Gum disease is a condition that affects millions of people. It usually starts off as inflammation of the gums, known as gingivitis. It then spreads to the supporting structures of the tooth and cause periodontitis.
In Australia, 30.1% of adults aged 15 years and over had periodontitis in 2017–18. Moderate or severe periodontitis (gum disease) is present in 22.9 per cent of the Australian population (Report of the national advisory council on dental health).
Certain bacteria which normally are found only in the oral cavity, have been found elsewhere in the body. This has led to more research showing that the mouth could be the “focus of infection”. It has become increasingly clear that the oral cavity can potentially act as the site from which harmful bacteria can disseminate to the distant body sites.
Some research points to a link between gum disease and inflammation that can precede heart attacks, strokes, and sudden vascular events. Currently, the exact nature of the cause-and-effect relationship is still unclear.
Heart disease can occur due to the bacteria settling on the imperfections within the heart, heart valves and its blood vessels resulting from trauma/injury. It could also be a result of the toxins released by the bacteria within the gums causing a reaction and damage to the lining of the heart and its blood vessels.
The relationship between diabetes and periodontitis (severe gum infection) is a 2-way street.
The gum disease could cause a growth in harmful bacteria within the inflamed gums. These harmful bacteria together with the immune responses that they create could raise the blood sugar levels resulting in uncontrolled diabetes.
The raised blood sugar levels in uncontrolled diabetics could also allow the harmful bacteria within the gums to flourish causing increased destruction of the tissues supporting the teeth (gum disease).
Pre-term low birth weight babies
In preparation for delivery, the uterus transitions from actively maintaining quiescence during pregnancy to a state of giving birth. The mother requires to deliver the baby by the process of parturition which is mediated through renewed inflammation.
Periodontal disease is thought to cause early onset of delivery of babies. The bacterial migration from periodontal tissues into blood circulation may stimulate the production of inflammatory mediators responsible for the onset of delivery.
A premature baby has less time in the mother’s uterus to grow and gain weight. Hence, the relation is thought to exist between periodontal disease and pre-term and low birth weight children.
Inflammation is a protective response by the immune system to bacterial and viral infections. But with autoimmune diseases like rheumatoid arthritis, the immune system mistakenly triggers inflammation even though there are no viruses or bacteria to fight off. It’s possible that the immune system is stimulated by infections within the mouth, setting off a cascade of events where inflammation develops at the site of joints leading to arthritis.
There is some evidence to show that a bacteria known to cause chronic inflammatory gum infections also triggers the inflammatory autoimmune response and are found in the joints of patients with rheumatoid arthritis.
Although the evidence is not clear, some researchers believe that harmful bacteria from the gums could cause gastritis, irritable bowel syndrome- ulcerative colitis & Chron’s disease, and even stomach cancers.
Helicobacter pylori is one of the main bacteria responsible for gastritis. Recent research has shown the presence of the same bacterium within the oral cavity.
Researchers discovered two pathways by which oral bacteria can potentially cause gastric issues. In the first pathway, gum disease leads to the increased presence of harmful bacteria in the mouth., it can then be swallowed and travel to the stomach. Once there, the bacteria can cause inflammation to develop in the stomach.
The second pathway, the body’s response to harmful oral bacteria triggers an immune system response that also contributes to an inflammation of the stomach.
Some researchers have found that periodontal disease causes an increased build-up of beta-amyloid in the brain, which is the neurological hallmark of Alzheimer’s disease.
Also, one type of bacteria commonly found in cases of periodontitis, Porphyromonas gingivalis has a tendency to infiltrate the body and has been reportedly found in the brains of individuals with Alzheimer’s disease.
Pneumonia, COPD (Chronic obstructive pulmonary disease) and asthma are another set of health conditions affected by chronic inflammation with gum disease. This could be in a direct pathway or an indirect pathway.
Indirect pathway– The infection in the gums could trigger the immune system to stay on high alert and ensures a body-wide inflammation, including the airways and lungs. If the tubes in the lungs that carry air are inflamed, they become narrower and air flow is restricted.
Direct pathway– The bacteria present in the mouth might also be breathed down into the lungs. Once within the lungs, the bacteria could trigger infections that could directly lead to inflammation.
Gum disease can be caused by poor dental hygiene. Chronic inflammation caused by gum disease can damage your endothelial cells, which form the lining your blood vessels (including that of the penis). When the blood flow to the penis is impeded, difficulties maintaining an erection can develop. Some studies show that men with severe gum disease are more than twice as likely to suffer from impotence compared to those with healthy teeth and gums.
The onset of gum infection is silent. Dental visits are extremely important to detect early signs of gum infection so that steps can be taken for prevention or early treatment.
Once gum infection has been established, it becomes impossible to completely eradicate, however it can be controlled with a good oral hygiene routine established by you with the help of your dentist. The regular follow up appointments are important to track the progress of the infection and to take necessary actions to keep it in check.
So, the next time you brush, floss or clean your tongue, please realize that you’re not only doing it for your mouth but also for the rest of your body. Awareness is the key, so please do not hesitate to contact our practice to make an appointment for your dental exams.