Chronic conditions and systemic diseases are inextricably linked to the health of our mouths. Around 15 million people in the UK have a long-term medical condition that affects them every day.
New research shows the bi-directional link between the oral cavity and various serious conditions such as rheumatoid arthritis, cardiovascular disorders, diabetes mellitus and chronic respiratory diseases.
We must encourage our patients to take a proactive approach to their health and demand better oral health care for those living with chronic conditions. The government must also take a proactive approach with improved funding, encouraging interdisciplinary treatment and greater access to preventative care. This will reduce oral pain, disease, and further expenses for the NHS.
Gum disease and inflammation
Gum disease is the body’s response to harmful pathogens in the mouth, triggering an immune reaction that can impact both oral and systemic health. When detected early, it is often controllable. However, untreated gum disease can contribute to chronic inflammation, exacerbating conditions such as arthritis. This underscores the urgent need for further research and funding to better understand the relationship between gum disease and inflammatory diseases.
Despite its widespread impact, access to timely diagnosis and treatment for gum disease remains inconsistent across the UK. Many patients struggle to secure dental appointments, limiting opportunities for early intervention. Regional disparities in dental workforce availability exacerbate this issue — recent data show that the South West has the highest vacancy rate for fully qualified dentists at 22%, compared to 15% in London. NHS treatment availability also varies, with only 60% of dentists’ time allocated to NHS care in the South West, compared to 77% in the North East and Yorkshire.
To tackle gum disease effectively, urgent action is needed to ensure equitable access to dental care. This includes increased government investment in NHS dentistry, workforce expansion, and stronger education policies that prioritise gum disease prevention. Without these measures, the growing burden of gum disease will continue to negatively affect both individual and public health.
Implications for cardiovascular health
Poor oral health can cause serious problems for heart health. Bacteria from the mouth can spread to the heart valves via the bloodstream, causing endocarditis.
This is why poor oral care is risky for individuals with pre-existing heart conditions. One of the best actions patients can take at home to help their overall health is to prioritise preventative care and look after their mouth health.
We must encourage patients during their doctor and dentist appointments to view their oral health as an intrinsic part of their overall well-being. One-in-four (25%) adults do not regularly brush their teeth twice a day, one-in-three (33%) have never flossed or cleaned interdentally. Meanwhile, two-in-three (66%) adults have visible plaque. These are shocking statistics for the UK, and we must change our attitude towards caring for our oral health.
Dental visits can catch early signs of oral health issues, addressing problems before they escalate so developing professional pathways to ensure good all-round treatment is crucial.
When patients present with potential for heart issues, they must be encouraged to consider their oral health at home. For this to work, there must be an interdisciplinary approach, and a two-pronged approach, involving the patients’ doctor and dentist, to achieve the best results.
Ramifications of diabetes
The latest data show that almost 4.6 million people in the UK live with diabetes. Additionally, nearly 1.3 million people could be living with type two diabetes who are yet to be diagnosed. Diabetes can affect the whole body and the mouth.
Patients living with and managing diabetes have a greater risk of caries. Too much sugar in a patient’s blood can lead to more sugar in saliva. More sugar equals more energy for bacteria to grow and multiply. These bacteria produce plaque acid which attacks teeth increasing the risk of caries.
It is common for patients with diabetes, both type one and type two to develop dry mouth. Having a chronic dry mouth is also a risk factor for tooth decay.
There have been screening trials for diabetes done in the past at dental practices. The results from these studies have proved to be vital in flagging potentially previously undiagnosed type-2 diabetes. This is an excellent example of professionals working together to deliver better overall care and improve patient pathways to treatment.
Respiratory and oral diseases
Respiratory and oral diseases are interlinked, particularly influenza, asthma, COPD, and pneumonia. Due to the air pathways through the mouth into the lungs, pathogens have a direct route back and forth through breathing. As a result, ‘there is a vicious loop whereby lung illnesses, oral disorders, and disruptions to the oral microbiota constantly get worse‘.
When treating respiratory diseases, oral hygiene must become a concern for patients, doctors, and dentists to prevent a patient’s health from continuing to spiral. Our patients need a proactive approach to looking after their overall health. If they can manage their oral care, we should offer training and support to equip them to prevent dental disease and thus improve respiratory conditions. Carers should also have this opportunity to learn about taking care of oral health.
This is not just a case of making training but also ensuring it is widely distributed and available for all who need it. The government and policymakers should make oral health knowledge a priority to help reduce the burden and strain on the NHS.
Conclusion
As clinical research continues to strengthen the link between oral health and systemic disease, it is clear that good oral health must be recognised as a fundamental part of overall healthcare. Addressing the connections between oral and general health requires a multidisciplinary approach, ensuring that all healthcare professionals are equipped to discuss and promote preventative care with their patients.
Greater awareness and education are essential—particularly for those living with chronic conditions that are known to have an oral health impact. Prevention messages must be reinforced across all patient touchpoints, with medical and dental professionals proactively engaging patients about these crucial links. This responsibility cannot rest solely with one profession; it requires a collaborative effort across healthcare disciplines to integrate oral health into routine care.
At present, underfunding in NHS dentistry presents a significant barrier to achieving these goals. Addressing this shortfall, alongside increasing access to preventative care, must be a priority if we are to improve patient outcomes and reduce the wider health burdens associated with poor oral health. The need for action is urgent—without it, we risk failing those who would benefit most from a more integrated and proactive approach to healthcare
