The Mouth is a Gateway to Personal Health – and to Some Diseases

Healthy teeth are beautiful and do not cause pain. But few people are aware that taking care of your teeth and mouth can help prevent infections like Covid-19 or pneumonia.

We discuss how a simple test can detect inflammation in the mouth and what influence the mouth has on our health with dentist Dr Walter Wille-Kollmar and the head physician at Park Igls, Dr Peter Gartner.

Dr Walter Wille-Kollmar: I couldn’t agree more. The more you’re able to crush the food in the mouth, the better it is absorbed and digested by the body.

Dr Peter Gartner: In the mouth, there are six large and hundreds of small salivary glands that produce digestive enzymes. Each time you chew, you crush the food twice, four times, eight times – up to a hundred times! The food’s surface area is thus enlarged, combined with enzymes through careful salivation and prepared for the digestion process. The better you are able to chew and add enzymes to food, the easier it is for the organs to filter out valuable substances from the food.

Dr Wille-Kollmar: To chew efficiently, you need a good set of teeth. The important thing here is occlusion, i.e. the process of biting together.

Dr Wille-Kollmar: Chewing is a complex process that involves cutting, shearing, up and down motions and grinding, which also puts a lot of strain on the muscles used. There are many factors involved, but optimal occlusion requires the interaction of all teeth. For those with fillings or dentures, this is particularly important. If occlusion is not occurring properly, problems with the spine, migraines or other diseases may be the result. Teeth are a part of a long, orthopedically functional chain.

Lay people are probably unaware that a tooth is not a rigid structure. It has a degree of mobility as long as its roots are there. As a result, occlusion is better over the long term when teeth are preserved as opposed to dental implants.

Dr Gartner: I once attended a seminar about ‘the physics of teeth’: Using different inserts in the denture, a dentist changed the occlusion of a seminar participant. This occlusal change corrected a previously visible pelvic obliquity with leg length deviation.

Dr Wille-Kollmar: For those suffering from seemingly unrelated physical symptoms, I would suggest also having your teeth examined. It should be mentioned, however, that not all dentists take a holistic approach. If just one tooth is ground down, then the entire chewing process changes. “Form is function, and function determines form.” This principle is the basis of Dr. Robert L. Lee’s concept of bio-occlusion. Lee studied dentures to better understand why some worked well over time and others did not.

Dr Gartner: Guests at Park Igls benefit greatly from the fact that we doctors here work closely with specialists in all fields.

Dr Wille-Kollmar: This allows me, for example, to give patients important tips when dealing with their general dentist.

Dr Wille-Kollmar: It is important to note that every tooth procedure – whether it is a filling or a denture – requires a customised approach. Therefore, patients also need patience. Levelling the tooth surface is the easiest and fastest procedure.

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A »HEALTHY MOUTH«

Dr Wille-Kollmar: Most viruses enter through the mouth, which acts like a conduit through which pathogenic germs can travel on into the body and cause infections such as pneumonia. Researchers have now discovered that the SARS-CoV-2 virus also enters the body mainly through the mouth. A healthy mouth is therefore an important defence mechanism against all infections!

Dr Wille-Kollmar: A healthy mouth includes saliva, which contains important enzymes and immunoglobulins that defend against infections. Saliva deficiency is a condition that should be treated.

Dr Gartner: Chewing muscles and salivary glands can be trained just like any other muscles. Mayr Medicine promotes such training by ensuring ample saliva production for the chewed food.

Dr Wille-Kollmar: There are many barriers against pathogenic germs. These include the healthy condition of the oral mucosa and gums, the immune system in the mouth and the microbiome of the oral mucosa, i.e. the composition of the bacteria, which also includes many beneficial forms.

Dr Wille-Kollmar: Nowadays, there is a simple saliva test, the aMMP-8 test, which can be used to measure oral immune defence. The enzyme aMMP-8 destroys protective proteins that the body uses to close openings between cells to prevent pathogens. When there are high levels of this enzyme, it is easier for viruses like SARS-CoV-2 to enter the body. Bacterial infections such as pneumonia are also more common then. Pre- existing chronic diseases such as diabetes, cardiovascular diseases or rheumatism can also be negatively influenced by inflammation in the mouth. For women, the risk of miscarriage may also be higher.

