What if someone told you that your health problems might be solved by going to the dentist? Would you believe them?
It’s absolutely true, says Dr. Lisa Marie Samaha, a Newport News dentist who for decades has been urging others to understand the direct correlation between good dental health and overall wellness.
She’s done it through her practice, Port Warwick Dental Arts. She’s done it through the teaching and research institute she founded. And for the past year, she’s been pushing an initiative to raise awareness across the community and to other medical practitioners.
The medical crisis is in our mouths,” says Samaha, who has published world-wide on the topic.
“In the past 34 years, I’ve watched people come into my office—they’re not just sick dentally, they’re sick physically. Through proper evaluation and collaboration with their medical teams, we can literally transform their lives.”
Decades of scientific research have connected periodontal disease with other diseases, including diabetes, high blood pressure, heart attacks, stroke, kidney and lung disease, dementia and Alzheimer’s disease, cancer, infertility, erectile dysfunction, preterm birth and other complications during pregnancy.
Samaha has numerous patient case studies from those who had dental work done and found their overall health improved as a result. Take Ellyn Tilburg, a retired Newport News teacher. She was supposed to have abdominal surgery last summer, but a day before surgery, she saw Samaha, who advised her against the procedure because of serious infections in her mouth.
Because Tilburg’s blood was already carrying a significant level of infection from dental disease, Samaha’s concern was that surgery could cause the infection to spread. The surgeon agreed to cancel surgery, and Tilburg instead got work done on her mouth. To her surprise, after dental treatment, her whole body began feeling stronger.
Over five months, she lost 25 pounds. Her looks changed—clearly evident in before and after photos.
People have remarked that my eyes look different, my skin tone looks different,” says Tilburg, who is 65.
“I have an increase in energy. For the first time, my body is well, and it’s getting better and better.”
The Research
The connection between oral health and the rest of the body isn’t just anecdotal, Samaha says— there’s hard science behind it. The connection was affirmed in 1996 by dental researchers Genco and Offenbacher, who revealed the results of their work to the American Academy of Periodontology. Since then, all of the United States surgeon generals have acknowledged the connection in their reports on Oral Health in America, published by the U.S. Department of Health and Human Services.
“The mouth can become a source of disease or pathological processes affecting other parts of the body,” former U.S. Surgeon General Dr. David Satcher wrote in his report in 2000.
Medical research has made great strides over the past century in helping people improve their oral health. Once upon a time, most Americans could expect to lose their teeth by middle age.
“Technology for the early diagnosis of disease and the repair of teeth, as well as bonding resins, new life-like porcelains, dental implants and dental lasers have revolutionized dentistry, making it safer, gentler and more efficient and effective than ever—even painless in most circumstances,” Samaha says.
Dentists can use the face and mouth as a mirror of health, reflecting disease in other parts of the body. Oral tissues can indicate a wide range of diseases, such as chicken pox, mononucleosis, even HIV. Vitamin deficiencies often are first manifest in the mouth, where bacteria aggressively attack the delicate, soft tissue there. Basically, the mouth can serve as a warning system—that something else is going on.
More than 500 bacterial strains have been identified in dental biofilm, which is basically the plaque that forms on surfaces in the mouth. Biofilms form throughout the body, but are usually sloughed off in some way. Not so in the mouth—the biofilm on the teeth only goes away with proper daily cleansing and professional care, Samaha says. If the biofilm isn’t cleaned away regularly, bacteria can grow and get into infectedgum tissue. From there, it can migrate throughout the bloodstream, attacking every tissue in the body.
More than 80 percent of the adult population in the United States has some level of periodontal disease, a chronic inflammatory, infectious disease that includes gingivitis and periodontitis, according to the Centers for Disease Control. Yet, Samaha says, the majority of all periodontal disease is undiagnosed and untreated. Left untreated, periodontal disease can encourage and complicate other diseases in the body.
“There is a direct link between periodontal disease and nearly all of the organ systems in our body,” Samaha says. “Bleeding gums allow for dangerous periodontal bacteria to invade the bloodstream and set up inflammation and disease throughout the body.”
Consider these statistics:
• There’s a 70 percent higher incidence of heart attack if you don’t brush twice a day, according to one Scottish study.
• People with gum disease are twice as likely to die from heart disease and three times as likely to die from stroke, according to the Mayo Clinic.
• Ninety-three percent of diabetics have periodontal disease—in 2013, it was recommended that all diabetics be screened regularly for periodontal disease, according to the Journal of Clinical Periodontology.
• Women with periodontal disease take an average of two months longer to conceive, according to a 2012 Australian study.
• A 2013 study published in the Journal of Sexual Medicine showed that 68 percent of men with periodontal disease had low or zero sperm counts and/or diminished sperm quality.
• Periodontal disease is found in 100 percent of pre-eclampsia in pregnancy cases.
• In nursing homes, there’s a 60 percent increase in pneumonia if there is no regular oral hygiene.
• In 2006, a Swiss researcher concluded there was a significant connection between periodontal disease and Alzheimer’s disease after discovering more than 60 species of bacteria that originate in the mouth and are also found in the blood, spinal fluid and brains of Alzheimer’s patients.
• Researchers at the Harvard School of Public Health
and the Dana-Farber Cancer Institute announced in 2007 that periodontal disease
was associated with a 64 percent increased risk of pancreatic cancer.
• Just six years ago, breast cancer was added to the list of cancers linked to periodontal disease, possibly connected to lymphatic drainage patterns from the lower jaw.
Most are Unaware Their Health Problems Began in Their Mouths
Many times, Samaha says, the body starts to break down before anyone realizes it started from a dental issue. According to the surgeon general’s report, oral examination can reveal signs and symptoms of more than 90 percent of systemic diseases.
Proper dental care can also help sleep apnea. Newport News resident Susie Wornom, a retired school nurse, had been a long-time patient of Samaha’s when Samaha noticed how tired Wornom frequently seemed. Learning that Wornom snored and noticing the formation of her palate, Samaha suggested she see a pulmonologist.
“I praise [Samaha] for being there for me and guiding me through everything,” says Wornom, 74, who has also had laser surgery on her gums and crowns replaced. “And for bringing things to my attention. It’s all been a process and an adventure. I think my health would have been much worse if I hadn’t done it. I think it makes a difference, I really do.”
But while the information sounds dire, it doesn’t have to be. With the right care, people can improve their health dramatically. When Samaha sees patients, she also suggests nutritional supplementation and a change in diet—to take care of the body from the inside out.
“Before you feel hopeless, it’s important to understand that periodontal disease is both preventable and treatable,” Samaha says. “It will never get better on its own, but the sooner it is diagnosed, the better the outcome for the mouth and the entire body.”
A simple dental screening exam is the first step. Beyond that, various tests are available, such as oral DNA testing—which measures both the risk of inherited disease and the quality and quantity of the bacteria that’s present. Further salivary testing is being researched to detect some cancers.
Samaha, meanwhile, is taking things a step further. In 2015, she launched her Healthy Mouth, Healthy Body 2020 Initiative. Her goal is to share the mouth/body message and increase the health and wellness of 20,000 people on the Virginia Peninsula by the year 2020. She started by reaching out to medical practitioners and has teamed up with Hampton University’s biology and sociology departments.
Dr. Lois Benjamin, professor emerita of sociology at Hampton University, was a patient of Samaha’s when she was asked to chair the initiative. A few years ago, Benjamin, a Newport News resident, was in pain from a cracked filling when she sought out a holistic dentist and found Samaha.
“I’ve gained so much insight, phenomenal insight, between the connection of the mouth and the body,” Benjamin says. “Hopefully we can make a dent in terms of educating people.”