In addition to chewing food, the main function of the teeth is believed to be just aesthetic. The reality is that teeth cannot be seen isolated from the rest of the body: actually, they are the mirror of the body’s health.

The current dentistry is focused too much on the aesthetic function that teeth cover: it is enough to have a look to any degree program in Dentistry or Orthodontics in any university to discover it. However, teeth should be studied through a holistic approach: a healthy and balanced mouth represents  a pillar of overall health.

There are several studies recognizing the direct relationship between what we consider as beauty and health. For example, an increased consumption of fruit and vegetables is associated with a different tone of skin-color (carotenoid) [1]. Looking to Figure 1, ask yourself which skin tone looks more attractive. When given a choice, people perceived the carotenoid skin-coloration as healthier and more attractive [1,2,3,4].

skinColor
Figure 1 – Same person, with different skin-colors: in the center, there is the normal tone, while on the left suntanned coloration and carotenoid on the right. A carotenoid color derives by higher consumption of fruit and vegetables. People in several studies found more attractive and healthier the skin-color on the right. (From [16])

The same is true for the teeth: beauty is health. A wide smile, with U-shaped palate and straight teeth, is considered more attractive than a narrow V-shaped palate with malocclusion. As the work of John Mew highlights (Figure 2), malocclusion is just a symptom of  poor craniofacial development, due to environmental causes. Interestingly, people with perfect straight teeth are those who never went to an orthodontist: their teeth are perfectly aligned because they found space in a forward-grown maxilla that has been shaped by forces coming from the tongue and the teeth in contact.

OrthotropicsCase6
Figure 2 – Patient before (on the left) and after (on the right) Orthotropics. Notice how malocclusion is directly related to a vertical growth of the maxilla (left), while a wider smile finds place into a face grown horizontally (right), that is also more attractive.

Malocclusion and narrow palate are symptoms of a down-siding of the entire craniofacial structure, with the maxilla that drops down and back. This reduces the eye support, flattens the cheekbones, narrows the nasal airway, lengthens the mid facial third, and lowers the palate, which narrows and create malocclusion [5]. Furthermore, a vertical growth of the maxilla means the mandible swings back, with the body that compensates with forward head posture [6,7], leading to an increased kyphotic and lordotic curve as further compensation. Then, this causes the pelvis to tilt forward, with consequences to legs and feet.

FHPrx
Figure 3 – Two patients from study [7]: subject HB003 shows vertical growth of maxilla, with facial retrognathism  and large mandibular inclination. Notice the forward head posture and the reduced airways’ space. Subject HB092 shows forward growth of maxilla, with facial prognathism and small mandibular inclination. Notice the head posture aligned with the cervical column and the bigger space for the airways.

Thus, it is clear that just by looking at an individual’s teeth it is possible to understand his/her posture. And it does not end here: asymmetries in the teeth highlight asymmetries in  the relationship of the skull bones (and facial asymmetries) [8], with the body that compensates with scoliosis and leg length alignment asymmetry.

When the craniofacial development is not as nature intended, the body actuates compensatory mechanisms in order to find the optimal balance. However, in the long term, these compensations causes predisposition to many problems: muscles tightness, headaches, blood vessels compression, respiratory problems, brain fog, hair loss and so on. The outcome is an increased risks of being dependent in activities of daily living, including higher mortality [9].

Apart from the alignment and presence of malocclusion, there are other factors that demonstrate how teeth are perfect indicators of body’s health. For example, think about smokers: smoking can lead to tooth staining, gum disease, tooth loss. Indeed, it has been long associated with higher predisposition to develop cancer [10], together with many other health issues.

smokingTeeth
Figure 4 – Example of smoker’s teeth. Teeth are the mirror of body’s health: smoking can lead to tooth staining, gum disease, tooth loss. Unsurprisingly, smoking is associated with cancer. (From [17])

Do you need other proofs? A 5-year long study [11] demonstrated that edentulism (that means loss of teeth, Figure 5) is associated with increased risks of cardiovascular disease and total mortality. Also, presence of periodontitis (gum inflammatory disease that can lead to loss of teeth, Figure 6) is associated with higher mortality rate.

Edentulism
Figure 5 – Edentulism: tooth loss. It has been associated with increased risks of cardiovascular disease, total mortality, rheumatoid arthritis and mental illness. (From [18])
periodontitis
Figure 6 – Periodontitis: inflammatory diseases affecting the tissues surrounding the teeth, involving progressive loss of the alveolar bone. It has been associated with increased risks of cardiovascular disease, total mortality, rheumatoid arthritis, mental illness and erectile disfunction. (From [19])

In another 17-year long study [12], a sample of 9760 subjects has been examined determining that dental diseases (periodontitis, oral debris, dental calculus) are associated with coronary heart disease and higher mortality. Another study [13] linked periodontal diseases to rheumatoid arthritis (pain, swelling and stiffness in the joints): indeed subjects with rheumatoid arthritis were more likely to be edentulous and have periodontitis.

