The mouth is connected to the body by blood vessels, lymphatic pathways, and the immune system. Ignoring oral health means risking more than a toothache — it could mean risking your life.

When most people think of oral health, they think of teeth, cavities, brushing, flossing, maybe the occasional root canal. But the truth is, what’s happening in your mouth can have a ripple effect throughout your entire body. This is the heart of the oral-systemic connection — a growing field of study that links oral health to overall health and well-being.

The oral-systemic connection

The oral-systemic connection refers to the link between oral health and systemic (whole-body) health. At its core, it’s based on how bacteria, inflammation, and immune responses in the mouth can influence, or be influenced by, other parts of the body.

The mouth harbors over 700 bacterial species. Some are harmless or even helpful, but others are pathogenic and can cause infection. When oral bacteria enter the bloodstream, especially through diseased gums or broken tissues, they can trigger inflammation and affect distant organs. Most dental infections have no pain. Gum disease has no pain, yet the bacteria in gum disease have been proven to cause cardiovascular disease. Most cavities have no pain, yet they also deposit harmful bacteria directly into the bloodstream.

Inflammation is a key player here. Periodontal (gum) disease is a chronic infection of the gums caused by bacteria. It causes chronic inflammation, which, in turn, is a common factor in many major illnesses. So it’s not surprising that researchers are finding strong correlations between poor oral health and chronic disease.

The evidence

Heart disease. Cardiovascular disease (CVD) is the leading cause of death worldwide and is closely tied to oral health. Studies have revealed that the risk of heart attacks, strokes, and other cardiovascular events is higher by 2–3 times for people with periodontal disease.

The reason is that when gum tissues are inflamed, bacteria and their byproducts can enter the bloodstream and contribute to atherosclerosis, a condition where plaque builds up in arteries, increasing the chances of a heart attack or other heart-related complications. These oral pathogens may also trigger an immune response that exacerbates inflammation in blood vessels.

The BaleDoneen Method, developed by Dr. Bradley Bale and Dr. Amy Doneen, details the role of periodontal disease in cardiovascular health. Bad bacteria in the mouth can contribute to creating the atherosclerotic triad — people with gum disease have twice the risk of developing dangerous LDL cholesterol, whose particles are thicker and denser, and hence, more easily able to penetrate arterial walls. Chemicals produced by oral bacteria make the arteries more permeable, facilitating a smoother buildup of plaque. They also make artery walls stickier, making it easier for plaque to latch on and get trapped inside. The studies conducted by Drs. Bale and Doneen have shown that addressing periodontal health can lead to improvements in arterial health, including the regression of atherosclerotic plaque. For instance, a study involving 324 patients over five years found that implementing the BaleDoneen Method led to the resolution of soft, inflamed, rupture-prone, lipid-rich plaque in all participants.

Diabetes. The relationship between diabetes and periodontal disease is bidirectional — one aggravates the other. Diabetics run a high risk of getting infected, including gum disease. At the same time, chronic gum inflammation makes it harder to control blood sugar levels.

Inflamed gums release cytokines, which can interfere with insulin signaling and worsen insulin resistance. In some cases, treating periodontal disease has been shown to improve glycemic control.

Pregnancy complications. Pregnant women with gum disease face a higher risk of preterm birth and low birth weight. Oral bacteria can travel through the bloodstream to the placenta, triggering inflammatory responses that disrupt normal pregnancy. Pregnant women suffering from gum disease also have a greater risk of developing preeclampsia, persistent high pressure during pregnancy or after, which can cause liver or kidney damage, threatening the lives of both mother and baby.

Several studies have found that treating periodontal disease during pregnancy can reduce the risk of these outcomes. Yet, dental care is often overlooked in prenatal care, leaving many women vulnerable.

Respiratory illness. Bacteria in the mouth can be inhaled into the lungs, especially in older adults or hospitalized patients. This can lead to infections like pneumonia, especially among those who are already immunocompromised.

