Oral health care prevents chronic diseases and improves physical fitness

PUCRS’s Dentistry PPG investigates the relationship between oral diseases and the emergence of other illnesses in the human body/ Photo: Bruno Todeschini

Throughout childhood, parents often remind their children to brush their teeth, floss, and visit the dentist. These good habits are usually recommended to prevent cavities, gingivitis, and other dental complications. However, researchers around the world have shown that maintaining good oral health is associated with a reduced risk of several chronic noncommunicable diseases, such as atherosclerosis, cardiovascular disease, diabetes, and even mortality.  

Chronic non-communicable diseases are those that develop over the course of a lifetime, often slowly, silently and without presenting symptoms. According to figures from the World Health Organization (WHO), these are responsible for 63% of deaths worldwide and are the cause of 74% of deaths in Brazil. Graduate Program in Dentistry at PUCRS, researchers seek to understand how infections and diseases of oral origin are associated with the worsening of other diseases in the human body.  

Um meta-analysis study A study conducted in partnership between PUCRS and the Federal University of Santa Maria (UFSM) showed that approximately 50% of adults in the world have at least one tooth with endodontic lesions throughout their lives, highlighting this disease as one of the most common in humanity. As explained by the coordinator and professor of the Graduate Program in Dentistry, Maximiliano Schunke Gomes, these data reveal that oral diseases are more prevalent than many other well-known diseases such as cancer, diabetes and cardiovascular diseases.  

“We need to increasingly discuss oral health, with more awareness-raising actions and public policies so that society understands that oral pathologies go beyond the presence of cavities or merely aesthetic issues, but have an important relationship with the health of the organism as a whole”, highlights the researcher.  

Oral and cardiovascular diseases 

The emergence of cardiovascular diseases and strokes are associated with the presence of oral diseases/ Photo: iStock

Analyses conducted by PUCRS researchers reveal that cavities and endodontic, gingival and periodontal infections have an influence not only on the teeth, mouth or gums, but also impact the individual’s blood circulation. According to Gomes, this happens because bacteria of oral origin can travel through the bloodstream, in addition to the immunological repercussions arising from the presence of oral infections and inflammations, which modify mediators of the inflammatory pathways throughout the body.  

A few years ago, a published study by Professor Maximiliano Gomes’ team in partnership with the University of Maryland (USA) presented longitudinal analyses with up to 40 years of follow-up in a group of North American patients, with the aim of understanding the impact of the presence of endodontic infections in the long term. 

The research showed that patients who had a higher burden of endodontic diseases at the beginning of the study had a 77% higher risk of developing cardiovascular complications (angina, acute myocardial infarction or even death due to cardiovascular reasons) in the long term, regardless of age, sex, or even the presence of comorbidities such as obesity, dyslipidemia, diabetes, among other factors. 

In other studies conducted at PUCRS, patients from Neurology Service of São Lucas Hospital, affected by Ischemic Stroke (CVA). The disease occurs when there is a sudden change in cerebral blood flow, compromising blood circulation in the brain region, which can cause reversible effects as well as irreversible sequelae such as changes in speech and movement and even death. 

In her doctoral thesis, completed at the Graduate Program in Dentistry at PUCRS, Professor Thayana Leão analyzed more than 400 patients who had suffered strokes, seeking to understand the association between the presence of oral diseases and the after-effects caused by the accident. Three recent studies resulting from her thesis were published in international scientific journals, showing that individuals who had fewer natural teeth and worse oral health conditions had a significantly increased risk of having a stroke and of presenting worse recovery outcomes. 

“Based on the results of the research being conducted at PUCRS, together with other evidence from other studies conducted at research centers around the world, we can relate the presence of oral problems to a higher risk of cardiovascular disease, regardless of the already known risk factors such as obesity, smoking and others. An unprecedented aspect that the results of our studies suggest is that stroke patients who have a higher burden of oral complications are associated with more severe consequences of the stroke, including the risk of death.”, highlights Gomes.  

Oral health and fitness 

The presence of oral lesions also affects physical fitness/ Photo: Bruno Todeschini

Another relationship studied by the researcher and his research group is the possible association between oral health and physical fitness. Studies currently underway at the Graduate Program in Dentistry at PUCRS have been analyzing whether there is any relationship between the presence of oral lesions and physical fitness. Preliminary results of studies on animal models conducted at Cembe suggest that rats with oral lesions do not become physically fit in the same way as animals without lesions, even after training for the same period of time. Thus, as explained by Professor Maximiliano Gomes, other studies are underway to investigate the hypothesis that oral lesions reduce or even cancel out the beneficial effects of aerobic physical fitness and also of anaerobic training.  

Two previous studies by the research group, which analyzed a group of military police officers, statistically demonstrated that those individuals who had a greater burden of oral diseases did not achieved such high levels in the physical fitness test (TAF), even if they trained regularly, regardless of other factors such as age or body mass index. 

“These are initial results that suggest that these silent oral lesions possibly affect physical fitness. It is no coincidence that dentists currently work in high-level sports teams, precisely to prevent these infections and inflammations of oral origin.”, concludes Gomes. 

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