic) form of organic mercury, commonly referred to as methyl mercury.

Toxic mercury levels are measured in micrograms. Depending on the number of fillings present, measurements of mercury vapor in the mouth can range from between 20 and 400mcg/m3 (microgram of mercury per cubic meter of air) or more. The World Health Organization (WHO) has recognized a time-weighted average for occupational exposure to mercury vapor at 25 mcg/m3. If set higher it believes that those individuals most sensitive to mercury toxicity, the young, the elderly, the fetus and nursing baby will be adversely affected.

The Agency for Toxic Substances and Disease Registry (ATSDR) takes the most prudent and realistic approach to mercury vapor exposure. After a lengthy study it established a minimal risk level (MRL) of 0.2 mcg/m3 of air. According to the agency, this is the upper limit to which a person can be continuously exposed without exhibiting any observable effects. This makes the most sense because anyone with amalgam fillings is being exposed to mercury vapor 24 hours a day, 365 days a year . . . for as long as the fillings are present.

The toxicity of mercury is undisputed. Mercury can impair the function of the blood and cardiovascular system. It can interfere with, or overload, the natural detoxification pathways of the liver, kidneys, skin, and bowel. It can impair the function of the nervous, endocrine, enzymatic, gastrointestinal, reproductive, and urinary systems. It can increase allergic reactions and act as an antibiotic, killing both good and harmful bacteria in the gut. Mercury can also cause a great deal of tissue damage by creating an abundance of free radicals, suspected to be one of the underlying causes of all degenerative diseases.

One study indicated that mercury can interfere with leukocytes. It also showed how it could not only compromise host defense, but also promote tissue injury via the local production of oxygen metabolites. Another study demonstrated that mercury can inactivate neutrophils.

These important immune system components are responsible for killing fungi inside the body (blood and soft tissue). Mercury poisoning was also shown to inhibit their ability to kill Candida. But the secondary effects of chronic mercury poisoning can also have devastating effects on health by depleting it of the important antioxidants the body needs to not only remove mercury and other heavy metals, but to fight free radicals and other toxins. This happens because each atom of mercury that is removed from the body requires an escort of 1 to 2 molecules of glutathione (GSH), the body’s most abundant and important antioxidant.

Because of this dynamic relationship (even if the input of mercury stays the same), over time more and more glutathione will be lost. This eventually results in a deficiency of GSH and an increase in mercury being stored in the body. This indirect, or secondary, effect of mercury is devastating to the immune system and can seriously reduce the body’s effectiveness at dealing with free radicals, toxins and other infections and diseases.

Yet, not everyone with mercury amalgam fillings will immediately show signs or demonstrate obvious symptoms of chronic mercury poisoning. The short and long-term effect of chronic mercury poisoning is related to the number of fillings, the length of time the fillings have been in the mouth, the health of the individual and the body’s ability to naturally rid itself of mercury. I believe that whether or not patients with amalgam fillings presently have any symptoms of mercury toxicity, they will still have mercury stored in their bodies and if mercury is in their body it is being poisoned, to one degree or another. Eventually even those people will begin to show symptoms related to mercury poisoning. There is no doubt in my mind that chronic mercury poisoning can be the most important dental problem to consider when treating patients in a holistic manner. Of course, there are many tens of millions of people who have both mercury amalgam fillings and gum disease, which when combined could dramatically weaken the body’s ability to effectively deal with any other health issue.

Mercury Amalgam Controversy

For over 150 years the American Dental Association (ADA) stated that mercury was not released from an amalgam filling. The long-standing controversy about whether mercury is released is over and the ADA now admits that it can no longer defend its position that mercury is locked into the filling. In its place they now claim that even though they admit that mercury is released from amalgam fillings, it is not enough to create a health hazard (except for those sensitive to it).

Yet we know that any amount of mercury in the body will cause harm to it and the more that is present the more harm will be caused. There are so many variables involved in how much mercury can be released from an amalgam filling that it is impossible to say who or who will not manifest overt symptoms of chronic mercury poisoning.

I have no doubt that any prudent health professional, knowing that a patient was continuously exposed to mercury on a daily basis, would want to make sure that the source of the poison is eliminated and initiate a mercury detoxification protocol. (A fecal metals test can be done to help determine a patient’s body burden of mercury.)

Sources

There are many sources of mercury exposure, including food (mostly mercury-contaminated fish), air, water, cosmetics, medications, and industrial occupations. However, according to the World Health Organization, the single biggest contributor of mercury to the body is amalgam fillings.