There is proof that good oral hygiene, especially in nursing homes and hospitals, has lowered the incidence of respiratory infections. It’s a simple preventive measure with big implications.

Cognitive decline and Alzheimer’s disease. Emerging research is exploring a possible connection between periodontal pathogens and neurodegenerative diseases like Alzheimer’s. Porphyromonas gingivalis, a key pathogen in gum disease, has been identified in the brain tissue of individuals with Alzheimer’s.

While the evidence is still preliminary, it raises serious questions: Could chronic gum infections contribute to the inflammation and plaque buildup seen in dementia? Could oral health interventions delay cognitive decline?

The research is ongoing, but it makes an important point: oral health may impact brain health more than we have imagined.

The role of inflammation. Chronic inflammation is the common denominator of all these connections. Periodontal disease doesn’t just damage the gums — it causes systemic inflammation, which is now recognized as a driver of many chronic illnesses.

This means your gums aren’t just bleeding — they are sending inflammatory signals throughout your body. Over time, this low-grade, persistent inflammation puts stress on the cardiovascular system, disrupts metabolic processes, and weakens immune defenses.

Oral inflammation is not silent. It speaks the same inflammatory language as arthritis, heart disease, and diabetes. If you’re fighting inflammation in your mouth, you’re fighting a war on multiple fronts.

The oral-systemic connection — a game changer

The oral-systemic connection has implications for medicine and public health. It transforms dentistry from a niche service into a frontline of preventive medicine. It breaks down the artificial barrier between oral care and general health care and calls for a more integrated approach.

Prevention over reaction. By investing in oral health — early and often — we can stop systemic diseases in their tracks. Regular dental checkups, good oral hygiene, and periodontal screenings should be as routine as blood pressure or cholesterol checks.

Interdisciplinary collaboration. Medical doctors, dentists, hygienists, and specialists should collaborate, share information, and make sure their treatment plans are aligned. For example, managing a diabetic patient without addressing their gum disease leaves the circle of care incomplete. The same principle applies to cardiac patients or pregnant women.

Health equity. Oral disease disproportionately affects low-income and marginalized communities, who often lack access to dental care. The result is not just more tooth decay, but higher rates of diabetes, heart disease, and pregnancy complications. Bridging the gap in dental care is an essential step toward ensuring health equity.

Dentistry is not expensive. Neglect is.

We don’t need to wait for a diagnosis to start protecting our oral and overall health. Start today:

• Brush and clean in between your teeth: This is a basic but essential component of the mouth care routine. Brushing removes plaque and prevents the buildup of bacteria, while flossing, interproximal brushes, or DWI (Directed Water Irrigation) cleans areas your toothbrush can’t reach.
• Don’t ignore bleeding gums: Bleeding gums are a sign of inflammation and need a check-up by the dentist.
• Visit your dentist regularly: Standard practice dictates dental visits two times a year, but people with chronic conditions may need to see the dentist more frequently.
• Quit smoking: Tobacco use accelerates gum disease and worsens nearly every other systemic condition. Stop now, before it gets too late.
• Eat a balanced diet: A tooth-friendly diet that is low in sugar but high in fiber and nutrients works both for your body and for your teeth. Remember: what’s good for your body is good for your teeth.
• Give your dentist a case history of your medical conditions: The case history will help your dentist learn more about your oral health history and how your oral health is responsible for other health issues. They’re more connected than you think.

To conclude, the mouth is a bridge to the rest of your body. It is the front door, so oral health isn’t cosmetic — it is systemic. It’s time we treated it that way. The science is clear: bleeding gums and chronic infections in the mouth are not just local issues. They are red flags for deeper systemic problems. By recognizing the oral-systemic connection, we can detect diseases earlier, treat them more effectively, and live longer, healthier lives.

Your body is listening to your mouth — what is it saying?

Charles Reinertsen is a dentist.