The Gateway to the Guts

By: Carson Bell

                You want to enter Disneyland . . . you enter through the front entrance; you want to enter your house . . . you walk through the door; you need to board a plane  . . . you must go through the door. The only way to pass into anywhere is through the entrance. The body is no exception! Anything that is to go into the body must pass through the gateway: the mouth. When times are good people have no problem getting check-ups regularly at the dentist, but when money gets tight, visits to the dentist are usually one of the first things to go. People don’t usually miss their physicals, or screenings with their doctor, but for some reason that priority does not live as high on the list for a person’s oral health. However, if you were to stop and really think about the importance of your mouth and its relationship with the rest of the body, that trend would change. Giardiasis, cholera, cancers, encephalitis, and the list goes on of diseases that come from entry through the mouth. So, there is no doubt that many disorders are linked to the oral health of a person, and the purpose of this paper is to explain the connections between oral health, gastrointestinal disorders, and brain disorders. Here we will appreciate how dentition is a powerful indicator of one’s self esteem and overall health, how the economics behind brain disorders affect healthcare providers, and how being able to write prescriptions as a dentist is related to disorders of the gut and brain.

                It’s the first day of school after a wonderful summer, the alarm goes off early and you jump out of bed. You choose the perfect outfit, get a good breakfast, and the last thing before you head out is you brush those teeth to make sure your smile is stunning! I mean you have to impress all the cute guys, or gals! We, as humans, link appearance of our teeth directly with how attractive we view ourselves (Geld, P.V. et al., 2007). This whole hierarchical ranking of ourselves, and others, has led to the development of a powerful stressor. When we view ourselves as unattractive or undesirable to people we find attractive, or even people that we MIGHT run into that are attractive it leads to a significant amount of stress. This stress becomes chronic as our self-esteem drops and this cascade of events lead to various health issues. With this decrease in self-esteem there are many physiological events occurring which basically lead to bad mental and physical health (Trzesniewski, Kali H. et al., 2006). One specific result is problems in our gastrointestinal tract. As our stress levels become chronic it leads to imbalances of hormones which lead to malnutrition because absorption is affected and irregular bowel movements. Stress is also linked to irritable bowel syndrome (Monnikes H, et al., 2001). Aesthetics is a very important esteem booster. As humans we are psychologically wired to be accepted socially, and when we aren’t, this is bad news for our mental and physical health!

                Money! That inescapable friend and foe! Diseases usually cost a LOT of money, as we saw previously with diabetes. Gastrointestinal diseases and brain disorders are no exception. Dementia is an umbrella term that covers a number of diseases that lead to memory dysfunction to the point that it affects the ability of a person to function at a normal level. Treatment, research, and other indirect costs of these diseases are extremely expensive! It has been estimated that this class of disease costs the United States about $85.5 billion annually (Langa, K.M., 2004). Realizing that, as a geriatric population, financial resources are limited as it is, this kind of extra cost can be very hard on these individuals. As I see it, healthcare providers that have hearts are more and more needed in this world. In addition, I think less healthcare providers who have their minds set on making an extra buck are not needed as much. As a future dentist I hope to be willing to accept all kinds of patients including people on Medicaid or medicare, etc. I think that older generations have done their part and continue to do their part in enhancing the quality of society. Their actions have shaped our lives in many aspects, and I believe that as healthcare providers we should give back to our communities and elders. I find no harm in giving a break on bills when you can, or trading services, or whatever it may be to lend a helping hand to those under financial ills. Understanding, as a healthcare provider, that patients are folks with problems and hardships just like me can help relieve financial stressors for people who deserve a helping hand.

                As is common knowledge, doctors are able to prescribe medications to help with pain, recovery, and other symptoms and complications of illness. Medications must be processed and metabolized just like anything else that is digested and through this process is how the alleviating effects can be felt. There are many complex biological pathways by which this occurs, and there are a lot of ways “things can go south” as a result. So, as a dentist it is very important to know what patients are taking and what kind of habits or lifestyles they have because it can determine what types of drugs the person is allowed to have. There are a variety of drugs used in the dental office such as: analgesics (pain medications), antibiotics, sedative therapies, vasoconstrictors, and anesthetics; all of which can have adverse reactions in the body depending on the person (Moore, P.A., et al., 1999). Not only does a dentist have to worry about the medications they are using and prescribing, but they also must know about the medications a patient is already taking. Medications react with pathways, organs, fluids, and so much more; but one very important reaction that should be a primary focus of doctors is the reaction of prescription drugs with other medications.  You always can read on labels of drugs don’t take with alcohol or with such and such other substance. The reason for this is those drugs react with those substances and can be lethal! The same can occur with any of the prescribed drugs. So for example, a person is having issues with IBS, or anxiety, or any other gut or brain disorder so their doctor prescribes a pill. The same person then has tooth ache and goes to the dentist. The dentist then has to operate and prescribe some more medications depending on the procedure done. Right there is where it is important for a dentist to know about their patient. He/She must know if the medication prescribed by the medical doctor will react adversely with the medications they are going to get. The dentist must choose the correct pill that will not react badly, or even lethally, with the other pills the patient is taking. As healthcare providers you have to prescribe drugs and with that comes the responsibility to know how those drugs react.

                It is simple to see that there is a definite relationship between oral health, GI disorders, and brain disorders. When self-esteem is in the gutter, our guts suffer. When there are memory ailments and other brain disorders they place a large burden on our wallets leading to the need for more healthcare providers who will give back to the community and geriatric generations. Medications from GI and brain disorders when mixed with prescribed drugs in the dental office can be lethal, so dentists must know their stuff when giving those out. Our oral health is extremely important for the well-being of the rest of our body, and taking care of our mouths is super important. These connections and many more show how the mouth truly is the gateway to our guts!

                 

REFERENCES

Mönnikes H, Tebbe J, J, Hildebrandt M, Arck P, Osmanoglou E, Rose M, Klapp B, Wiedenmann B, Heymann-Mönnikes I, Role of Stress in Functional Gastrointestinal Disorders . Dig Dis 2001; 19:201-211

Geld, P. V., Oosterveld, P., Heck, G. V., & Kuijpers-Jagtman, A. M. (2007). Smile Attractiveness. The Angle Orthodontist, 77(5), 759-765. Doi: 10.2319/082606-349     

Trzesniewski, Kali H.; Donnellan, M. Brent; Moffitt, Terrie E.; Robins, Richard W.; Poulton, Richie; Caspi, Avshalom. Low self-esteem during adolescence predicts poor health, criminal behavior, and limited economic prospects during adulthood. Developmental Psychology, Vol 42(2), Mar 2006, 381-390. http://dx.doi.org/10.1037/0012-1649.42.2.381

Langa, K. M., Larson, E. B., Wallace, R. B., Fendrick, A. M., Foster, N. L., Kabeto, M. U., & ... Herzog, A. R. (2004). Out-of-pocket health care expenditures among older Americans with dementia. Alzheimer Disease and Associated Disorders, 18(2), 90-98.

Moore, P. A., DMD, Gage, T. W., DDS, Hersh, E. V., DMD, Yagiela, J. A., DDS, & Haas, D. A., DDS. (1999). Adverse Drug Interactions in Dental Practice. The Journal of the American Dental Association Volume 130, Issue 1, Pages 47-54