Oral Health

The oral-systemic connection

Oral health is far more than cavity prevention — it is a critical determinant of longevity and systemic well-being. The mouth harbors over 700 species of bacteria that form the oral microbiome, and when this ecosystem falls out of balance, the consequences extend well beyond the gums. Chronic periodontal disease creates a persistent inflammatory state that allows pathogenic bacteria to enter the bloodstream, triggering immune responses throughout the body ^[1].

Research has established that individuals with severe periodontitis face significantly higher risks of cardiovascular disease, type 2 diabetes, and neurodegenerative conditions. A 2021 meta-analysis found that severe periodontitis increases the incidence of type 2 diabetes by 53%, while diabetes itself elevates the risk of developing periodontal disease by 34% — a bidirectional relationship driven by shared inflammatory pathways ^[2].

Periodontal disease, heart disease, and Alzheimer's

The bacterium Porphyromonas gingivalis, a primary driver of chronic gum disease, has been found in atherosclerotic plaques and in the brains of Alzheimer's patients. P. gingivalis produces toxic enzymes called gingipains that can compromise the blood-brain barrier, allowing bacteria and inflammatory mediators to enter the central nervous system. This process promotes neuroinflammation, accelerates amyloid-beta aggregation, and contributes to brain atrophy ^[3].

Cardiovascular research shows that individuals with periodontitis have a significantly elevated risk of heart attack and stroke. In diabetic patients with severe periodontal disease, the risk of cardiorenal mortality increases 3.2-fold after adjusting for other risk factors ^[2]. A 2025 Lancet review emphasized that oral health should be integrated into chronic disease prevention strategies, particularly for aging populations ^[4].

The oral microbiome and aging

As we age, the composition of the oral microbiome shifts. Beneficial bacteria decline while pathogenic species proliferate, creating dysbiosis that accelerates both oral and systemic aging. This age-related microbiome shift has been linked to increased susceptibility to cardiovascular disorders, diabetes complications, and cognitive decline ^[5]. The oral-gut axis represents another important pathway: pathogenic oral bacteria can migrate to the gastrointestinal tract, producing harmful metabolites like trimethylamine N-oxide (TMAO) that damage cardiovascular health ^[6].

Evidence-based oral health practices

A 2024 systematic review found that daily toothbrushing and interdental cleaning lower the risk of developing type 2 diabetes and hypertension ^[6]. Beyond brushing and flossing, tongue scraping reduces bacterial load, and regular professional cleanings remove calcified plaque that harbors pathogenic bacteria.

Oil pulling — swishing oil in the mouth for 10–20 minutes — has shown modest benefits for gingival health and reducing Streptococcus mutans counts in some studies, though a 2024 meta-analysis concluded that while it may improve gum health, the evidence certainty remains low and it should not replace conventional oral hygiene ^[7]. Hydroxyapatite-based toothpastes have emerged as a fluoride alternative that can remineralize enamel, and probiotic lozenges targeting oral bacteria are under active research.

Maintaining oral health is one of the most accessible and impactful longevity strategies available, with benefits that extend to the heart, brain, and metabolic health ^[8].