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My dentist said that the purpose of semiannual visits is to bug patients on a regular basis to brush and floss properly. People will treat oral hygiene like goi

My dentist said that the purpose of semiannual visits is to bug patients on a regular basis to brush and floss properly. People will treat oral hygiene like going to the gym: they'll be all pumped up for a bit and then slack off eventually. The six-month mark is about when most people need that kick in the arse to get back on track. Scientists have been learning how crucial and vital good oral health is, because it affects the health of every other organ system in the body. Periodontal disease is a direct cause of both diabetes and heart disease. They even recently learned that poor gum health is a causal factor in colorectal cancer. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5159274/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5159274/

the_real_cher 2y ago
> periodontal disease is a direct cause of both diabetes and heart disease. I thought that diabetes was glucose processing dysfunction?
- sydbarrett74 2y ago
  The chronic inflammation from gum disease causes systemic insulin resistance, which leads to T2D. It's a direct and linear pathway.
  - the_real_cher 2y ago
    That's pretty nuts if true. There doesn't seem to be any logical connection there but with nature anything is possible.
    - sydbarrett74 2y ago
      I'll make it even more general. Any chronic inflammation leads to insulin resistance. It's just that with modern western diets, oral inflammation is the one that is almost universal.
sigmonsays 2y ago
it seems hard to swallow this connection. How can oral health cause diabetes?
- sydbarrett74 2y ago
  See my reply to u/the_real_cher.
tharkun__ 2y ago
And flossing has ... not been shown to improve anything at all really. Which is why I truthfully tell every dentist that asks: No I did not floss a single time since the last time you told me to. Also: My dad never really brushed his teeth much if at all. No fillings ever. No teeth removed. He used toothpicks "relentlessly" (in the XP sense) like while on the couch, while thinking through some chess moves etc. Turns out that's how our (smart) ancestors "brushed": with sticks.
- JumpCrisscross 2y ago
  > Turns out that's how our (smart) ancestors "brushed": with sticks If you're eating the diet our prehistoric ancestors ate, are at their level of physique and generally okay with their life expectancy, this is fine advice. For everyone else, there is limited evidence it helps prevent gum disease and halitosis [1]. [1] https://en.wikipedia.org/wiki/Dental_floss#Evidence https://en.wikipedia.org/wiki/Dental_floss#Evidence
  - tharkun__ 2y ago
    Yes that's two different ways to say the same thing. With respect to flossing, this shouldn’t have been news either. A systematic review in 2011 concluded that, in adults, toothbrushing with flossing versus toothbrushing alone most likely reduced gingivitis, or inflammation of the gums. But there was really weak evidence that it reduced plaque in the short term. There was no evidence that it reduced cavities. That’s pretty much what we learned recently. "Surprisingly little evidence for usual wisdom about teeth (nytimes.com)" https://news.ycombinator.com/item?id=19706409 https://news.ycombinator.com/item?id=19706409 (https://archive.is/e1jcB https://archive.is/e1jcB)
    - sydbarrett74 2y ago
      Different types of bacteria cause cavities as opposed to those causing periodontal disease. The former are caused by obligate aerobes, the latter by facultative anaerobes and are far more dangerous. The purpose of flossing is to get at the plaque (which forms tartar within 1-3 days) that exists interdentally and below the gum-line.

the_real_cher 2y ago

> periodontal disease is a direct cause of both diabetes and heart disease. I thought that diabetes was glucose processing dysfunction?

sydbarrett74 2y ago
The chronic inflammation from gum disease causes systemic insulin resistance, which leads to T2D. It's a direct and linear pathway.
- the_real_cher 2y ago
  That's pretty nuts if true. There doesn't seem to be any logical connection there but with nature anything is possible.
  - sydbarrett74 2y ago
    I'll make it even more general. Any chronic inflammation leads to insulin resistance. It's just that with modern western diets, oral inflammation is the one that is almost universal.

sigmonsays 2y ago

it seems hard to swallow this connection. How can oral health cause diabetes?

sydbarrett74 2y ago
See my reply to u/the_real_cher.

tharkun__ 2y ago

And flossing has ... not been shown to improve anything at all really. Which is why I truthfully tell every dentist that asks: No I did not floss a single time since the last time you told me to. Also: My dad never really brushed his teeth much if at all. No fillings ever. No teeth removed. He used toothpicks "relentlessly" (in the XP sense) like while on the couch, while thinking through some chess moves etc. Turns out that's how our (smart) ancestors "brushed": with sticks.

JumpCrisscross 2y ago
> Turns out that's how our (smart) ancestors "brushed": with sticks If you're eating the diet our prehistoric ancestors ate, are at their level of physique and generally okay with their life expectancy, this is fine advice. For everyone else, there is limited evidence it helps prevent gum disease and halitosis [1]. [1] https://en.wikipedia.org/wiki/Dental_floss#Evidence https://en.wikipedia.org/wiki/Dental_floss#Evidence
- tharkun__ 2y ago
  Yes that's two different ways to say the same thing. With respect to flossing, this shouldn’t have been news either. A systematic review in 2011 concluded that, in adults, toothbrushing with flossing versus toothbrushing alone most likely reduced gingivitis, or inflammation of the gums. But there was really weak evidence that it reduced plaque in the short term. There was no evidence that it reduced cavities. That’s pretty much what we learned recently. "Surprisingly little evidence for usual wisdom about teeth (nytimes.com)" https://news.ycombinator.com/item?id=19706409 https://news.ycombinator.com/item?id=19706409 (https://archive.is/e1jcB https://archive.is/e1jcB)
  - sydbarrett74 2y ago
    Different types of bacteria cause cavities as opposed to those causing periodontal disease. The former are caused by obligate aerobes, the latter by facultative anaerobes and are far more dangerous. The purpose of flossing is to get at the plaque (which forms tartar within 1-3 days) that exists interdentally and below the gum-line.