Yes. There are new findings which support something that dental professionals have suspected for a long time: infections in the mouth can cause problems in other parts of the body.

What problems could my dental health cause?

Problems which may be caused or made worse by poor dental health include:

• Heart disease
• Strokes
• Diabetes
• Premature and low-birth-weight babies
• Respiratory (lung) disease..

People with gum disease are almost twice as likely to have coronary artery disease than people without gum disease. When people have gum disease, bacteria from the mouth can get into their bloodstream. The bacteria produce protein. This can then affect the heart by causing the platelets in the blood to stick together in the blood vessels of the heart. This can make clots more likely to form. Blood clots can reduce normal blood flow, so that the heart does not get all the nutrients and oxygen it needs.

Several studies have looked at the connection between mouth infections and strokes. They have found that people who have had a stroke are more likely to have gum disease than people who have not had one.

When the bacteria that cause gum disease get into the bloodstream, they produce a protein. This can cause inflammation of the blood vessels, and this can block the blood supply to the brain. This can cause a stroke.

People with diabetes are more likely to have gum disease than people without it. This is probably because diabetics are more likely to get infections in general. People who do not know they have diabetes, or whose diabetes is not under control, are especially at risk.

If you do have diabetes it is important that any gum disease is diagnosed, because it can increase your blood sugar. This would put you at risk of diabetic complications.

Also, if you are diabetic, you may find that you heal more slowly. If you have a problem with your gums, or have problems after visits to your dentist, discuss this with your dentist before you have any treatment.

Pregnant women who have gum disease may be over three times more likely to have a baby that is premature and so has a low birth weight. There is a one-in-four chance that a pregnant woman with gum disease will give birth before 35 weeks.

It seems that gum disease raises the levels of the chemicals that bring on labour. Research also suggests that women whose gum disease gets worse during pregnancy have an even higher risk of having a premature baby.

Having gum disease treated properly during pregnancy can reduce the risk of a premature birth.

Bacterial chest infections are thought to be caused by breathing in fine droplets from the throat and mouth into the lungs. This can cause infections, such as pneumonia, or could make an existing condition worse. People with gum disease have more bacteria in their mouths and may therefore be more likely to get chest infections.

What are the tell-tale signs I should look out for?
Visit your dentist or hygienist if you have any of the symptoms of gum disease, which can include:

• Inflammation of the gums, causing them to be red, swollen and to bleed easily, especially when brushing.
• An unpleasant taste in your mouth.
• Bad breath.
• Loose teeth.
• Regular mouth infections..
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Always tell your dentist about any changes to your general health. It is especially important to tell them if you are pregnant or have heart disease, diabetes, lung disease or have ever had a stroke. You also need to tell them about any medicines you are taking as these can affect both your treatment and the health of your mouth.

Although there is some evidence that gum disease runs in families, the main cause is the plaque that forms on the surface of your teeth. To prevent gum disease, you need to make sure you remove all the plaque from your teeth every day by brushing and cleaning in between your teeth.

If you have gum disease, your dentist or hygienist will usually give your teeth a thorough clean to remove any scale or tartar. This may take a number of sessions with the dentist or hygienist.

They will also show you how to remove the soft plaque yourself, by cleaning all the surfaces of your teeth thoroughly at home. Plaque is a sticky film of bacteria which forms on the teeth every day (See our leaflet 'Tell me about gum disease').

Gum disease is never cured. But as long as you keep up the home-care you have been taught you can slow down its progress and even stop it altogether. You must make sure you remove plaque every day, and go for regular check-ups with the dentist and hygienist, as often as they recommend.

A recent study found that people with fewer teeth had a higher risk of experiencing memory loss or early-stage Alzheimer's disease.

This may be because the gum infections that can cause tooth loss may release chemicals that increase the brain inflammation which leads to earlier memory loss.

A recent study has shown that people who stay fit and healthy are 40% less likely to develop tooth-threatening gum infections that could lead to gum disease. It also found that not exercising, not keeping to a normal body weight and unhealthy eating habits made a person much more likely to get advanced gum disease.

If you are serious about your health - and your teeth - you will need to exercise, eat a healthy, balanced diet and keep to a normal body weight.

Smoking can make gum disease much worse. People who smoke are more likely to produce bacterial plaque that leads to gum disease. The gums are affected because smoking means you have less oxygen in your bloodstream, so the infected gums do not heal. Smoking can also lead to tooth staining, tooth loss because of gum disease, bad breath, and in more severe cases mouth cancer

Sources

• American Academy of Periodontology.
• British Dental Health Foundation Leaflet - Gum disease.
• Journal of Periodontology

The letters TMJ are short for of 'temporo-mandibular joint', which is the joint connecting your lower jaw and your skull. The movement in this joint lets you open and close your mouth and chew from side to side.

