If you know Dr. Weston Price, it’s probably for his landmark research on how the modern Western diet affects the development and health of the teeth and jaws. Yet through his root canal research, he was also largely responsible for popularizing an idea called focal infection theory. This is the idea that local problems can have distant effects – that infections in the mouth can cause problems elsewhere in the body.
Despite the word “infection,” conditions don’t always involve harmful bacteria or other pathogens. Mercury fillings, for instance, can be considered “foci.” Most of the time, though, there is infection, as in the case of root canal (dead) teeth and osteonecrotic lesions (cavitations).
From its beginnings, biological dentistry has recognized the reality of focal infection, which conventional dentistry abandoned in the 1930s. While dentists began extracting teeth left and right, believing it would cure or prevent disease, the results weren’t all that great. Patients weren’t getting better.
The problem? While dentists were indeed addressing a potential cause of disease, most failed to address its other effects, such as the build-up of pathogens and other toxins. It was like shutting off the water in an overflowing tub while leaving the spilled water to soak into the floor.
Some, though, – such as Edward Rosenow, whose earlier research informed Price’s – insisted that just removing teeth was not enough. Price himself envisioned a future in which a dentist would be not just a “mouth mechanic” but a dental physician.
Dental diagnosis is so intricate and involved that it requires a greater knowledge of the human body, its structures and diseases, and of the various means for understanding the normality and abnormality of the same than any specialty of the healing arts; and probably no specialty finds such great opportunity for doing injury to humanity, or for extending human life, as does the highest application of intelligence in this field. A competent diagnostician of the local and systemic expressions of dental infection must be familiar with the clinical and structural pathology required for a general medical diagnosis, and in addition, be completely familiar with dental anatomy, dental pathology, and dental operative procedures.
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They will be neither a physician nor a dentist, nor both in a sense that they will be a combination of the two as they exist today….I can see the necessity for a new type of practitioner; we could not develop them today in any institution, available for teaching that now exists. There must be developed both a new foundation of combined special medical and dental science, and a new method of application.
This is the tradition of biological dentistry. We review health histories deeply – dental and medical alike. We ask questions. We look at the mouth in the context of the whole body. We strive to be the type of practitioner Dr. Price envisioned.
And now some in mainstream dentistry are reconsidering focal infection theory in light of modern research revealing the links between periodontal (gum) disease and a wide array of health problems. These include heart disease, stroke, diabetes, Alzheimer’s, rheumatoid arthritis, and some cancers. Scientists have documented the presence of “oral” bacteria such as P. gingivalis (one of the main “bad bugs” involved in gum disease) in the hearts of those with cardiovascular issues, in the joints of those with RA – even the brains of those with Alzheimer’s. All these have chronic inflammation in common, as well.
As a recent summary in the BDJ noted, under the headline “Focal Infection Revisited,”
Between 1947 and 1989, 82 papers were published, addressing possible links between oral and systemic disease. Since 1989, however, there have been more than 1,200 such publications. These indicate that there are associations between oral disease and conditions such as coronary heart disease, stroke, pneumonia, diabetes, liver disease, rheumatoid arthritis and infant low birth weight. Whilst these links are not established as causal, the relationship between the mouth and the rest of the human body is being made yet again but this time on a scientific basis, showing that the dental profession does have a role to play in the health of the patient as a whole.
It’s exciting – and refreshing – to see this shift in perspective. Meanwhile, more research on the perio-systemic link continues to be published, including recent work on oral connections to cancer.
For instance, research earlier this year in Community Dentistry & Oral Epidemiology investigated the association between gum disease and breast cancer. Sixty-seven cancer cases were compared with 134 controls of roughly the same stage and smoking status. Overall, the cancer patients were found to have “two to three times higher odds of breast cancer than women without periodontitis,” even after adjusting for common risk factors.
Other research has supported this, such as the large study published this past August in Cancer Epidemiology, Biomarkers & Prevention, which found that
Periodontal disease increases risk of total cancer among older women, irrespective of smoking, and certain anatomic sites appear to be vulnerable.
Those sites include the breast, lungs, esophagus, and skin.
We need to note that this study does have some significant limitations, such as being based on self-reported information (vs. clinical exams). And like the previous study, it can only show that the two things are related, not that one caused the other.
Even so, you have nothing to lose by tending to your gums’ health and plenty to gain – from keeping all your teeth into old age to controlling the chronic inflammation that may be, as some have suggested, have a role to play in all disease.