Can you name the number one cause of tooth loss in adults? It's not tooth decay, accidents or grinding. Instead, the culprit is periodontal (gum) disease - a "silent" disease that affects about one in two adults, but is often not recognised until it has reached a serious stage. But tooth loss is not the only consequence of periodontal disease: it is linked to diabetes, heart disease and other so-called systemic disorders - diseases that affect the whole body rather than just one organ or part of it.
According to the U.S. Centers for Disease Control and Prevention, periodontal disease affects nearly half of all adults over the age of 30 and 70% of those 65 and older. Approximately 64.7 million Americans suffer from the most serious form of gum disease known as periodontitis. This oral infection can damage the gums and underlying bone, causing teeth to loosen or even fall out.
People with periodontal disease often find that it causes health problems beyond the mouth. Through years of research, scientists have established links between uncontrolled gum disease and serious health problems such as diabetes, cardiovascular disease, Alzheimer's disease, respiratory and rheumatic diseases, etc. People with these diseases are much more likely to have gum disease and people with advanced gum disease are more likely to suffer from many of these foods.
How can gum disease affect the health of other parts of the body? One connection is via harmful bacteria, which can travel between the mouth, bloodstream and lungs, potentially causing disease in these areas. But beyond the bacteria themselves, inflammation is a common thread among many systemic conditions. While this natural process is essential for healing, too much inflammation can have negative effects.
The inflammatory response is an important part of the human immune system. An acute (abrupt) response begins shortly after an injury or infection: white blood cells are mobilised, releasing chemicals to fight foreign substances; blood flow to the affected area increases and the walls of tiny blood vessels become more porous, allowing substances to pass more easily. The acute inflammatory response is the body's way of rapidly eliminating harmful stimuli or microscopic invaders and beginning the healing process.
But sometimes inflammation becomes chronic, which means that it persists for a long time and can damage your health. Chronic inflammation can be caused by an uncontrolled infection, a foreign substance that remains in the body or an overactive immune response.
Researchers suspect that the inflammation associated with periodontal disease is what links it to other systemic diseases. After all, gum disease is the most common chronic inflammatory disease in humans. If the body is continually fighting a periodontal infection, the persistent immune response designed to promote healing may instead become an agent of tissue damage and systemic disease. Studies suggest that chronic low-grade inflammation may contribute to Alzheimer's disease, Parkinson's disease, obesity, and some types of cancer.
A number of systemic diseases have known or suspected links to periodontal disease. Here are some of the more common ones:
In the United States, nearly 30 million people have type II diabetes, and the link between gum disease and diabetes is one in which the problems go both ways. Research shows that people with poorly controlled diabetes are more susceptible to gum disease and have a reduced ability to fight infection. And, in turn, periodontal disease (like other infections) can make diabetes harder to control. Blood sugar is a factor linking the two diseases: higher levels of glucose in saliva feed oral bacteria, making gum disease worse; it also makes diabetes more difficult to manage. Diabetes can also damage the walls of blood vessels, which interferes with the body's ability to eliminate waste. Therefore, the better you control your blood sugar, the lower your risk of gum disease; and the better you control your gum disease, the less you can cope with the harmful effects of diabetes.
People with periodontal disease are twice as likely to have cardiovascular disease, the leading cause of death in the United States. Research shows that gum disease worsens existing heart disease and increases the risk of stroke. Oral bacteria have been found in arterial plaque: hardened deposits that form on blood vessel walls, which can cause dangerous constriction of blood flow. In addition, the inflammatory response triggered by periodontal disease can damage blood vessels and cause blood clots, which can block arteries and lead to heart attacks and strokes. On a positive note, a 2017 study found that intensive treatment for gum disease lowered blood pressure by up to 13 points.
Periodontal disease has been identified as a "probable risk factor" for Alzheimer's disease, which affects 5.7 million American adults. A 2017 study found that people over 70 who had gum disease for 10 years or more were 70% more likely to develop dementia than those with healthy gums. Another study found that people with Alzheimer's who also had gum disease declined faster over a six-month period than those without gum disease.
Harmful bacteria from periodontal disease can be inhaled into the lungs, causing bronchitis, emphysema and pneumonia - and chronic inflammation from periodontal disease can make these conditions worse. COPD, or chronic obstructive pulmonary disease, is the third leading cause of death in the United States. This inflammatory lung disease includes chronic bronchitis, emphysema and sometimes asthma. Although smoking is the major contributor to respiratory disease, periodontal disease plays a role in the contraction of bronchitis, emphysema and pneumonia, and aggravates COPD.
Rheumatic diseases include many potentially debilitating conditions that can damage joints, connective tissue and other parts of the body. These chronic and progressive inflammatory diseases make life painful for an estimated 4 million Americans. Moderate to advanced gum disease is common in people with rheumatoid arthritis - and those with the disease who also have advanced periodontal disease tend to have more painful flare-ups. A higher incidence of gum disease and more severe gum disease is also found in people with other immune-mediated chronic inflammatory diseases, including lupus and inflammatory bowel disease. Again, the research points to a two-way street: just as people with chronic, progressive inflammatory diseases may be at risk of periodontal disease, periodontitis appears to contribute to the progression of these conditions.
Although there is clearly a link between gum disease and many systemic diseases, in most cases researchers cannot say definitively that gum disease causes these other diseases or that these other diseases cause gum disease. However, research indicates that oral health is a major indicator of overall health and a link to specific systemic diseases. Here is what you can do to improve your oral health:
Make good dental hygiene a habit. Early stage gum disease can usually be reversed with good oral hygiene, so brush your teeth morning and night with a fluoride toothpaste and floss once a day.
Know the common signs of gum disease. These include gums that are red, swollen, tender or bleeding when brushing and flossing. People with gum disease may notice that their gums are receding or that their teeth look longer, feel loose or separate from the gums.
See your dentist. If you have gum disease or a systemic health problem, it is especially important to see your dentist at least twice a year for professional examinations and cleanings. Inform your dental team if there have been any changes in your health or medications.
Stop smoking. Smoking - or smoking in any form - is one of the most important risk factors for developing gum disease. Of course, it is also a major risk factor for many types of cancer and other diseases. So if you need one more reason to quit smoking, gum disease could be it.
Watch your weight. Carrying extra weight can contribute to a variety of health problems, and losing even a few pounds can pay off. Weight loss is a major factor in reducing the incidence of diabetes: one large study found that the risk of diabetes decreased by 16% for every kilogram lost (= 2.2 pounds).
Pay attention to your diet. Research also suggests that diet can have an effect on gum disease. A recent study found that an "anti-inflammatory" diet, low in refined carbohydrates and high in whole grains, omega-3 fatty acids, vitamins C and D, antioxidants and fibre, can help control gum disease. Many researchers have found that avoiding empty calories, sugary foods and beverages (including sodas and other sweetened beverages) and highly processed foods can help improve your oral and overall health.
Keep your body and mind active. According to one study, people who incorporate regular physical activity into their lives reduce their incidence of diabetes by 44%, even without losing weight. equipment... or take the stairs instead of the lift. It is equally important to take care of your mental health. Keeping your social life and engaging your brain with puzzles, intellectual activities and new experiences can help stave off mental decline.
With careful management, many systemic diseases can be well controlled, even if they cannot be completely cured. Similarly, periodontal disease deserves constant attention and proper care. Monitoring your oral health and paying attention to the early symptoms of periodontal disease can lead to better overall health and quality of life. If you have any questions or concerns about periodontal disease, your dentist can be an excellent source of information and help.
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