Behind the Science: Oral health and overall health: Healthy Canadians podcast episode 8



Madeline Poplett: Hello and welcome to Healthy Canadians: Behind the Science, where we get science-specific about the health topics that matter to all of us living in Canada. I'm your host, Madeline Poplett.

Ever since our childhoods, we've heard how it's important to go to the dentist for regular checkups, and to brush and floss your teeth to make sure they stay squeaky clean and hopefully free of cavities. Well, what if it turns out that your oral health habits can also have a direct impact on your overall health – and could actually play a part in preventing serious health conditions such as diabetes or even stroke and cardiovascular disease? Last week, Megan spoke with Lisette Dufour, senior oral health advisor with Health Canada's Dental Care Task Force (and a dental hygienist with over 40 years of experience) about the importance of oral health throughout our lifetime. Today, Lisette is back to talk about some of the connections between oral health and our overall physical health and wellness. We'll dig into all of that in a moment. But first, a word from us.

Healthy Canadians is brought to you by Health Canada and the Public Health Agency of Canada. We aim to give you information and perspectives about the health topics that matter to all of us living in Canada. Just a heads up that what we discuss here won't always reflect the official positions of policies of the Government of Canada, but that's okay. These are conversations, not news releases.

Madeline: Hello, Lisette! Last week, you chatted with Megan about oral health. Lots of great information there. I think that when people in Canada think about oral health, they're not really thinking about overall health, but it appears that there is actually quite a link between the two. So: I don't know if that's something you want to speak to today? I'm interested to learn, because it's not normally an association that I make.

Lisette Dufour: Absolutely, because for so long, oral health, so, the mouth, has never been placed in the actual body. I think it's time now that we look at the science. As far as the science goes, it's actually demonstrating that there's quite a lot of links with the oral health – or, the health conditions that we can have – and poor oral health. So if you do suffer from gum disease, the advance and the severe. So we call it periodontal disease. It's a big jargon to say.

Madeline: I've heard that in a commercial, maybe? [Laughs]

Lisette: Well, that's good!

Madeline: But you're saying "gum disease" is a good way to say that.

Lisette: Gum disease can have actually a more mild sense to it, which is reversible. So: if you have gingivitis, for say, it's gums that bleed, they get puffy, you brush, you get rid of the plaque and it gets better. That's reversible. So the problem is that as it gets deeper and it goes, it infects the tooth, the tissues surrounding your tooth, and you start losing the bone that's holding your tooth. That's irreversible. So that's why we call it gum disease, but more the moderate and severe stage of it - that's the one that I'm talking about.

Madeline: Okay, okay. 

Lisette: The bacteria that's actually causing periodontal disease (the moderate and the severe staging) will have links with chronic diseases such as cardiovascular disease, like heart disease or stroke, or lung conditions – so, pneumonia. It could have actually links up to there, as well as diabetes. So let's talk about the first ones, the first two.

Madeline: There's a lot to unpack, I think.

Lisette: Oh my God, yes!

Madeline: It's a surprise! I mean, there's so much that can be happening within your mouth that can show signs to everything going on.

Lisette: And there's more! These are the ones the science that demonstrates it. There's going to be more, there is going to be more research required.

Madeline: There's more to learn, but right now we do know for some of them that there is a direct link.

Lisette: Yes, yes.

Madeline: Oh, wow.

Lisette: So with lung disease and with heart disease, what happens is: the bacteria that's actually causing the tissue around the tooth to get lost is going to be proliferating. So big word that says the more bacteria you have, by not brushing properly and not flossing properly, the more it is going to go down deeper into the gums because it prefers to have no oxygen to survive. The deeper it goes, the less oxygen there is, right? Then it goes down. It travels through the bloodstream and it will go all the way and attack the organs. It's actually kind of scary when you think about it.

Madeline: It is, yes!

Lisette: So, it may infect the envelope of the heart and you don't want that to happen because you end up with a lot of problems as well.

Madeline: Of course! So, I feel like this is brand new information for a lot of people. Importance on your oral health should not be forgotten. I would imagine that in your life, in your working life: have you encountered situations during an oral exam, or maybe a colleague during an oral exam has seen signs of potential problems that could lead to overall health issues?

Lisette: Absolutely. One that has a bidirectional link is diabetes as well. You will have a hard time controlling your diabetes if you suffer from gum disease, right? But both of them; I'm going to have a hard time controlling my gum disease if I cannot control my diabetes. So it's very important that when you go see your oral health professional that you actually state that you have diabetes. But 50% of people don't even know that they have diabetes, so it's important to ensure that there are some signs that can actually tell us. The breath sometimes has a kind of smell that's very distinguished if you have diabetes. That's why oral health and overall health are intertwined. It's very important to visit your oral health professional, because they're actually maybe the ones to tell you to go visit the doctor.

