The Mouth-Body Connection

Research has recently proven what dentists have long suspected: that there is a strong connection between periodontal disease and other chronic conditions such as diabetes, heart disease and osteoporosis.

Periodontal disease is characterized by inflammation of the gum tissue, presence of disease-causing bacteria, and infection below the gum line. Infections and bacteria in the mouth can spread throughout the body and lead to a host of problematic health issues. Therefore, maintaining excellent oral hygiene and reducing the progression of periodontal disease through treatment will have benefits beyond preventing gum disease and bone loss. It can also save you from the chance of developing another serious condition.

Periodontal Disease and Diabetes

Individuals suffering from diabetes, especially uncontrolled diabetics, have a higher risk of developing bacterial infections of the mouth. These infections may impair your ability to process insulin, resulting in greater difficulty with controlling your diabetes. Diabetics with insufficient blood sugar control also develop periodontal disease more frequently and severely than those who have good management over their diabetes.

Steps to prevent periodontal disease include daily brushing and flossing to remove plaque from your teeth and gums, regular dental visits for professional cleaning and regular periodontal evaluations. Your health professional must also be told of your history and the current status of your condition. And finally, you can help resist periodontal infection by maintaining control of your blood sugar levels.

Smoking and tobacco use is detrimental to anyone’s oral and overall health, but it is particularly harmful to diabetics. Diabetic smokers 45 and older are in fact 20 times more likely to develop periodontal disease than those who do not smoke.

Periodontal Disease and Tobacco

You are probably familiar with the links between tobacco use and lung disease, cancer and heart disease. Current studies have now linked periodontal disease with tobacco usage as well. These cases may be even more severe than those of non-users of tobacco. There is a greater incidence of calculus formation on teeth, deeper pockets between gums and teeth as well as greater loss of the bone and fibers that hold teeth in your mouth. In addition, your chance of developing oral cancer increases with the use of all forms of tobacco.

Chemicals in tobacco such as nicotine and tar slow down healing and the predicability of success following periodontal treatment and dental implants. Other problems caused by tobacco include: lung disease, heart disease, cancer, delayed healing, mouthsores, gum recession, loss of bone and teeth, bad breath, and tooth staining.

Quitting tobacco will reduce the chance of developing the above problems and assist in maintaining a healthy mouth once treatment is complete.

Periodontal Disease, Heart Disease and Stroke

Coronary heart disease occurs when fatty proteins and a substance called plaque build up on the walls of your arteries. This causes the arteries to narrow, constricting blood flow. Oxygen is restricted from traveling to the heart which results in shortness of breath, chest pain, and even heart attack.

The link between periodontal disease and heart disease is so apparent that patients with oral conditions are nearly twice as likely to suffer from coronary artery disease than those with healthy mouths. Periodontal disease has also been proven to exacerbate existing heart conditions. Additionally, patients with periodontal disease have been known to be more susceptible to strokes. A stroke occurs when the blood flow to the brain is suddenly stopped. This may occur, for example, when a blood clot prevents blood from reaching the brain.

One of the causes of the connection between periodontal disease and heart disease is thought to be oral bacteria entering the bloodstream. There are many varieties of periodontal bacteria. Some species enter the bloodstream and attach to the fatty plaques in the coronary arteries. This attachment can lead to clot formation and increased risk to a variety of issues including heart attack.

Inflammation caused by periodontal disease creates an increase in white blood cells and C-reactive proteins (CRP). CRP is a protein that has long-been associated with heart disease. When levels are increased in the body, it amplifies the body’s natural inflammatory response. Bacteria from periodontal disease may enter the bloodstream, causing the liver to produce extra CRP, which then leads to inflamed arteries and possibly blood clots. Inflamed arteries can lead to blockage, which can cause heart attacks or strokes.

Coronary heart disease is the leading cause of death in the United States for both men and women. Enacting positive oral hygiene practices and obtaining treatment for periodontal problems can help prevent the risk of developing this unfortunate condition.

Periodontal Disease and Women’s Health

Throughout a woman’s life, hormonal changes affect tissue throughout the body. Fluctuations in levels occur during puberty, pregnancy and menopause. At these times, the chance of periodontal disease may increase, requiring special care of your oral health.