Still not convinced? Ok, then let us consider the essential aim of every living being, that is the survival of the species: for this, reproduction is essential. When a living entity is not able to reproduce, then there is something wrong for sure. Well, not surprisingly a study [14] has found out that chronic periodontitis has a high association with erectile dysfunction.

And in a holistic approach, do not forget the strict connection between body and mind. According to another study [15], people with severe mental illness have higher odds of having lost all their teeth than the general community. They also have significantly higher scores for dental decay.

So, there are no doubts, the title of this page is correct! Teeth: the mirror of body’s health. Italians use to say “a caval donato non si guarda in bocca” (literally translated as “do not look a gift horse in the mouth“) that is a proverb for saying that if someone gives you a present do not look to its quality since it is a present (so it is for free). This proverb arose since in the past the horse’s dentition was used to identify its age and state of health (Figure 7).

HorseTeeth
Figure 7 – Horse dental chart comparison. It is possible to age a horse and to know its health condition by looking to its teeth. (From [20])

In your case, it is better to check your mouth! And the intention here is not to say that the cure of dental diseases is an appointment with your dentist: this is just a way to treat the symptoms. If you have dental diseases, there is something wrong in your lifestyle: try to understand what it is and avoid it. Prevention is the real cure: if you have already a dental disease it might be already too late. Remember that those with the healthiest teeth are those that never saw a dentist!

 

References

[1] Whitehead, Ross D., et al. “You are what you eat: Within-subject increases in fruit and vegetable consumption confer beneficial skin-color changes.” PloS one 7.3 (2012): e32988.

[2] Stephen, Ian D., et al. “Facial skin coloration affects perceived health of human faces.” International journal of primatology30.6 (2009): 845-857.

[3] Stephen, Ian D., et al. “Skin blood perfusion and oxygenation colour affect perceived human health.” PLos one 4.4 (2009): e5083.

[4] Stephen, Ian D., Vinet Coetzee, and David I. Perrett. “Carotenoid and melanin pigment coloration affect perceived human health.” Evolution and Human Behavior 32.3 (2011): 216-227.

[5] Mew, M. “Craniofacial dystrophy. A possible syndrome?.” British dental journal 216.10 (2014): 555-558.

[6] Marcotte, Michael R. “Head posture and dentofacial proportions.” The Angle orthodontist 51.3 (1981): 208-213.

[7] Solow, Beni, and Antje Tallgren. “Head posture and craniofacial morphology.” American Journal of Physical Anthropology 44.3 (1976): 417-435.

[8] Strokon, Dennis. “Correction of Dental and Cranial Sidebend with ALF.” IJOM 21 (2010): 3.

[9] Kamitani, Kojiro, et al. “Spinal posture in the sagittal plane is associated with future dependence in activities of daily living: A community-based cohort study of older adults in Japan.” Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences 68.7 (2013): 869-875.

[10] Hecht, Stephen S. “Cigarette smoking: cancer risks, carcinogens, and mechanisms.” Langenbeck’s Archives of Surgery 391.6 (2006): 603-613.

[11] LaMonte, Michael J., et al. “History of Periodontitis Diagnosis and Edentulism as Predictors of Cardiovascular Disease, Stroke, and Mortality in Postmenopausal Women.” Journal of the American Heart Association 6.4 (2017): e004518.

[12] DeStefano, Frank, et al. “Dental disease and risk of coronary heart disease and mortality.” Bmj 306.6879 (1993): 688-691.

[13] de Pablo, Paola, Thomas Dietrich, and Timothy E. McAlindon. “Association of periodontal disease and tooth loss with rheumatoid arthritis in the US population.” The journal of rheumatology 35.1 (2008): 70-76.

[14] Oğuz, Fatih, et al. “Is there a relationship between chronic periodontitis and erectile dysfunction?.” The journal of sexual medicine 10.3 (2013): 838-843.

[15] Kisely, Steve, et al. “Advanced dental disease in people with severe mental illness: systematic review and meta-analysis.” The British Journal of Psychiatry 199.3 (2011): 187-193.

Other Websites

[16] Looking good on greens, University of Nottingham

[17] The links between oral and systemic health, by Clinical Advisor

[18] Dental treatment for partial edentulism, by Blende Dental Group

[19] Periodontitis, by Clinica Dental Blay Monzò

[20] Aging Horses by Their Teeth, by Melissa Rouge