Madeline: It's true! I mean, I'm sure that within that community, they're more aware of this relationship. But as you're saying: if you don't have a great awareness of your overall health or vice versa. Do you feel like there's been times where you've said to someone, "Hey, you know we're mid exam, but I'm noticing that there may be something to do with this checkup that indicates a further issue" like a cardiovascular issue for example. Have you seen instances of that?

Lisette: Exactly. When you actually come and visit the oral health professional, our job is to ensure that we have a good write up of your medical history. As part of medical history, we have to take down all the medications that you're taking, and we also take the blood pressure. If you take the blood pressure, sometimes what happens is that if it's higher than it should be, usually or usually higher, but not just caused by the anxiety exactly. 

Madeline: Not the stress, yes! I know I always say I'm a little nervous, if that affects it? So, you're saying there is a little bit of a range for that.

Lisette: Yes!

Madeline: But there can still be further indicators of an underlying issue just with that alone.

Lisette: Oh my God, yes. And it's happened that I had to stop the evaluation and the appointment to say the blood pressure was too high. I said, "you need to visit your doctor". They came to the subsequent visit, and what happened is that they said: "Thank you so much. I'm now on medication." Because actually blood pressure is what we call "the silent killer". There's no symptom, but it's pretty hard on your heart. So what happens is that you need medication to counteract the high blood pressure.

Madeline: And with that, the opportunity to take that test that led to the medication. I think that kind of runs into my next question: I know that as part of their overall health, people may experience, in their life, the need to be taking medication regularly. Is that tied to oral health as well? Are there effects of the medication? Sometimes you hear about side effects. Will that impact oral health? Is the relationship still there?

Lisette: Well, the biggest side effect of most of all the medications that we take, it's called xerostomia. It's a big word.

Madeline: Can you say that fast for us, Lisette? [Laughs]

Lisette: [Laughs] I think I could, but I don't want to do it! Basically, what xerostomia is, is that is the lack of saliva flow in the mouth.

Madeline: OK, so a drier mouth. Understood.

Lisette: Exactly! Dry mouth. So I'm not going to start stating all the medications that have this side effect, but basically everything, everything has it. And actually, we also want to talk about children who are asthmatic when they use their inhalers and their pumps, you've got to look at how to use it. Some of the inhalers, you've got to make sure that you rinse your mouth afterwards because you may end up with a condition called "candidiasis". It's a big word just to say that you may end up with some kind of lesions as well, so make sure that you rinse your mouth.

Madeline: That's uncomfortable for a kid as well. It's the type of thing that if a simple rinse can prevent that sort of situation, I'm sure they'd be happy to do that.

Madeline: So you've mentioned these conditions where there is a clear linkage, but I understand as you've said, there's further research being done on other conditions. Is that something you can speak to today?

Lisette: Actually, Maddy, there's some conditions like dementia or obesity that we may believe that there's some sort of link or association. But the research is not quite there yet, so we can't really say for sure that it's linked with periodontal disease. That's why Statistics Canada is now going across the country and they're collecting data on health. Not just health, but oral health measures as well. It is fantastic because right now, those trailers that are mobile clinics, are undergoing 16 cities across the country. Some people will have the opportunity to volunteer for the survey. They will get their health checked and they will get their dental health checked as well. So right now, I believe that this is a 2-year survey. By 2025, we're probably going to get some preliminary results as well. All the researchers across Canada are happy that all of this data is going to be available for them.

Madeline: You're going to have to come back and tell us about it, I think.

Lisette: I hope! I hope you invite me again.

Madeline: Thank you so much Lisette for coming here and giving me a bunch of revelations. I'm sure that people listening have definitely learned something here today. If someone does want to research a little bit more about the connection between oral health and overall health, or if they just want to look into this on their own time, where can they go?

Lisette: Well, actually one link I can provide them is the under the Government of Canada website. You could just use the keywords "oral health" and it will bring you to our oral health web page. There's a few pages on how to take care of your teeth and how to care for other people's teeth – if you're a caregiver, let's say. These are filled with links that can take you to other pages, and there's plenty of information in there to start with. 

Madeline: Excellent! So they'll head to, search "oral health", and have an afternoon of reading! Sounds great. Well, thank you again for coming today and hopefully we'll be speaking to you soon for more about oral health. 

Lisette: It was my pleasure, Maddy. Take care. Thank you so much.

Madeline: You're welcome.

Madeline: Thanks for tuning in to Healthy Canadians: Behind the Science. If you're watching on YouTube, don't forget to click the like button below and subscribe to stay up to date on future episodes. Find us wherever you get your podcasts and leave us a review if you've liked what you've heard. For more information on the health topics that matter to you, visit

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