Regular Exercise May Prevent Loss of Teeth

Aug. 23, 2005 - Senior citizens and baby boomers are pounded with advice saying that with exercise and a healthy diet their mental and physical health is substantially improved. Now, a new study says that even oral health is better. The exercise-and-eat-right lifestyle, the study says, can reduce periodontal disease, the main cause of loss of teeth.

The advice is particularly important to aging people because the oral benefit is primarily a big reduction in the risk for periodontitis, the gum infection that causes most of the tooth loss in America. And, the severity of periodontal disease increases with age. About 23 percent of Americans between age 65 and 74 have severe cases. It is also estimated that about 30 percent of all U.S. senior citizens 65 and older no longer have any natural teeth.

Researchers found that individuals who exercised, had healthy eating habits and maintained a normal weight were 40 percent less likely to develop periodontitis, a gum infection that can result in loss of teeth.

The prevalence of periodontitis was reduced by 29 percent for those individual who only met two of the healthy behaviors and 16 percent in those that met at least one, according to Mohammad S. Al-Zahrani from the division of periodontitics at King Abdulaziz University in Jeddah, Saudi Arabia (and alumnus of Case Western Reserve University's School of Dental Medicine and Case School of Medicine).

He conducted the study for his doctoral dissertation work in epidemiology at Case in collaboration with Elaine A. Borawski from Case's department of epidemiology and statistics at the Case medical school and Nabil F. Bissada, chair of the department of periodontics at the Case School of Dental Medicine.

The researchers from Case Western Reserve University examined data from 12,110 individuals who participated in the third National Health and Nutrition Examination Survey (NHANES III).

Beside healthy brushing and flossing habits, prior to this study other healthy behaviors that contribute to the prevention of the disease were unknown, according to the researchers.

This new study is published in the current issue of the Journal of Periodontology, the official publication of the American Academy of Periodontology. The findings were reported in the article, "Periodontitis and Three Health-Enhancing Behaviors: Maintaining Normal Weight, Engaging in Recommended Level of Exercise and Consuming a High-Quality Diet."

Advances in dental medicine have permitted more people to keep their teeth as they grow older. Understanding the underlying ways to prevent gum diseases have become increasingly important, according to the researchers. More than 30 percent of the population suffers from periodontitis, an infection of the gums that can lead to heart disease, diabetes and pre-term labor.

Curious whether the same factors that can prevent heart disease and lower the risks for diabetes might also impact oral health, the researchers examined the cumulative relationship between weight, exercise and a high-quality diet and dental disease in the United States population.

NHANES III, used in the study, is a cross-section survey conducted by the National Center for Health Statistics. It includes comprehensive systemic and dental components.

Information about weight, eating and exercise were collected during the survey. Participants were monitored for 24 hours on their food intake and also questioned about nine leisure-time physical activities (walking a mile or more at a time without stopping, jogging or running, bike riding, aerobic dancing or exercise, dancing, swimming, calisthenics, garden or yard work, and weight lifting). If individuals reported five or more moderate physical activities or three intensive activity sessions a week, it was considered healthy. Weight was considered within normal range if it fell within the body mass index (BMI) of 18.5 to 24.9 kg/m² (obesity was considered at 25 kg/m²).

The researchers concluded that the healthy behaviors such as exercise and diet that lower the risks of diabetes also can lower the risk factors for periodontitis. Exercise--also known to reduce the C-reactive protein in the blood associated with inflammation in the heart and periodontal disease. Healthy eating habits, which builds the body's defenses against disease, also reduce the production of plaque biofilm, which is the primary epidemiological factor associated with periodontal disease.

Conquering periodontal disease, according to the researchers, may mean more than just targeting the disease but addressing multiple risk behaviors, too.

"Since oral health professionals may see their patients two or four times a year, it gives them several opportunities to promote these healthy behaviors," report the researchers.