Oral Care Expert Angie Stone: Five Leading Causes of Death from Dirty Teeth

A lack of good oral hygiene is killing the elderly and the ailment is completely preventable, according to a new book.

“There is an epidemic going on among nursing home residents,” says Angie Stone, RDH, BS, author of the new book “Dying from Dirty Teeth: Why the Lack of Proper Oral Care Is Killing Nursing Home Residents and How to Prevent It” (Indie Books International, 2015). “The elderly have increased risk factors for heart disease, stroke, diabetes, COPD, aspiration pneumonia, and thrush. The lack of adequate oral care increases these risks significantly.”

According to Stone’s research, the situation has been happening for years; the problem is only getting larger, yet residents and family members remain unaware of it. Even the caretakers at nursing facilities are often times unaware of the magnitude of this issue.

Stone’s book summarizes numerous studies indicating that teeth and gums burdened with the bacteria that cause periodontal disease can initiate cardiovascular disease, stroke, diabetes, and dementia. These bacteria can also complicate the control of existing diabetes.

Stone is the founder of HyLife, a network of committed, dental hygienists who make it their quest to provide oral care to those who need it the most. A 30-year veteran of the dental profession, she has served patients as a dental assistant and clinical hygienist. Her original research was published in the journal “Integrative Medicine.”

Stone says there are several causes of death that can be associated with poor oral health, including heart disease, stroke, diabetes, chronic obstructive pulmonary disease (COPD), and dementia.

  1. Heart Disease: Several studies have shown that periodontal disease is associated with heart disease. Research has indicated that periodontal disease increases the risk of the development of heart disease.  Scientists believe that inflammation caused by periodontal disease may be responsible for the association. The development of periodontal disease can also worsen existing heart conditions.
  2. Stroke: Additional studies have pointed to a relationship between periodontal disease and stroke.
  3. Diabetes: People with diabetes and periodontal disease may have more trouble controlling their blood sugar than diabetic patients with healthy gums. This appears to be a two way street. Those with periodontal disease are more likely to develop diabetes.
  4. Chronic Obstructive Pulmonary Disease: Research has shown those with periodontal disease have a 60 percent higher likelihood of developing COPD than those without periodontal disease.
  5. Dementia: Oral bacteria in the mouth due to poor dental hygiene have been linked to brain tissue deterioration.

Periodontal disease occurs when bacteria are allowed to thrive in the mouth and create a biofilm in which to live and do their dirty work. Once the body realizes the bacteria are doing damage, the immune system releases substances that inflame and damage the gums, the ligaments around the teeth, and eventually the bone that support the teeth. The body does this in an attempt to get rid of the bacteria.

“Oropharyngeal bacteria are wreaking havoc,” says Stone. “These bacteria can be controlled, and typically are controlled by most people through brushing and between the teeth cleaning. However, once people become dependent on others to remove these bacteria, the microbes run wild in the mouth, because they are not being kept at bay on a daily basis with tooth brushing and between the teeth cleaning.”

Stone says the greatest risk of dying from dirty teeth comes when the bacteria in the mouth get aspirated into the lungs and the person contracts aspiration pneumonia. Aspiration pneumonia is a lung infection that is a result of oral bacteria, stomach contents, or both, being inhaled (aspirated) into the lungs. It is not unusual for small amounts of this material to trickle or be inhaled into the airway and into the lungs. In the general population the inhaled secretions have low bacterial count and are usually cleared out by normal defense mechanisms such as coughing.

In the 2000 report, Oral Health in America, the U.S. Surgeon General pointed out that total health cannot be attained until oral health is improved. There needs to be a movement to end this epidemic. While death certificates do not list oropharyngeal bacteria as the cause of death, they are most certainly the origin of many illnesses that lead to death.

“There are many challenges and this problem can seem unmanageable, however the circumstances can be turned around so elders are not dying from dirty teeth,” says Stone. “This needs to be done sooner than later. The population is aging and our baby boomers are going to be the next generation of dependent adults.

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