Dental Health and Overall Health

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Healthy mouth, healthy body: The link between them may surprise you.

The condition of your mouth is closely tied to your overall health. Find out how oral health is linked to diabetes, heart disease, cancer, and more.

Taking care of your teeth isn’t just about having a nice smile and pleasant breath. Recent research has found a number of links between oral health and overall health. While in many cases, the nature of this link still isn’t clear — researchers have yet to conclude whether the connections are causal or correlative — what is certain is that the condition of your mouth is closely tied to your overall physical health.

Oral Health and Diabetes

Doctors have known for years that type 2 diabetics have an increased incidence of periodontitis, or gum disease. In July 2008 the connection was further highlighted: Researchers at Columbia University’s Mailman School of Public Health followed 9,296 nondiabetic participants, measuring their level of periodontic bacteria over the course of 20 years. “We found that people who had higher levels of periodontal disease had a twofold risk of developing type 2 diabetes over that time period compared to people with low levels or no gum disease,” explains Ryan Demmer, PhD, associate researcher at the department of epidemiology at the Mailman School and the lead author. While more research is needed before doctors can conclude that gum disease actually leads to diabetes, there are already a few theories about why this might be the case: One proposes that when infections in your mouth get bad enough, they can lead to low-grade inflammation throughout your body, which in turn wreaks havoc on your sugar-processing abilities. “There are all kinds of inflammatory molecules,” says Dr. Demmer, “and it’s believed that maybe some attach to insulin receptors and prevent the body’s cells from using the insulin to get glucose into the cell.”

Oral Health and Heart Disease

As with diabetes, the connection between poor oral health and cardiovascular conditions has been recognized — the two are often found together — but it still hasn’t been determined conclusively whether or not there is a direct causal relationship between them. (One reason is that there are a number of other potential risk factors — such as smoking and old age — that can lead both to gum disease and heart disease.) However, in a 2005 study funded by the NIH, 1,056 randomly selected participants with no prior heart attacks or strokes were evaluated for levels of periodontal bacteria: After removing the effects of the other risk factors of age, gender, and smoking, it was found that there was an independent relationship between gum disease and heart disease, says Moise Desvarieux, MD, PhD, associate professor of epidemiology at the Mailman School and lead author of the study. One theory about why this may occur, says Dr. Desvarieux, is that small amounts of bacteria enter your bloodstream while you’re chewing. “Bad” bacteria from an infected mouth may lodge itself inside blood vessels, ultimately causing dangerous blockages. Strengthening his theory is the fact that when scientists have looked at atherosclerotic blood vessels, they have sometimes found fragments of periodontal bacteria. Meanwhile, a study published in the New England Journal of Medicine in 2007 established that aggressive treatment of gum disease reduces the incidence of atherosclerosis within six months.

Pregnancy Complications and Gum Disease

For many pregnant women, gum infections stem from the fluctuating hormone levels that come with pregnancy, says Marsha Rubin, DDS, practicing diplomat of special-care dentistry at New York-Presbyterian/Weill Cornell, who sees many pregnant patients in her practice. Others neglect their oral care during pregnancy, since they have much on their minds, she adds. But that’s a mistake: Scientists believe that gum disease or inflammation in the mouth possibly triggers an increase in a chemical compound called prostaglandin, which induces early labor. While this theory has not yet been confirmed, a 2001 study found that pregnant women who develop gum disease between weeks 21 and 24 are four to seven times more likely to give birth before week 37. There is evidence that poor gum health in the extreme can lead to low birth weight as well. A number of studies — including a 2007 study of 3,567 Turkish women and a 2007 study of 1,305 Brazilian women — found a relationship between periodontal disease, preterm birth, and low birth weight.

Pneumonia and Gum Disease

There has been a link established between poor oral health and pneumonia, though much of the research focuses on high-risk populations. A 2008 study of elderly participants found that the number who developed pneumonia was 3.9 times higher in patients with periodontal infection than in those free from it. “The lungs are very close to the mouth,” says Rubin. “Even in a healthy mouth there is lots of bacteria, but bacteria in a not-healthy mouth can get aspirated into the lungs, causing pneumonia or aggravating COPD, chronic obstructive pulmonary disorder.” Several intervention studies cited by the CDC show that an improvement in oral health can lead to a reduction in respiratory infection.

Pancreatic Cancer and Gum Disease

A study published in 2007 in the Journal of the National Cancer Institute surveyed 51,529 American men about their health every two years between 1986 and 2002. Of the 216 participants who developed pancreatic cancer, 67 of them also had periodontal disease. Independent of the participants’ smoking status, the study found that having a history of periodontal disease was associated with an increased risk of pancreatic cancer. This, according to the study, could be because of systemic inflammation or increased levels of carcinogenic compounds produced in the infected mouth. Interestingly, another viable theory about why gum disease may cause type 2 diabetes points to damage to the pancreas as well. “With the pancreatic cancer study, we thought it was very interesting that you have this localized infection that has an impact on a systemic organ that is very intimately tied to the pathophysiology of diabetes,” says Dr. Desvarieux. Reasons for why this might be are as yet unknown.

