Dental Currents March 2009

Stomach Ulcers and Dental Disease

What do dental disease and stomach ulcers have in common? Both are caused in large part by specific bacteria. In fact, the types of bacteria that cause both diseases are quite similar. They are gram negative (excuse the scientific term) and require little or no oxygen. On the other hand, the majority of bacteria in a healthy mouth are gram positive and require oxygen to produce energy.
Bacterial involvement in stomach ulcers has not been recognized for a long time. The cause used to be thought of as an over production of stomach acid and most remedies were focused on controlling acid production. Australian physician, Dr. Barry Marshall tried for 10 years through the 1980’s to convince the establishment that the bacteria known as H. Pylori, was the cause of stomach ulcers and gastritis (stomach inflammation). Eventually, he even drank a beaker of H. pylori bacteria to give himself gastritis to prove it was the cause. By the mid-nineties, beliefs were changing and Dr. Marshall was awarded a Nobel Prize for his contribution in 2005. Nowadays, antibiotics for H. Pylori bacteria are part of treatment for stomach ulcers.
In the mouth, not all bacteria cause periodontal disease. Most of the bacteria in our mouth are friendly and necessary to our bacterial balance and our health. Periodontal disease, however, is caused by toxins produced by a few gram negative types that don’t like oxygen, similar to H Pylori. When the body’s immune system can no longer cope with the bacterial toxins, the disease process advances from bleeding gums to bone loss and loose teeth. For many years, we have intervened by prescribing antibiotics when we felt it was necessary to control periodontal infections. So far, so good, but we had some problems.
Some people had stomach upsets with the medication. Others had allergies and some didn’t want to take it because you had to restrict alcohol consumption. There were two other problems. One was that the pill form of medication eliminated the gram negative bacteria along the gum line but not on the tongue. The second was that we did not have a maintenance program to keep the bad bacteria at bay after the antibiotic.
Today, when the bacteria are out of balance, we intervene by using antibiotic rinses to kill the specific bad bacteria along the gum line and on the tongue surface. We provide other prescription rinses to maintain the balance in the mouth. By managing the oral bacteria, we are helping people not only to control periodontal disease before it becomes a measureable problem but we are helping them eliminate the bad breath that goes along with oral infections.
Recently, researchers in Japan noted that people with periodontal disease had a 15.7% chance of having H.Pylori bacteria in their mouth as well. Wow, who knew, but I guess we shouldn’t be surprised. They also studied people who complained of bad breath. Even though they did not show signs of stomach disease yet, 6.4% of the bad breath sufferers had H.Pylori bacteria in their mouth.
Balancing oral bacteria can pay big dividends for your mouth, stomach and your breath odour. By the way, we can now measure and balance the bad bacteria that contribute to dental decay as well. More about that in a future issue.
Imagine a world where you can treat the cause of periodontal disease, bad breath and dental decay by balancing the oral bacteria before we have to repair the result of bacterial damage.

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