Relationship of dental and oral pathology to systemic illness.

THE CLASSIC DENTAL DISEASES, CARies and periodontal disease, are commonly thought to have little effect on systemic health. These diseases result from infections by microbes with highly specific adhesion mechanisms in the mouth. Systemic disease resulting from infectious oral microbes is generally recognized to occur in patients with immunological and nutritional deficiencies, such as when individual host defenses are compromised, allowing oral microbes to gain systemic access. Systemic complications from oral microbes are usually thought to be confined to only a few specific clinical scenarios, such as bacterial endocarditis. Given this perspective, it is understandable that primary care physicians pay little attention to oral microbial infections and dental diseases. However, in view of the results of recent studies that examined the relationship of oral and dental infections to chronic cardiovascular disease and other systemic illnesses, such inattention can no longer be justified. Additionally, changing demographics in the United States suggest that an aging population will increasingly present medically significant oral problems. In this article, we review recent studies on dental disease prevalence, the systemic impact of dental infections, and age-associated oral medical problems.