Thursday, November 7, 2013

Clean teeth, clean heart

image: imgur
OK, so the Halloween candy is gone...unless you are very disciplined, so how about some help with post-candy tooth brushing?

Yes, I know, you've been doing this for awhile now and are probably an expert. Or are you?

For those uncertain about their brushing and flossing techniques or frequency, here is a helpful guide.

OK, here is the real helpful guide.

Why am I bothering with a post on teeth-brushing?

I, for one, have gotten lazy about brushing lately, plus it's important for more than just your teeth and gums.

image: VetHammond
Good oral hygiene is associated with lower risk of heart disease: among the nearly 12,000 participants in a study in Scotland, those who reported poor oral hygiene (they never or rarely brushed their teeth) had a higher risk of cardiovascular disease (mainly coronary heart disease) and low-grade system-wide inflammation.

And yes, the analysis made adjustments for "age, sex, socioeconomic group, smoking, visits to dentist, BMI, family history of cardiovascular disease, hypertension, diabetes, and acute infections (including influenza, pneumonia, bronchitis, and upper respiratory tract infections in the three weeks before assessment)". I wondered about that too. They really tried to consider just the effects of personal oral hygiene!

How are clean teeth related to your heart?

The scientists did not determine the reason for the cleaner teeth- lower heart disease connection, but they are exploring the importance of system-wide inflammation.

a party you want to close down early!
image: ToothMonster
Periodontal disease, a relatively common chronic infection of the tissue surrounding the teeth, is caused mainly by poor oral hygiene. It leads to a loss of connective tissue and bone support of the teeth, which causes gums to separate from the teeth.

It also produces inflammation throughout the body. Diseased gums have been shown to release higher levels of bacteria-generated toxic substances into the bloodstream than healthy gums do.

Scientists have found a consistent association between biological markers of this type of low-grade inflammation (which they can measure) and a higher risk of heart disease, thus their interest in periodontal disease as well.

By keeping your teeth and mouth clean, you lower the chance of infection, which, in turn, lowers the risk of inflammation and related broader health problems.

How do cavities form?

The establishment and progression of cavities (caries), depends on 3 main factors:

1. the animal or person's health status, age, genetic makeup, and tooth shape/size, etc
2. the types of bacteria that find their way to the animal or person's mouth (some are more virulent)
3. the individual's diet, as certain foods, such as those high in calcium, promote strong teeth, while others, mainly carbohydrates, promote the growth of harmful bacteria.

Tooth decay is caused primarily by certain types of bacteria that produce acid when they get their hands, so to speak, on fermentable carbohydrates, such as sucrose, fructose, and glucose.

easy to keep those front surfaces clean
image: DenverAnimalCenter
Tooth enamel is made primarily of minerals, which get broken down by the acid these bacteria produce. Saliva, mouthwash, and the flouride in toothpaste help to "remineralize" teeth by neutralizing the acid and raising the pH in the mouth back up to a non-acidic level (above 5.5).

There is a back-and-forth between the bacteria generating this acidic environment and the saliva/toothpaste taking it away. Thus, foods that contain calcium or that help you produce saliva are thought to help protect teeth.

Most cavities develop in between teeth or in the grooves of our teeth that are harder to reach with a toothbrush. Areas that we can easily brush, such as the front and back surfaces, develop fewer cavities.

How do animals keep their teeth clean and healthy?

But what about all those animals out there -- they don't brush OR floss, so why don't they run around with periodontal disease and related coronary heart failure?

While tooth decay is common among pets, it is rare among wild animals, though it becomes more common with age. How do they avoid the problem?

Siberian tiger cleaning teeth with dry grass
© Konrad Wothe /
A) For one, wild animals don't eat much in the way of carbohydrates (sugars, starches), so they provide much less food to cavity-causing bacteria. Cavities in wild animals tend to result from injury, rather than diet, whereas those in domesticated animals tend to stem from food lodged in between teeth, like those of humans.

A 1945 study of tooth decay in North American carnivorous mammals found that bears, which eat berries and honey, had a greater tendency to have tooth decay than other large mammals (including polar bears, which eat seals - no honey or berries at the Arctic Circle). Though not conclusive, the author suggested that their dietary specialization might cause bears to experience greater tooth decay.

B) In nature, herbivores eat fiber-loaded plants, while carnivores chew on the bones of their prey. In both cases, their chewing on tough material mechanically cleans food particles from their teeth as they eat. Multi-tasking!

Some also chew and gnaw on things, including grasses and bones, to further remove food stuck in their teeth, like we use dental floss and a toothbrush. In fact, pre-toothbrush humans (and some cultures still today) rubbed their teeth with frayed sticks from certain trees to remove food particles.

C) They grow or start to use new teeth. Eating plants gradually wears down teeth, so some herbivores use only some of their molars at any given time.

These emerge and move forward gradually, wear down, and are replaced by the ones behind them. Many mammals have two sets of teeth as we do, but they tend not to outlive their teeth. Elephants replace their teeth 6 times in a lifetime, which reflects their naturally long lifespan (when left in peace, they live for decades).

Sharks, on the other hand, develop new teeth every two weeks or so, so they are always ready to attack.

"Sharks look friendlier with human teeth"!    image: HuffingtonPost

D) At least one Japanese macaque has learned to floss its teeth, though it's not clear if s/he has communicated this skill to others! (This video shows Chompe in action).

E) They get help from others. The relationship between the Egyptian plover and the Nile crocodile is mutualistic, that is, it benefits both species and harms neither. The crocodile gets a nice teeth cleaning, and the plover gets lunch. Win-win.

Egyptian plover cleans the teeth of basking
Nile crocodiles    photo: Bio390Parasitology
a cleaner shrimp cleaning the mouth of a moray eel.
I'll bet it tickles!    photo: Brocken Inaglory, Wikimedia

Cleaner fish and shrimp perform similar services on marine fish, gaining a meal and cleaning their clients' mouths and teeth at the same time.

Is that better or worse than a trip to the dentist??


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