Multivitamins: Should You Take One?

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Food is the best source of most nutrients, but a multivitamin can help provide what your diet doesn’t. Find out what to look for in a daily multivitamin.

Our bodies need many different vitamins and minerals to function properly.

Vitamins and minerals also offer us protection against a host of ailments, including heart disease and some cancers, such as colon and cervical cancer.

The good news is that we can get most of the vitamins and minerals our bodies need daily by choosing the right foods and eating a wide variety of them.

Still, many people take a multivitamin daily as an insurance policy — just to be sure they are getting all the vitamins and minerals that their bodies require.

“A multivitamin is a good idea for the trace elements,” says Donald Novey, MD, an integrative medicine physician with the Advocate Medical Group in Park Ridge, Ill.

“You want a multivitamin for all those little things at the bottom of the ingredients list. The ones at the top of the list are familiar and the ones we can’t avoid if we’re eating enriched foods. It’s the trace elements at the bottom that are the ones often missing.”

Trace elements include chromium, folic acid, potassium, iron, manganese, selenium, and zinc.

Daily Vitamin: Our Needs Change With Age

Vitamin supplements can be particularly important during certain stages of our lives, Dr. Novey says. For example, women in their childbearing years can benefit from folic acid, which decreases the risk of some birth defects. A pregnant woman needs a multivitamin, starting in the first trimester, to ensure that the baby receives proper nutrition. Active and older women can benefit from increased calcium, which can help prevent bone loss and fractures. Vegetarians also can benefit from taking extra calcium, iron, zinc, and vitamins B12 and D.

Does it matter what time of day you take a multivitamin? Not really, says Stephen Bickston, MD, AGAF, professor of internal medicine and director of the Inflammatory Bowel Disease Center at Virginia Commonwealth University Health Center in Richmond. However, he says, some people find it helpful to take vitamins at the same time every day. If it becomes part of their routine, they are less likely to forget. Also, he says, some people feel that if they take their vitamin with food, it is less likely to cause stomach upset. “I often recommend that people take a chewable vitamin,” Dr. Bickston says, “because they seem to be well tolerated, even in people who have serious digestive conditions, which is what I deal with in my practice.”

Daily Vitamin: Tips for Shopping for the Right Multivitamin

Do you need to buy brand name vitamins? Novey says vitamins are like any other consumer product: “You get what you pay for.” He suggests shopping for vitamins in health food or natural food stores. Read the label and make sure its expiration date is at least a few months away. The U.S. Food and Drug Administration’s advice on how much to take — or the Recommended Daily Allowance (RDA) — is often written as “% DV” for percentage of daily value on the label. However, be careful because the DVs on the label may not take into consideration the different requirements for age and gender as RDAs do.

Multivitamins can be beneficial, but doctors warn not to be suckered by “mega” vitamins. The amount of vitamins in a standard multi is generally what you need for health benefits. Rarely do people need more than the RDA of any vitamin. When it comes to vitamins, the too-much-of-a-good-thing rule can apply, Bickston says.

Daily Vitamin: Ensuring Good Health

Clearly, eating a variety of fresh fruits and vegetables, whole grains, fish, lean meats and poultry, and low-fat dairy products is the best way to get your daily dose of vitamins and nutrients to keep your body functioning properly and to ward off illnesses. But taking a multivitamin daily is a good backup plan, and an easy way to fill in any gaps in your diet.

A Guide to Good Personal Hygiene

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Proper grooming and healthy personal habits can help you ward off illnesses and feel good about yourself. Find out which personal hygiene habits should be part of your regular routine.

Personal hygiene habits such as washing your hands and brushing and flossing your teeth will help keep bacteria, viruses, and illnesses at bay. And there are mental as well as physical benefits. “Practicing good body hygiene helps you feel good about yourself, which is important for your mental health,” notes Donald Novey, MD, an integrative medicine physician with the Advocate Medical Group in Park Ridge, Ill. People who have poor hygiene — disheveled hair and clothes, body odor, bad breath, missing teeth, and the like — often are seen as unhealthy and may face discrimination.

