Vision is how we learn, move, read, watch and do countless other daily things. Because of how much we use our eyes, it can be easy to take them for granted, leading to neglect in ocular health maintenance. In the UK, 250 people start to lose their sight every day, with more than 2m Brits living with impaired vision. By 2050, led by an ageing population, the number will double.
There are several causes of sight loss, with age-related macular degeneration (AMD) and cataracts being the most prevalent. Glaucoma is a third factor, with seven per cent of people losing their vision to it. For dental practitioners, glaucoma is of particular interest due to its growing association with infectious bacteria in the oral cavity. Through a greater understanding of vision loss, glaucoma and the relationship with the oral microbiome, practitioners can arm at-risk patients with the actions to avoid sight loss.
Glaucoma chameleon
Glaucoma is dubbed the ‘silent thief’ of sight as significant visual loss often occurs over many years before a patient is diagnosed with it. Worldwide, this hidden disease is the leading cause of irreversible blindness, making it essential to recognise and manage early. Adults in their 70s and 80s are at a greater risk of glaucoma, as are those of an African, Caribbean or Asian origin or those with a family history of it.
There are several variations of the disease, but the most common is primary open angle glaucoma. Here, the eye’s drainage channels become increasingly clogged over time, building up fluid and intensifying pressure inside the eye. The optic nerve at the back of the eye contains millions of nerve fibres that connect the retina to the brain, transmitting the sensory information needed to generate the vision – when this is damaged by the increased pressure, vision deteriorates, beginning with the peripheral. Along with blurring vision, seeing rainbow-coloured circles around bright lights is also an early sign of glaucoma, and an eye test is recommended. However, glaucoma can occasionally develop suddenly, causing intense pain, nausea, vomiting, headaches and red eye.
An eye for an eye
As infections in the ear, nose or throat can increase pressure in the optic nerve, it is essential to treat them as quickly as possible to avoid intensified glaucoma symptoms. Research has also found an association between glaucoma and oral diseases, especially periodontitis.
The oral cavity is the only body part through which infectious microorganisms can spread to distant organs and cause disease; teeth are a doorway to overall health. The dysbiosis of the oral microbiome, triggered by diseases such as caries and periodontitis, leads to the immune system generating inflammatory markers to combat the infection. From the base of the teeth, inflammatory bacteria can reach the optic nerve head microcirculatory system, causing endothelial cell dysfunction and increasing the risk of glaucoma. This can have a reciprocating impact on oral health: visually impaired patients are likelier to report a higher incidence of dental trauma, plaque and oral disease. An interdisciplinary approach between dental practitioners and other healthcare providers is therefore required to lower the risk of glaucoma.
A tooth for a tooth
Dental practitioners can reduce the risk of glaucoma in two key ways: promoting a consistent and effective oral hygiene routine to limit infectious diseases, and to follow a healthy diet. For advice on the latter, at-risk patients should be recommended leafy greens (such as kale and spinach), eggs, squash, sweet potatoes, lean meats and poultry, and fatty fish like salmon, trout and tuna. Many of these foods contain essential nutrients like vitamins C and E, and fatty acids like omega-3, all of which help maintain ocular health. As high blood pressure is also a threat for glaucoma, eating fruits, vegetables and wholegrains and avoiding sugary treats and salty foods can keep hypertension in check and limit the prevalence of harmful bacteria in the oral cavity, maintaining an all-round healthy body.
To prevent periodontitis and reduce the risk of glaucoma, practitioners should reaffirm the importance of an effective oral hygiene routine to patients. For a reliable toothbrush, recommend the CS 5460 from Curaprox. Featuring ultra-fine Curen filaments for excellent cleaning power, the toothbrush’s gentle feel and slightly angled head ensures a comfortable and compliant experience. Available in a range of colours, patients can mix and match the look of their handle and brush for added enjoyment.
Glaucoma’s prevalence and the impact of impaired sight demands an inter-disciplinary solution. For dental practitioners, identifying at-risk patients and encouraging a healthier diet and consistent oral hygiene routine can reduce the risk of periodontitis and limit the spread of inflammatory microbes around the body. By protecting their oral cavity, patients can better protect their overall health.
References available on request.
For more information visit www.curaprox.co.uk