Good Oral Health is the Key to a Happy Gut

A healthy mouth is linked to overall health and well-being. Especially for people with long-term illnesses, such as Inflammatory Bowel Disease (IBD), oral and dental health is essential for maintaining general health and managing the underlying chronic illness. For Laura Jalasto, an athlete from Finland diagnosed with IBD, good oral and dental hygiene is especially important.

The association between IBD and periodontal disease is starting to emerge in recent scientific literature. Due to the inflammatory nature of both disorders, it is hypothesized that underlying IBD can trigger a raised basal cytokine response that can induce periodontal disease (1). 

Several studies have been conducted to explore this relationship further. For instance, a German study has identified that twice as many patients with IBD had clinical attachment loss >5 mm compared to those without IBD (2). Other studies have shown that IBD patients have a higher prevalence of periodontal disease, deeper gum pockets, and more clinical attachment loss – a key symptom of periodontitis and peri-implantitis.

Laura Jalasto is one of the best triathletes in Finland today. She has won Ironman Tallinn 2020 and Ironman Mallorca 2021, among other major Triathlon competitions. 

- I have been a goal-oriented athlete all my life. In my childhood, I was a skier and later a horseback rider. Triathlon came into the picture four years ago. I did my first full-distance Ironman competition three years ago, says Jalasto. 

Last October, Jalasto competed in the full-distance Triathlon World Championships in Kona, Hawaii, bringing home a World Championship bronze medal in the W40-44 category. Her goal for this season was to win an award at the half-distance World Championships in Lahti, but a stress fracture put a damper on her plans for this summer.

What fascinates Jalasto about triathlon is the versatility of the sport. The training is varied, and there are always new areas to develop. 

- The sport is also surprisingly social, and the vibe in the community is lovely. Even though most competitions are individual, training and competitions are often done as a group, and people have found friends outside the sport, she adds. 

Making health a priority

Inflammatory bowel disease (IBD) mainly comprises two separate inflammatory conditions: Crohn's disease (CD) and ulcerative colitis (UC). Laura Jalasto was diagnosed with ulcerative colitis in October 2020. 

Ulcerative colitis is a chronic inflammatory bowel disease in which the lining of the large intestine becomes inflamed. The main symptoms of the disease are abdominal pain, bloody stools, and diarrhea. The condition may also be associated with extraintestinal complications such as joint and skin symptoms. The disease is characterized by both active and asymptomatic periods.

- My abdominal symptoms started unexpectedly in August 2020, initially just as a bout of unnecessary abdominal activity. After a couple of months, however, I also started having severe abdominal cramps. In October 2020, I was diagnosed with Ulcerative Colitis with an endoscopy, Jalasto says. 

Competitive sport is highly demanding. It requires intense training, a regular lifestyle, and a varied and healthy diet. If you suffer from a long-term illness, the list of demands becomes even longer. Taking care of your health becomes even more critical.

- The medications associated with IBD combined with intense training can predispose to vitamin and mineral deficiencies and create additional needs for certain nutrients, Jalasto reminds.

Studies show that malnutrition is, in fact, very prevalent within the IBD population. Literature has previously estimated this number to be almost one in four outpatients and nearly nine out of ten inpatients (3,4). This could be due to direct factors such as loss of normal resorptive mechanisms and higher nutritional requirements due to the inflammatory process. Particularly in CD, involvement of the small bowel can hinder the absorption of vital nutrients.

Jalasto admits that living with inflammatory bowel disease can pose both practical challenges to everyday life and additional demands on goal-oriented sport, depending on the stage of the disease. 

- However, if the disease can be balanced with medication. By listening to your body, and taking a holistic approach to your health, in most cases, you can live a nearly normal life with inflammatory bowel disease and even be active in sports with ambition. 

The gut starts from the mouth 

Teeth supporting tissue, or periodontal tissue, can become inflamed similarly to the tissue that lines intestines in IBD. Scientists have, in fact, proposed that treating periodontitis impacts the management of IBD positively. 

According to Tommi Pätilä, cardiac and transplant surgeon at the New Children's Hospital at HUS, bowel diseases, such as colitis and Crohn's disease, often appear together with severe gum diseases, such as periodontitis or peri-implantitis. 

- Not surprisingly, because the gut can be seen as a long, twisting tube that starts from the mouth and has bacteria present all along the way. In both diseases there is a strong overreaction of the immune system against a theoretically relatively mild bacterial trigger. Practically, the immune system attacks one's own body, Pätilä says. 

Laura Jalasto has acknowledged the importance of oral health to her IBD. She is also aware of the risks that intense training puts on her oral health. 

Active training requires sufficient energy to pass through the mouth. This in turn can be reflected in the number of times you eat. In addition, heavy breathing during hard training sessions reduces oral saliva secretion and dries out the athlete's mouth. Saliva naturally provides good protection for the teeth. When this is no longer present, bacteria can enter the mouth to form caries.

Jalasto’s oral care routine includes brushing her teeth every morning and evening and using Lumoral twice weekly to help achieve and maintain optimal oral health. 

The Lumoral teeth cleaning method improves dental self-care and oral health even when traditional methods fail. Lumoral is a new oral hygiene method developed by Finnish researchers that can remove 99.99% of plaque bacteria from the surface of teeth. Lumoral is a targeted treatment, which means that the normal, important bacterial flora of the mouth is preserved. At the same time, gingivitis is treated.

 

References:

1. Chandan, J., Thomas, T. Inflammatory bowel disease and oral health. BDJ Team 4, 17083 (2017). https://doi.org/10.1038/bdjteam.2017.83
2. Chandan, J., Thomas, T. Inflammatory bowel disease and oral health. BDJ Team 4, 17083 (2017). https://doi.org/10.1038/bdjteam.2017.83
3. Li S, Ney M, Eslamparast T, Vandermeer B, Ismond KP, Kroeker K, Halloran B, Raman M, Tandon P. Systematic review of nutrition screening and assessment in inflammatory bowel disease. World J Gastroenterol. 2019 Jul 28;25(28):3823-3837. doi: 10.3748/wjg.v25.i28.3823. 
4. Scaldaferri F, Pizzoferrato M, Lopetuso LR, Musca T, Ingravalle F, Sicignano LL, Mentella M, Miggiano G, Mele MC, Gaetani E, Graziani C, Petito V, Cammarota G, Marzetti E, Martone A, Landi F, Gasbarrini A. Nutrition and IBD: Malnutrition and/or Sarcopenia? A Practical Guide. Gastroenterol Res Pract. 2017;2017:8646495. doi: 10.1155/2017/8646495

 

World Digestive Health Day on 29 May

World Digestive Health Day is celebrated every year on 29 May. Each year World Digestive Health Day marks the start of a one-year-long campaign that focuses on raising public and professional awareness of a particular digestive disease or disorder.

The campaign for 2023 is entitled "A Healthy Gut from the Start.” From birth, the GI tract serves to provide nutrients to our bodies, enhance the immune response, house the intestinal microbiota, and serve as a "second brain" with the brain-gut axis.