Symptoms

A wide variety of symptoms is related to chronic mercury poisoning. Because mercury can be stored in virtually every cell, organ, and tissue (particularly the brain, kidneys, and nervous system) of the body, its symptoms are vast. Of course, other health issues could contribute to these symptoms, or even cause them; clearly, no single symptom is specific to chronic mercury poisoning. Certainly if any of these symptoms are present in a patient with amalgam fillings their effect must be taken into consideration.

It is also important to realize these symptoms can be directly proportionate to the number of fillings and the length of time they have been in the teeth. Although this is a long list, I feel it important to include it here. You can use this as a checklist (see Figure 1) when diagnosing your patients for chronic mercury poisoning.

1. Neurological/mental

a. Slurred speech

b. Memory loss

c. Learning disorders

d. Lack of concentration

e. Fine tremor

2. Heart

a. Rapid heart rate

b. Irregular heartbeat

c. Pain in chest

3. Head Area

a. Dizziness

b. Ringing in ears

c. Faintness

d. Insomnia

4. Energy Levels

a. Chronic tiredness

b. Apathy

c. Restlessness

5. Emotions

a. Mood swings

b. Fits of rage

c. Fear and nervousness

d. Anxiety

e. Depression

f. Aggressiveness

g. Confusion

6. Digestive System

a. Loss of appetite

b. Diarrhea/constipation

c. Loss of weight

d. Nausea/vomiting

e. Cramping

7. Oral/throat

a. Chronic coughing

b. Bleeding gums

c. Bone loss

d. Metallic taste

e. Inflammation of the gums

f. Bad Breath

g. Ulcers of oral cavity

h. Mouth inflammation

i. Sore throat

8. Muscles & Joints

a. Muscle aches

b. Joint aches

c. Stiffness

9. Nose

a. Inflammation of the nose

b. Sinusitis

c. Excessive mucus formation

d. Stuffy nose

10. Other

a. Hair loss

b. Water retention

c. Vision problems

d. Skin problems

e. Frequent illnesses

f. Sense of smell loss

g. Genital discharge

h. Unspecified allergies

i. Excessive perspiration

j. Anemia

k. Kidney disease

l. Candida

11. Lungs

a. Asthma/bronchitis

b. Shortness of breath

c. Chest congestion

d. Shallow respiration

The Effect of Mercury from Amalgam Fillings on Autism and Other Learning Disorders

The fact is that the first time a person can be exposed to mercury from amalgam fillings is at the moment of conception if the mother has these fillings. Thus, during the critical period of development the fetus is being continually exposed to mercury. The amount of exposure depends on many factors but must be taken into consideration in regards to its effect on Autism and other learning disorders. As mercury also passes into breast milk this exposure will also continue during breast feeding. Of course the baby’s exposure to organic mercury from Thimerosal in vaccinations is also a factor that must be taken into consideration when evaluating the effect of mercury on the fetus and nursing child. Every pediatric health practitioner should be well versed in this important relationship when consulting with his or her patient.

This section on mercury does not allow the space needed to cover this important health issue in detail but it should provide enough information for you to acknowledge that mercury could be a major contributing factor in your patients’ health problems. In order to fully understand the relationship of chronic mercury poisoning to overall health I strongly recommend that you read A Mouth Full of Poison: The Truth about Mercury Amalgam Fillings and Your Complete Guide to Mercury Detoxification: How to Safely Remove Mercury from Your Teeth and Body. These books are available at www.dentalwellness4u.com.

Root Canals

The idea that a root canal can cause health problems is not new. In the 1930s and 40s, Dr. Weston Price dealt with this subject in two classic books, Dental Infections-Oral and Systemic, Volume I, and Dental Infections and the Degenerative Diseases. The subject of root canals and their relation to general health is also thoroughly examined in Dr. George Meining’s book, Root Canal Cover-Up.

The idea is called the “focal infection theory.” It is based on the fact that traditional root canal therapy cannot guarantee that the inside of the tooth’s canal, and the thousands of dental tubules (3-5 miles) that radiate out from the canal, can always be effectively sterilized. The theory proposes that an infection (and related toxins produced) existing in one part of the body can be transferred, via the circulatory system, to other parts of the body where they can initiate an entirely new infection. Such an infection, resulting from an infected root canal, can migrate and infect the kidneys, the heart, intestines, and other sites. Some researchers claim that health problems resulting from root canals rank in severity right behind mercury/amalgam fillings.

