I made a minor but painful error on Saturday morning. I stopped in Chicago on the way back from a business meeting to visit with my daughter, Kate, and her husband, Andy, and especially to play with Rowan who’s now just about a year and a half old.
A staple of Saturday morning for Ro is Wiggleworms, a really delightful toddler class at The Old Town School of Music. Imagine a dozen 12- to 20-month olds and a parent or two for each sitting on the floor bouncing, running, singing (parents), banging a huge drum, ringing bells, chasing bubbles, mostly laughing, sometimes crying … for about 40 minutes. Crazy … crazy wonderful.
Problem is that this semester, Wiggleworms ends just about when nap time should begin. This means that the 15 minute ride home isn’t much fun. Now for the mistake … I put my finger on Ro’s lips to play one of our games where I wiggle it and she blows out making funny, silly noises. Sleepy Ro didn’t blow, she chomped down.
Ouch … strong kid, legs, lungs, arms, teeth … and jaw!
Don’t underestimate the importance of good dental care, for kids, for us all.
The American Dental Association advises that kids see a dentist within six months of getting their first tooth and certainly once they’re one year old. Getting into good habits of caring for teeth and regular professional examinations early certainly pays off later. We all know people who struggle throughout their lives to make up for ignoring their teeth early on. It can be a mess — time consuming, uncomfortable, costly and annoying. On the other hand, early good habits, ongoing surveillance and a bit of luck can lead to a lifetime of great checkups. Kate still texts me every six months, so far able, each time, to boast of never having had a cavity!
Besides the obvious advantage to how we look, chew and avoid pain, dental health has less obvious but quite significant effects on overall health as well.
There are some intriguing studies that suggest that poor oral health, especially gum inflammation, is associated with heart disease. It seems there’s some connection, probably involving mouth germs causing a generalized inflammatory response in the body that affects the lining of blood vessels. When this irritation involves the coronary arteries, the heart’s fuel lines, worsening of pre-existing blockages or development of plaques can occur.
As we’ve noted many times, these plaques are the culprits in causing angina or chest pain and when the plaques become chemically unstable and blood clots on them, causing heart muscle to die, a heart attack. When and if the irritation damages arteries in the head or neck, especially the fuel lines for the brain, a stroke can occur.
Really, bad teeth causing heart attacks and strokes? Seems so; more research will tell. Also seems that bad oral health in pregnant women is connected to premature labor and babies with low birth weight.
Among the awful consequences of inflamed gums and bad teeth that are absolutely certain are life-threatening infections, especially of heart valves.
Germs, especially bacteria, are in our mouths at all times. I still remember how in the second year of medical school at Johns Hopkins, during our microbiology course’s lab section, we took a swab, wiped our teeth, gums and cheek and then wiped the used swap on culture plates, incubated them overnight at body temperature and examined the “zoo” of germs that grew under the microscope the next morning. OMG! Those things were in my mouth!
Every day as we chew, brush and just live our lives, millions of germs get into our bloodstreams. Usually they get filtered out by our lungs, liver, kidneys and lymph system and destroyed by our immune system; but sometimes, unfortunately, they settle in bad places, places where blood flow is rough, not smooth.
They settle and grow … and multiply … and damage tissue, until terrible consequences develop. One especially bad place to have a germ take up house-keeping, is on a heart valve. This leads to endocarditis, a nasty, dangerous, life-threatening problem that we’ll delve into next week.
For now, take care of your teeth: brush your teeth at least twice a day with a fluoride toothpaste; floss daily; watch your diet and limit between-meal snacks; get a new toothbrush every three to four months or sooner if bristles become frayed; have regular dental checkups and cleanings, and yet again … don’t smoke or chew tobacco.
As for me, Ro’s asleep, my finger’s OK and I’m gonna figure out a new game to play with her when she’s tired.
Dr. Alfred Casale, a Cardiothoracic Surgeon, is Associate Chief Medical Officer for the Geisinger Health System and Chair of the Geisinger Cardiac Institute. Readers may write to him via [email protected]