  • Puberty

    During puberty, there is increased production of sex hormones. These higher levels increase gum sensitivity and lead to greater irritations from plaque and food particles. The gums become swollen, turn red and feel tender.
  • Menstruation

    Similar symptoms occassionally appear several days before menstruation. There can be bleeding of the gums, bright red swelling between teeth and gum, or sores on the inside of the cheek. The symptoms clear up once the period has started. As the amount of sex hormones decrease, so do these problems.
  • Pregnancy

    Your gums and teeth are also affected during pregnancy. Between the second and eighth month, your gums may also swell, bleed and become red or tender. Large lumps may appear as a reaction to local irritants. However, these growths are generally painless and not cancerous. They may require professional removal, but usually disappear after pregnancy.
    Periodontal health should be part of your prenatal care. Any infections during pregnancy, including periodontal infections, can place a baby’s health at risk.
    The best way to prevent periodontic infections is to begin with healthy gums and continue to maintain your oral health with proper home care and careful periodontal monitoring.
  • Oral Contraceptives

    Swelling, bleeding and tenderness of the gums may also occur when you are taking oral contraceptives, which are synthetic hormones. You must mention any prescriptions you are taking, including oral contraceptives, prior to medical or dental treatment. This will help eliminate the risk of drug interactions such as when antibiotics combine with oral contraceptives and reduce the effectiveness of the contraceptive.
  • Menopause

    Changes in the look and feel of your mouth may occur if you are peri-menopausal or post-menopausal. They include feeling pain and burning in your gum tissues and salty, peppery or sour tastes.  Careful oral hygiene at home and prefessional cleaning may relieve these symptoms. There are also saliva substitutes to treat the effects of “dry mouth”.

Periodontal Disease and Respiratory Disease

Respiratory disease occurs when fine droplets are inhaled from the mouth and throat into the lungs. These droplets contain germs that can spread and multiply within the lungs to impair breathing. Recent research has also shown that bacteria found in the mouth and throat can be drawn into the lower respiratory tract and cause infection or worsen existing lung conditions.

Bacteria that grows in the oral cavity and travels into the lungs can cause respiratory problems such as pneumonia. This occurs mostly in patients with periodontal disease. Periodontal disease has also been shown to have a role in the contraction of lung tissues in bronchitis and emphysema. In addition, chronic obstructive pulmonary disease (COPD), a respiratory condition characterized by blockage of the airways, and caused mostly by smoking, has been proven to worsen if the patient also has periodontal disease.

One of the reasons for the connection between respiratory problems and periodontal disease is low immunity. Patients who experience respiratory problems generally have low immunity, meaning bacteria can easily grow above and below the gum lines without being confronted by the body’s immune system. Once periodontal disease is contracted in this way, it will only progress and worsen respiratory issues.

Inflammation of the oral tissue has also been linked to respiratory problems. Oral bacteria cause irritation which can travel to the lungs, thereby contributing to the inflammation of the lung lining. This creates respiratory problems because it limits the amount of air that can be passed freely through the lungs.
 

Periodontal Disease and Osteoporosis

Osteoporosis is a condition common in older patients, particularly women, that is characterized by the thinning of bone tissue and loss of bone density over time. Osteoporosis occurs when the body fails to form enough new bone, or when the body resorbs too much old bone. The leading cause of osteoporosis is a drop in estrogen in menopausal women, or a drop in testosterone among men. Sufferers of osteoporosis must take extra care in daily activities, as they are at increased risk for bone fractures.

Because periodontal disease can also lead to bone loss, the two diseases have been studied for possible connections. Research found that women with periodontal bacteria in their mouths were more likely to have bone loss in the oral cavity and jaw, which can lead to tooth loss. Studies conducted over a period of 10 years also discovered that osteoporosis patients could significantly reduce tooth loss by controlling periodontal disease. Further, it was found that post-menopausal women who suffer from osteoporosis are 86% more likely to also develop periodontal disease.

One of the reasons for the connection between osteoporosis and periodontal disease is an estrogen deficiency. Estrogen deficiency speeds up the progression of both oral bone loss and other bone loss. It also accelerates the rate of loss of fibers and tissues which keep the teeth stable. Tooth loss occurs when these fibers are destroyed.

Low mineral bone density is just one of several causes of osteoporosis. The inflammation from periodontal disease can further weaken bones which are already more prone to break down. This is why periodontitis can be particularly detrimental and progressive to patients with osteoporosis.

If you are diagnosed with osteoporosis, it is extremely important to take preventative measures against periodontal disease to protect your teeth and oral bones.