Dr Gartner: Incidentally, a healthy oral microbiome is also important in preventing atherosclerosis. Signs of inflammation in the mouth can therefore indicate the onset of vascular hardening.

Dr Wille-Kollmar: That really depends on the level. If the aMMP-8 test reveals an incipient inflammation, then targeted oral hygiene is the therapy of choice. In my opinion, oral hygiene should be monitored professionally. This does not necessarily mean that the dentist is entirely in charge, but that it should be supervised by him or her. For cleaning, I prefer to use a hand instrument instead of an ultrasonic device to work on the tooth surface very delicately and without scratches. This allows the teeth to be made smooth without damaging them.

It is also important to pay close attention to the condition of the tooth pockets, where tartar can build up, in order to clean them thoroughly. Depending on the level of inflammation, I can then determine the frequency of oral hygiene. As a rule, once or twice a year is sufficient. For those with high inflammation levels, I would recommend every three to four months.

Dr Wille-Kollmar: Periodontitis, also called periodontal disease, is a bacterial inflammation of the tooth bed that, if left untreated, can lead to loosening and eventual loss of teeth. In old age, people are more prone to gum recession, which can be stopped with proper oral hygiene. The aMMP-8 test can detect the preliminary stage of periodontitis and prevent the progression of the inflammation. There are even preventive measures I can recommend for children.

HEALTHY TEETH ARE BEAUTIFUL TEETH

Dr Wille-Kollmar: First and foremost: Brush your teeth twice a day; evening cleaning is more important than morning cleaning. Second: Clean the interdental spaces daily. This is another area where I think doctors have a responsibility. I give my patients tips on this. Whether they use dental floss or dental brushes is up to them. It is essential that I show people who lack fine motor skills or older people who find it difficult to clean dentures how to clean their dentures as efficiently as possible.

Dr Gartner: When choosing toothpaste, make sure that the enamel is not damaged.

Dr Wille-Kollmar: It’s best to ask your dentist for advice. He or she can also tell you whether or not you need a toothpaste with fluoride added.

Dr Wille-Kollmar: My advice is to use mouthwashes sparingly. In the long run, the chlorhexidine contained in many rinses damages the good microbes in the mouth. A mouthwash is a medication and, as a result, should be used sparingly. Mouthwashes are also not recommended for long- term use.

Dr Wille-Kollmar: We all know that sugar and carbohydrates damage teeth. Just like we know that smoking is poison to the mouth’s immune system, by the way. Giving your teeth something to chew on is all well and good, but a diet too rich in grains leads to increased abrasion, which damages the enamel.

Dr Gartner: Moderation, as is usually the case, is the sensible choice. To keep our mouths and the related bones in shape, good chewing practices are important, which leads us back to Mayr Medicine.

Dr Wille-Kollmar: Absolutely. I’m always excited to see a healthy set of teeth. But, and this is important for me to emphasise, beautiful teeth are not necessarily healthy teeth. There are people who only pay attention to the beauty of their teeth, especially the visible front row of teeth. Such measures have nothing to do with dental health. Because in fact, the back molars and grinders are more important for the overall health of your teeth than the incisors. That is why a good dentist is always a holistic medical practitioner and more than a good craftsman or a purely aesthetic medical practitioner.

Gesundheitszentrum Park Igls in Tirol

Dr Walter Wille-Kollmar MD –

Dr Wille-Kollmar studied medicine and dentistry at the FAU Erlangen-Nuremberg. After passing his state examination in 1996, he worked as a dentist in Germany before founding a dental practice in Italy (Barletta) in 2001. He set up the ‘Zahnarzt im Roten Adler’ dental practice in Innsbruck in 2016. Dr Wille-Kollmar also contributes his expertise in implantology and periodontology as a journalist as well as editor-in-chief for various specialist media and as a speaker. The Park Igls consultant is also a member of  the European Dental Association and the German Society for Periodontology.