As dental professionals, we are only too aware of the associations between oral and systemic health. We all dedicate time and resources trying to educate patients on the topic, whether that is during appointments or in our practice marketing. Given that Urology Awareness Month is promoted across the UK in September, I thought this an interesting opportunity to explore the impact of oral health on this area of the body.
Urinary infections (UTIs)
A study[i] has found a positive correlation between pyelonephritis – a kidney infection – and tooth decay. In this evaluation of children and adolescents, it was noted that those with UTIs often also had dental caries. The authors concluded that the prevention of dental decay could also reduce the risk of systemic infections such as UTIs.
Kidney disease
Other than UTIs, periodontitis has been associated with kidney disease too. Almost 80% of patients with chronic kidney disease demonstrate changes in their oral cavity, with loss of kidney function manifesting in the mouth.[ii] The most common of these were tongue coating and pallor of the oral mucosa. Risk of tooth loss also appears to be higher among patients with kidney disease.
Urological cancers
Research[iii] has also reported a link between periodontitis and urological cancers, such as those that affect the prostate, bladder and kidneys. As is the case with other systemic interactions, it may be possible for oral bacteria to travel through the bloodstream to the urinary system. It has been postulated that the oral microbiota in patients with periodontal disease may provide biomarkers that help to predict the risk of developing various genitourinary cancers.
Two for the men
Periodontal disease strikes again for men’s health, increasing the risk of benign prostatic hyperplasia by 1.68 times according to research in 2019.[iv] Authors of this particular study went as far as to suggest that periodontal disease could be an independent risk factor for benign prostatic hyperplasia, with age, hypertension status, BMI and ethnicity having no influence over the links between the two conditions.
In addition, there is growing evidence that periodontitis is a risk factor for erectile dysfunction.[v] Men are up to 2.85 times more likely to experience erectile dysfunction when they develop periodontal disease.
Ammunition for education
Many patients are unaware of the close relationship between the mouth and the rest of the body. It wouldn’t be a stretch to suggest that most probably wouldn’t link their oral health with that of their urological system. This presents a new opportunity for the dental team to engage with patients and share useful information or resources. There is plenty of information about Urology available right now (The Urology Foundation is a good option). Why not start the conversation in the dental practice?
Author: Dr Michael Sultan
EndoCare, led by Dr Michael Sultan, is one of the UK’s most trusted Specialist Endodontist practices. Through the use of the latest technologies and techniques, the highly-trained team can offer exceptional standards of care – always putting the patient first. What’s more, EndoCare is a dependable referral centre, to which dentists from across the country send their patients for the best in specialist endodontic treatment.
[i] Kılıç FE, Almiş H, Bucak İH, Turgut M. Evaluation of the relationship between dental caries and urinary tract infections. Zeynep Kamil Med J 2022;53(3):146–150.
[ii] Silva DF, Oliveira ICR, Medeiros SA, Baeder FM, Albuquerque ACL, Lima EO. Oral health challenges in patients with chronic kidney disease: A comprehensive clinical assessment. Saudi Dent J. 2024 Feb;36(2):364-367. doi: 10.1016/j.sdentj.2023.11.026. Epub 2023 Nov 27. PMID: 38419998; PMCID: PMC10897613.
[iii] Yuan S, Fang C, Leng WD, Wu L, Li BH, Wang XH, Hu H, Zeng XT. Oral microbiota in the oral-genitourinary axis: identifying periodontitis as a potential risk of genitourinary cancers. Mil Med Res. 2021 Sep 29;8(1):54. doi: 10.1186/s40779-021-00344-1. PMID: 34588004; PMCID: PMC8480014.
[iv] Wu, L., Li, BH., Wang, YY. et al. Periodontal disease and risk of benign prostate hyperplasia: a cross-sectional study. Military Med Res 6, 34 (2019). https://doi.org/10.1186/s40779-019-0223-8
[v] Connolly, L. The effects of oral health on erectile dysfunction. BDJ Team 9, 29–31 (2022). https://doi.org/10.1038/s41407-022-0805-2
