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Family Care Dental Clinic

How depression threatens oral health, and other oral-systemic links

How depression threatens oral health, and other oral-systemic links

Severe periodontal disease increases the risk of some systemic diseases. This article will outline chronic kidney disease, coronary artery disease, stroke, and depression and their proposed links to severe periodontal disease.


Severe periodontal disease increases the risk of death in chronic kidney disease patients, a new study suggests. The authors found the 10-year death rate among chronic kidney disease patients was 41% for those with severe periodontal disease, compared with 32% for those without severe periodontal disease.

According to a 2012 Scientific Statement from the American Heart Association, “A link between oral health and cardiovascular disease has been proposed for more than a century.” The latest research to delve into this association comes from Karolinska University Hospital in Sweden and is known as PAROKRANK (Periodontitis and Its Relation to Coronary Artery Disease). The PAROKRANK study found a 28% increased risk of first myocardial infarction (MI) in patients with periodontitis after controlling for variables such as diabetes and smoking.

As this was an observational study design, a direct cause and effect cannot be established, but only an association between the two conditions. The study was multicentered, case-controlled, and enrolled 805 patients. In an editorial published regarding the study, it was stated that the study “adds to the strong evidence for an association between periodontitis and myocardial infarction, but does not prove causation.”

In a study of patients entering the hospital for acute stroke, researchers have discovered an association between certain types of stroke and the presence of Streptococcus mutans. They investigated the roles of cnm-positive S. mutans in this single hospital-based, observational study that enrolled 100 acute stroke subjects. The cnm gene in S. mutans isolated from saliva.

The results showed that the presence of cnm-positive S. mutans was significantly associated with intracerebral hemorrhage and increased number of deep cerebral microbleeds. (5) Cerebral microbleeds may cause dementia, and were diagnosed with MRIs. Strokes can be either ischemic strokes, which involve a blockage of one or more blood vessels supplying the brain, or hemorrhagic strokes, in which blood vessels in the brain rupture, causing bleeding.

Links Between Oral Health and Depression, and Depression and Cardiovascular Disease

And lastly, there have been assertions of links between oral health and depression, and depression and cardiovascular disease. Depression is one of the most prevalent mental health issues in the United States of America. In a 2010 study, the it was shown that there were significant relationships between depression and oral health, oral health behavior, and oral health-related quality of life. As depression affects a person’s ability to cope with daily life, it comes as no surprise that depression might be related to health and oral health-related self-care behavior and thus potentially affect patients’ oral health. In addition to a lack of motivation for self care, depression and oral health might be related through salivary changes in depressed patients. Decreased salivary flow can lead to several oral health problems, such as an increase in pathogenic bacteria and dental decay.

An older paper corroborates this information. According to the paper, physiological consequences of depression may lead to poor oral health due to xerostomia, cariogenic diet, and impaired immune functioning contributing to oral infection. Antidepressant medications have been shown to cause hyposalivation, which may lead to decay or other dental problems. Case reports also describe possible occurrences of antidepressant-induced bruxism. As well, patients with cardiovascular disease are three times more likely to develop depression, which makes mental health monitoring critical. A study reported last month in the Journal of the American College of Cardiology is one of the latest to confirm the association between heart disease and depression.

It is easy to see that the mouth is connected to the rest of the body, and vice versa. Taking a thorough medical history and performing intra- and extra-oral examinations can assist us in delivering the best care to our patients.

Contact Family Care Dental Clinic for your consultation today!

We at Family Care Dental Clinic offer our clients a wide range of comprehensive dental services for the whole family. Our dentists can help everyone in your family understand the importance of proper oral hygiene over time and the positive effects it has on your health. At Family Care Dental Clinic, we treat our clients to a soothing environment where they can receive quality dental care no matter what their needs are. Call (604) 987-3545 or write us at to schedule an appointment with a member of our excellent team!

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