In 2002, at least 60 million root canals were performed. While I do not believe that every root canal will be a source of focal infection, I do believe it must be considered when attempting to diagnose a patient’s illness. The root canals that I consider to be at risk are those whose infection has spread to the bone surrounding the root tip. Looking to the mouth as a source of chronic infection is especially important when the source of a health problem is elusive or an accurate diagnosis cannot be made.

Cavitations

Cavitation is a relatively new dental term. It refers to the destruction of bone in the area where a tooth has been extracted or where there is/was a root canal filled tooth. One of the most common problems that can result from a cavitation is a neuralgia inducing cavitational osteonecrosis (NICO). According to experts, if the tooth is not removed properly, complete healing will not take place, leaving a hole or spongy place inside the jawbone. In some cases, particles of the periodontal membrane, along with bacteria, can be left behind, becoming a breeding ground for bacteria and their toxins. Studies indicate that the bacterial waste products can be extremely potent. Many holistic/biological dentists believe that cavitations can also contribute to focal infections and thus can have an impact on systemic health.

Signs and Symptoms of Other Diseases

Diseases whose early signs and symptoms appear in the mouth can affect the patient’s overall health and life expectancy. Of these, oral cancer is of primary concern. More than 30,000 people are diagnosed with oral cancer each year. If the cancer is caught early, the five-year survival rate is 90%. If it is not caught early, the survival rate drops to 50%. As a physician or health professional, you may not be responsible for screening your patients for oral cancer. However, considering that only 50% of the population sees a dentist on a regular basis, many of your patients will not be regularly screened for oral cancers at the dental office. It would be prudent to suggest that your patients make this screening a part of their total health assessment. This means a recommendation by you for them to visit the dentist or an ear/nose/throat specialist.

The early detection of any of the following diseases increases the possibility of successful treatment, and may extend or even save lives. Some of the more serious diseases that may first show signs in the oral cavity, lips, or tongue, include leukemia, hemophilia, Kaposi’s sarcoma, malignant melanoma, syphilis, diabetes, squamous cell carcinoma, myoblastoma, tuberculosis, epilepsy, and hemangioma. My book, Tooth Fitness: Your Guide to Healthy Teeth, includes an educational chapter about patient oral self-examination and its importance to dental and overall health.

Sensitivity to Dental Materials

Sensitivity to dental materials may not be a serious problem for many people. But for those who are allergic to any one of the 2,000 different metals, compounds, chemicals, and products used in dentistry, these materials present a potentially serious health hazard. A physician may treat a patient for allergies and look at every potential source of it except for the mouth. If you are unable to track down the culprit, I recommend that patients be tested for potential allergic reaction to dental materials.

Fluoride

Although it poses a potentially serious health hazard, the subject of fluoride is not within the scope of this article. It does relate to teeth, but is not really a dental health issue. I see it as a public health issue, as the greatest single source of fluoride is delivered to the individual via the municipal water systems. Regardless of how it is delivered, fluoride is a poison, and increasing evidence suggests it can create, or contribute, to many health problems. I suggest evaluating for potential fluoride toxicity when doing a complete health assessment of your patient. This would be particularly important if you cannot establish a diagnosis that fits the symptom exhibited by the patient.

It should be noted that today people are exposed to far greater quantities of fluoride than 25 years ago. At that time, the major source of fluoride exposure was fluoridated water. Today, it is also found in mouthwash, toothpaste, rinses, and tablets. Some evidence shows that fluorosis has affected children in areas where the water is not even fluoridated. No one knows how much fluoride each individual is getting. Fluoride poisoning is definitely something to watch for, especially in communities where the water is fluoridated.

Surgeon General’s Report

The Surgeon General’s Office released a landmark study, Oral Health in America: A Report of the Surgeon General, in 2000. It focused on the seriousness of dental disease, its proven impact on general health, and the need for improved patient education. I will not elaborate on the report here. However, I believe that as the public becomes more aware of the effects of dental disease on health, your patients will appreciate that they heard about it from you first. In fact, they may expect to hear it from you first. This is something for every physician and health professional to think about.

Real Age Evaluation

I believe it appropriate to comment about the effect of dental disease on longevity. In a book by Dr. Michael F. Roizen, Real Age: Are You as Young as You Can Be?, he offers a revolutionary, systematic approach to calculating the aging effect of more than 100 different health behaviors. These range from diet and medication to stress control and dental disease.