If your teeth don't fit together properly, you can have problems not only in your teeth themselves, but also the gums, the temporo-mandibular joint or the muscles that move your jaw. These problems are called 'occlusal' problems.

Teeth Teeth that are out of line, heavily worn or constantly breaking, fillings that fracture or crowns that work loose may all be signs of occlusal problems. Your teeth may also be tender to bite on or may ache constantly.

Gums
Loose teeth or receding gums can be made worse by an incorrect bite.

TMJ
Clicking, grinding or pain in your jaw joints, ringing or buzzing in your ears and difficulty in opening or closing your mouth could all be due to your teeth not meeting each other properly.

Muscles
If your jaw is in the wrong position, the muscles that move the jaw have to work a lot harder and can get tired. This leads to muscle spasm. The main symptoms are continual headaches or migraine, especially first thing in the morning; pain behind your eyes; sinus pain and pains in your neck and shoulders. Sometimes even back muscles are involved.

Many people have imperfect occlusion and missing teeth, yet never have symptoms because they adjust to their problems. Occasionally, in times of increased stress and tension, the symptoms may appear and then go away immediately. Or, your teeth and gums may be affected straight away and instead of headaches, you may suffer:

• flattened, worn teeth.
• broken teeth, fillings and crowns.
• loose teeth.
• continual sensitivity of your teeth to temperature change.
• toothache with no apparent cause.

If you think you have any of these problems, ask your dentist.

You may find that you clench or grind your teeth, although most people who do aren't aware of it. Sometimes can be caused by anxiety, but generally most people clench their teeth when they are concentrating on a task - housework, gardening, car mechanics, typing and so on.

You may wake up in the morning with a stiff jaw or tenderness when you bite together. This could be due to clenching or grinding your teeth in your sleep. Most people who grind their teeth do it while they are asleep and may not know they are doing it.

If you suffer from severe headaches, or neck and shoulder pain, you may not have linked this with possible jaw problems. Or you may keep having pain or discomfort on the side of your face around your ears or jaw joints or difficulty in moving your jaw. These are all symptoms of TMJ problems.

If you are missing some teeth at the back of your mouth, this may lead to an unbalanced bite, which can cause uneven pressure on your teeth.

Together, all these symptoms are called TMJ syndromeZ.

See your dentist. He or she may be able to help you or may refer you to a specialist who deals with occlusal problems.

Depending on the problems you are having, it can be possible to spot the signs of an occlusal problem. Various muscles may be sore when tested, or the broken and worn areas of your teeth will show you are grinding your teeth - a common sign of an incorrect bite.

If your dentist suspects that your problems are due to an incorrect bite, he or she may help to improve the problem by supplying a temporary soft nightguard or hard plastic appliance that fits over your upper or lower teeth. This appliance needs to be measured and fitted very accurately so that when you bite on it, all your teeth meet at exactly the same time in a position where your muscles are relaxed. You may have to wear this all the time or, just at night. If the appliance relieves your symptoms then your bite may need to be corrected permanently.

Tooth Adjustment (equilibration)
Your teeth may need to be carefully adjusted to meet evenly. Changing the direction and position of the slopes that guide your teeth together can often help to reposition the jaw.

Replacement of teeth
The temporo-mandibular joint needs equal support from both sides of both jaws. The chewing action is designed to work properly only when all your teeth are present and in the correct position. Missing teeth may need to be replaced either with a partial denture or bridgework.

Replacement is not usually done until a diagnosis has been confirmed by using an appliance and this has fully relieved the symptoms. Relief in some patients is instant: in others it can take a long time.

Medication
Some drugs can help in certain cases, but this is usually only temporary. Hormone replacement therapy may also help some women.

Diet and Exercise
As with any joint pain, it can help to put less stress on the joint. So a soft diet can be helpful, as can Corrective exercises and external heat. Physiotherapy exercises can often help, and your dentist may be able to show some of these to you.

Relaxation
Counselling and relaxation therapy may help in some cases. These techniques help the patient to become more aware of stressful situations and to control tension.

If your teeth are too far out of line or in a totally incorrect bite position, it may be necessary to fit an orthodontic appliance to move them into a better position.

Up to 1 in 4 people may have some symptoms. Both men and women are affected equally, although women tend to seek treatment more often than men. The symptoms can often start with the menopause or other hormonal changes.