Most body parts wear out at a fairly predictable rate, but one part that could remain healthy _ if you take care of it _ is the mouth.
As dentists warn, failure to brush and floss every day can lead to trouble. Given an opportunity, bacteria will set up thriving colonies below the gum line. Once that happens, your teeth and gums will come under constant assault from bacterial toxins. Cavities and infection are sure to follow, no matter your age.
"You can have an 80-year-old with the gums of a 20-year-old, and you can have a 20-year-old with the gums of an 80-year-old," said Bruce Crawford, a St. Petersburg periodontist. "The rest of the body is going to age, but the mouth doesn't have to."
Keeping a clean mouth will do more than preserve your smile. Healthy gums create a tight seal around the teeth, but even so, some bacteria can breed below the gum line. In the warm, moist, nutrient-rich environment of the mouth, bacteria can multiply rapidly. As they proliferate, they separate the gum from the tooth. Eventually, the trench provides access to the jawbone, where bacteria can attack the socket that holds each tooth in place.
By this point the gums, swollen and tender, will be chronically inflamed as they try to fight the bacteria. They also bleed easily, giving bacteria access to the bloodstream, where it can damage the artery walls and promote heart disease.
Dr. Robert J. Genco, a professor in the School of Dental Medicine at the State University of New York at Buffalo and the editor-in-chief of the Journal of Periodontology, has found that people with periodontal disease are 2.7 times more likely to suffer a heart attack than people with healthy gums.
"We found that gum disease was an even more important risk factor for cardiovascular disease than high blood pressure," Genco said. Genco suspects that after bacteria enter the blood through inflamed gums, they cause small blood clots. An article in the New England Journal of Medicine reinforces that finding, adding that inflammation may also promote the accumulation of plaque on artery walls.
In addition to promoting heart disease, mouth bacteria can be inhaled easily into the lungs, where they contribute to pneumonia and other breathing problems. Diabetics face a double danger. Because of their elevated blood sugar, diabetics have a harder time fighting off infection, but certain kinds of bacteria in the mouth seem to make diabetes worse.
How can we protect ourselves from these periodontal perils?
The body provides some resistance. Saliva constantly flushes bacteria down the throat and into the stomach, where they are dissolved by stomach acid.
But saliva production diminishes with age, and the immune system becomes less robust, so bacteria can gain a foothold more easily. Still, age itself is not a crucial risk factor. Periodontal problems tend to accumulate over time, which means older people who have neglected oral hygiene have given bacteria more years to do damage. But people who maintain a ruthless assault on mouth bacteria can keep their mouth in great shape year after year.
"I wish a red flag went up, but gum problems tend to be relatively symptom-free," said Dr. Michael Rethman, president of the American Academy of Periodontology. "Bleeding gums should tell the patient that the teeth need better cleaning and more attention."
The first line of defense is brushing, which removes the food particles that nourish bacteria. Flossing every 24 hours disrupts bacterial colonies between the teeth and below the gum line, preventing them from gaining a foothold.
And anyone who is serious about preventing gum disease should refrain from smoking. Smokers are about four times more likely to have advanced periodontitis than nonsmokers. A periodontist can turn the tide in the battle against mouth bacteria, but the patient must keep up the fight.
"I let patients know when they meet me that this is a two-way street," said Crawford. "If they don't brush and floss on a daily basis, the treatment will fail. If they come in for a cleaning every three months, we can see how they're doing, and if there's a problem developing, we can catch it early."
Scientists are trying to develop vaccines against the most dangerous mouth bacteria, and better antibacterial mouth rinses, but for now the health of your mouth remains primarily in your own hands.
_ Tom Valeo is a freelancer who writes about medical and health issues. Write to Tom Valeo, c/o Seniority, the St. Petersburg Times, P.O. Box 1121, St. Petersburg, Fl 33731 or e-mail featuressptimes.com.