He cited one study that showed people with gingivitis and periodontitis have a 23% to 46% higher mortality rate. Another study indicated that men under age 50, who have advanced periodontal disease, are 2.6 times more likely to die prematurely and three times more likely to die from heart disease than those who have healthy teeth and gums. Both studies considered other pertinent factors, such as smoking, alcohol, and overeating. Studies have also shown that a bacterial strain commonly found in tooth plaque has also been found in the fatty deposits that clog arteries. Other studies demonstrate that periodontal disease increases the white blood cell count, an indicator that the immune system is under increased stress.

Dr. Roizen concluded that dental disease and tooth loss do not just make you look older, they actually make you older. Indeed, periodontal disease can make our Real Age more than 3.4 years older. Conversely, the absence of periodontal diseases makes you 6.4 years younger than the median person.

As a health practitioner, it is your responsibility to do all you can to not only improve the health of your patients, but to extend their lives. I suggest that this extend to considering the effect of your patients’ oral health on their overall health. This is even more important if you are specializing in longevity medicine.

Conclusions

The long-held belief that dental disease is a localized, minor disease that only affects the teeth and gums has not withstood the test of time. Dental disease, and other issues related to the mouth, can contribute to serious health problems. They can also interfere with successful medical treatment and healing; and can actually shorten life expectancy.

I believe that the evidence supporting the relationship of oral health in systemic diseases is conclusive. As a health professional, I believe you cannot afford to overlook this relationship when treating a client for any disease, or when offering a program to extend life expectancy and improve the quality of life. If a patient suffers from any of the symptoms and systemic diseases mentioned in this article, you must determine if periodontal disease, mercury amalgam fillings, or another oral health issue could be contributing to its cause or severity. Certainly, you want to ensure that you have at least eliminated dental disease or chronic mercury poisoning as a possible cause of, or contributor to, your patient’s health problems.

Neglecting the issue of oral health, in my opinion, jeopardizes the success of treatment and could lead to disappointing outcomes. It could also result in great frustration for you and your patient. While there is no legal responsibility to include an assessment of a patient’s oral health, I do believe there is a moral and ethical one.

Solutions

Discussing problems without offering solutions does not have much value. Therefore, I will offer some solutions to help you address the problems of dental disease and its effects on overall health. I am not suggesting that you become a dentist or provide any form of dental treatment to your patients. Yet, it is vitally important to address the issue of oral health, especially since it could affect the success of your treatment and/or longevity program.

Every health professional understands that successful treatment hinges on making an accurate diagnosis. In order to make a truly ‘whole body’ diagnosis you must be aware of the condition of your patient’s oral health. And the patient must understand the importance of oral health when participating in any effort to eliminate disease and extend the length and quality of life.

My suggestion is that you determine if your patient is presently under the care of a dentist. If not, strongly recommend that they make an appointment for a complete oral health assessment. Inform your patients that you will need an evaluation from their dentist regarding the status of the following:

1. Their periodontal health

2. Whether or not they have any infected root canals

3. The condition of extraction sites, if any

4. Whether or not they now have amalgam fillings, including how many

5. Whether or not they have been examined for other diseases whose early signs and symptoms are found in the mouth

If the results show that the individual has no oral health problems, it will allow you to at least eliminate these oral health issues as a potential health risk factor. If the report shows that oral health problems exist, you will be doing your patient a service by informing him or her that, unless the necessary steps are taken to deal with these oral issues, your treatment of their health issues may be less successful. In patients with numerous oral health problems, it would also be beneficial to contact and work directly with their dentists.

Neither you nor their dentist can prevent this disease for them, but you can help support their efforts to have it treated. If your patients are willing to do their part, your treatment will be more successful. If they are not, you will at least know that you have fulfilled your responsibility. In effect, doing so will also provide you with a disclaimer if a patient does not take care of his or her oral health issues.

Tom McGuire, D.D.S. received his B.S. at San Francisco State University and his D.D.S. at the University of the Pacific School of Dentistry, San Francisco. He is President of The Dental Wellness Institute, Founder of the International Association of Mercury Free Dentists (IAMFD), and a member of the International Academy of Oral Medicine and Toxicology (IAOMT). Dr. McGuire has been an innovator and leader in preventive dental education for over 30 years. He founded the Dental Wellness Institute in 1997 with the goal of bridging the gap between the dental and medical professions. He is the author of two best sellers, The Tooth Trip (Random House, 1972) and Tooth Fitness: Your Guide to Healthy Teeth. He has lectured and written articles on oral health and is considered one of the few recognized authorities on the subject of holistic dental wellness. His innovative Dental Wellness Education Program has been utilized by the dental profession, businesses, schools, and dental insurance companies.

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