Personal Hygiene: Healthy Habits Include Good Grooming

If you want to minimize your risk of infection and also enhance your overall health, follow these basic personal hygiene habits:

  • Bathe regularly. Wash your body and your hair often. “I’m not saying that you need to shower or bathe every day,” remarks Dr. Novey. “But you should clean your body and shampoo your hair at regular intervals that work for you.” Your body is constantly shedding skin. Novey explains, “That skin needs to come off. Otherwise, it will cake up and can cause illnesses.”
  • Trim your nails. Keeping your finger and toenails trimmed and in good shape will prevent problems such as hang nails and infected nail beds. Feet that are clean and dry are less likely to contract athlete’s foot, Novey says.
  • Brush and floss. Ideally, you should brush your teeth after every meal. At the very least, brush your teeth twice a day and floss daily. Brushing minimizes the accumulation of bacteria in your mouth, which can cause tooth decay and gum disease, Novey says. Flossing, too, helps maintain strong, healthy gums. “The bacteria that builds up and causes gum disease can go straight to the heart and cause very serious valve problems,” Novey explains. Unhealthy gums also can cause your teeth to loosen, which makes it difficult to chew and to eat properly, he adds. To maintain a healthy smile, visit the dentist at six-month intervals for checkups and cleanings.
  • Wash your hands. Washing your hands before preparing or eating food, after going to the bathroom, after coughing or sneezing, and after handling garbage, goes a long way toward preventing the spread of bacteria and viruses. Keep a hygiene product, like an alcohol-based sanitizing gel, handy for when soap and water isn’t available.
  • Sleep tight. Get plenty of rest — 8 to 10 hours a night — so that you are refreshed and are ready to take on the day every morning. Lack of sleep can leave you feeling run down and can compromise your body’s natural defenses, your immune system, Novey says.

Personal Hygiene: Poor Hygiene Hints at Other Issues

If someone you know hasn’t bathed or appears unkempt, it could be a sign that he or she is depressed. “When people are sad or depressed, they neglect themselves,” Novey says. Talking about the importance of proper personal hygiene for preventing illnesses and providing personal hygiene items may help some people. Be candid but sensitive and understanding in your discussions, Novey says. Despite your best efforts, your friend or loved one may need professional help. You should encourage them to see a counselor or doctor if their personal hygiene doesn’t improve.

Personal Hygiene: Good Habits Help Keep You Healthy

For most people, good hygiene is so much a part of their daily routines that they think little about it. They bathe, they brush their teeth, visit the dentist and doctor for regular checkups, and wash their hands when preparing or eating food and handling unsanitary items. To keep those you care about healthy and safe, help them learn, and be sure that they are practicing, good personal hygiene.

Drinking Alcohol: Health Boost or Health Risk?

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When it comes to alcohol, how much is too much? Find out what the experts recommend and how to recognize the signs that you’re drinking too much.

A large number of studies have shown that moderate alcohol intake can lower the risk of cardiovascular disease in men and women. Moderate drinking means one drink per day for women and one to two for men, says Donald Novey, MD, an integrative medicine physician with the Advocate Medical Group in Park Ridge, Ill. “The difference in amounts is because of how men and women metabolize alcohol,” Dr. Novey explains.

“When you say one drink, the size of that drink matters,” Novey adds. According to the U.S. Department of Agriculture one drink is equal to:

  • 12 ounces of beer or
  • 5 ounces of wine or
  • 1½ ounces of spirits (hard liquor such as gin or whiskey, 80-proof)

The Dangers of Drinking Too Much

Unfortunately, some people can’t stop at just one or two drinks. Too much alcohol can result in serious health consequences. Heavy alcohol intake can damage the liver, causing cirrhosis, a fatal disease. Excessive drinking also can raise blood pressure and damage the heart, and is linked to many different cancers, including mouth, esophagus, breast, prostate, and colorectal cancers. The health risks are even greater for those who not only drink but smoke as well.

The consequences of excessive drinking can be serious not only for the alcoholic, but also for their friends, family, and even innocent bystanders. According to the National Institute of Alcohol Abuse and Alcoholism, more than 16,000 people die each year in automobile accidents that involve drunken drivers. Other data indicates that one in three violent crimes involves the use of alcohol and as many as three out of four violent incidents against a spouse involve alcohol. “Alcohol is a depressant. It makes people sad over time, not happy,” Novey says. When depressed, people can do some rather unfortunate things to themselves and their loved ones.

Signs of Alcohol Abuse

How can you tell if you or someone you know might have a drinking problem? Physicians often use the CAGE test, which involves four simple questions, Novey says:

  • Cutting down. Have you ever felt you should cut down on your drinking?
  • Annoyance by criticism. Have people annoyed you by criticizing your drinking?
  • Guilty feeling. Have you ever felt guilty about drinking alcohol?
  • Eye-openers. Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover (an “eye-opener”)?

If the answer to just one of these questions is yes, a drinking problem is likely and professional help is needed, Novey says.

Other signs of a drinking problem:

  • You find you can’t stop drinking once you start.
  • You’re having problems at work or at school.
  • Other people notice your drinking and comment on it.
  • You can’t remember what you did when you were drinking alcohol.

Moderation Rules

Consuming no more than one drink a day for women and no more than two drinks for men is safe, and perhaps even heart healthy. On the other hand, excessive drinking can have serious consequences. If you think you may have a drinking problem or suspect that someone you love does, seek professional help. Contact your family physician or a support group for substance abuse before irreparable damage is done.