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

Diabetes is a serious, incurable disease that is characterized by too much glucose, or sugar, in the blood. Type II diabetes occurs when the body is unable to regulate insulin levels, meaning too much glucose stays in the blood. Type I diabetics cannot produce any insulin at all. Diabetes affects between 12 and 14 million Americans, and can lead to a variety of health issues, such as heart disease and stroke.

Research has shown people with diabetes are more likely to develop periodontal disease than non-diabetics. Diabetics with insufficient blood sugar control develop periodontal disease more frequently and severely than those who have good management over their diabetes.

The connection between diabetes and periodontal disease results from a variety of factors. Diabetics are more susceptible to all types of infections, including periodontal infections, due to impaired blood circulation and white cell function, which allows bacteria to colonize. Diabetes also reduces the body’s overall resistance to infection, which increases the probability of the gums becoming infected.

Moderate to severe cases of periodontal disease elevate sugar levels in the body, increasing the amount of time the body has to function with high blood sugar. Diabetics with periodontitis are most likely to suffer from increased blood glucose levels, making it more likely for them to experience the complications of diabetes. Further, high glucose levels in saliva promote growth of gum disease-causing bacteria.

Blood vessel thickening is another concern for diabetics. Blood vessels function by providing nutrients and removing waste products from the body. When they become thickened by diabetes, these exchanges are unable to occur. As a result, harmful waste is left in the mouth and can weaken the resistance of gum tissue, leading to infection and disease.

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 no smoke.

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It is imperative for individuals to practice good oral hygiene on a daily basis as well as visit their dentist regularly. These measures are especially critical for diabetics due to their vulnerability to infection.

Periodontal Disease, Heart Disease and Stroke

Coronary heart disease occurs when fatty proteins and 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 possibly a heart attack.

The link between periodontal disease and heart disease is so significant 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 a stroke. A stroke occurs when the blood flow to the brain is suddenly interrupted. This may occur, for example, when a blood clot prevents blood from reaching the brain.

There is a growing body of evidence correlating periodontal disease with heart disease, one mechanism being the oral bacteria of periodontal disease entering the bloodstream and contributing to inflammation of the internal walls of the coronary arteries. There are numerous strains of periodontal bacteria. Some strains enter the bloodstream and attach to the fatty plaques in the coronary arteries. This attachment leads 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 are a group of proteins that have 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 a heart attack or stroke.

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 Pregnancy

Pregnant women with periodontal disease expose their unborn children to a variety of risks and possible complications. Pregnancy causes many hormonal changes in women, which increase the likelihood of developing gingivitis and other periodontal problems. Symptoms include swollen and bleeding gums. These oral problems have been linked to preeclampsia (elevated blood pressure during pregnancy), low birth weight of the baby, as well as premature birth. Fortunately, halting the progression of periodontal disease through implementation of good oral hygiene and treatment of existing problems can help reduce the risk of periodontal disease-related complications by up to 50%.

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There are several factors that contribute to why periodontal disease may affect the mother and her unborn child. One is an increase in prostaglandins in mothers with advanced stages of periodontal disease, particularly periodontitis. Prostaglandins are a chemical our bodies produce during inflammation and injury and will be released when our bodies are exposed to the oral bacteria associated with periodontitis. Prostaglandins have been found to be labor-inducing in high enough concentrations over long enough periods of time.  Because periodontitis increases the levels of prostaglandin, the mother may go into labor prematurely and deliver a baby with a low birth weight.

Another compound that has recently been linked to premature birth and low birth weights is C-reactive protein (CRP). CRP is a protein that has long-been associated with heart disease. Periodontal disease increases CRP levels in the body, which then 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 a heart attack or stroke. Although it is not completely understood why elevated CRP can cause preeclampsia, studies have overwhelmingly proven that an extremely high rates of CRP in early pregnancy definitely increases the risk.

Finally, harmful bacteria that invade and live in the oral cavity can travel through the bloodstream and affect other parts of the body. For pregnant women, research has shown that these bacteria may colonize the mammary glands and coronary arteries.

If you are pregnant, it is important to practice effective home care for preventing gum disease. Your dentist and/or periodontist can help assess your level of oral health and develop preventative measures and treatment plans to best protect you and your baby.

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 proven 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 grow 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 proven to have a role in the contraction of bronchitis and emphysema. Chronic obstructive pulmonary disease (COPD), a respiratory condition characterized by blockage of the airways, and caused mostly by smoking, has also been proven to worsen if the patient has periodontal disease.

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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 line 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 causing the irritation can travel to the lungs, and contribute 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.

If you are diagnosed with respiratory disease or periodontal disease, we will work with your physician to plan how to best treat both conditions and eliminate further complications.

Periodontal Disease and Osteoporosis

Osteoporosis is a condition common in older individuals (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 absorbs too much old bone. One of the leading causes of osteoporosis is a drop in estrogen in menopausal women or a drop in testosterone among men which leads to impaired calcium absorption. Although sufferers of osteoporosis must take extra care in daily activities as they are at increased risk for bone fractures, in fact, exercise has been found to be beneficial for increasing bone density and strength. 

Because periodontal disease can also lead to bone loss, the two diseases have been studied for possible connections. Research has found that women with periodontal bacterial pathogens 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 10 year time period discovered that patients with osteoporosis 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 due to the drop in estrogen levels in perimenopausal and menopausal women. Estrogen deficiency speeds up the progression of both oral bone loss and bone loss in the spine and hips. It also accelerates the rate of loss of the connective tissue fibers and tissues which keep the teeth stable. Tooth loss occurs when these fibers are destroyed.

Low mineral bone density is a sign of osteoporosis. The inflammation from periodontal disease weakens bone 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 preventive measures against periodontal disease to protect your teeth and their supporting tissues.