Gum disease is the infection of soft tissues around the teeth. Prolonged untreated infection can destroy the bone around the teeth. This can loosen the teeth, eventually leading to tooth loss. It is a common condition that can be easily prevented.
Your oral health influences your general wellbeing. In this articles, you’ll learn the connection between the mouth and the body and how a decline in your oral health can impact body.
How mouth and body are interconnected?
The mouth and body are closely interconnected. A healthy mouth contributes to a healthy body, as the mouth serves as the gateway for the food that nourishes us.
Teeth play a crucial role in grinding food into a fine paste (bolus) with the help of saliva. This grinding process increases the surface area of the food, allowing digestive enzymes to act more effectively. Without teeth, these enzymes would struggle to break down food and extract essential nutrients. Therefore, it is vital to chew food thoroughly before swallowing.
The role of enzymes is to breakdown complex macronutrients into simpler compounds that can be absorbed by the body. This enzymatic breakdown that begins in the mouth continues in the stomach and small intestine, where nutrients are absorbed, and waste products are passed to the colon for elimination.
Individuals with missing teeth, whether due to periodontitis or other reasons, often face nutritional deficiencies. They tend to rely on soft, refined foods that require minimal chewing effort.
Additionally, beneficial oral bacteria convert nitrates into nitrite in the mouth. Nitrite is a precursor to nitric oxide, which dilates blood vessels and helps regulate blood pressure. Without these healthy bacteria, the body cannot produce sufficient nitric oxide.
Different stages of gum disease
Gum disease is an umbrella term that encompasses various stages of gum tissue damage, broadly classified into gingivitis and periodontitis.
Dental plaque and tartar deposits on the teeth trigger an inflammatory response. Gum disease begins as gingivitis, characterized by gum inflammation. If left untreated, it can progress to periodontitis, which involves the loss of tooth attachment fibers, bone, and cementum.
In periodontitis, bacterial byproducts (e.g., proteolytic enzymes that break down proteins) and inflammatory mediators (e.g., C-reactive protein) destroy the supporting tissues of the teeth. This condition manifests as loose or mobile teeth, along with bluish-purple, swollen gums.
Click the link for full article on, Can loose teeth be saved?
Can gum disease make you sick?
Early stages of gum disease may not significantly impact overall health. However, advanced gum disease, such as periodontitis, can lead to systemic health issues.
Periodontitis is a chronic gum disease that can exacerbate existing inflammatory conditions and affect various organ systems, including the heart, kidneys, brain, lungs, and endocrine organs. It can even increase the risk of cancer. The low-grade, chronic inflammation and infection of the gums can spread to other parts of the body, leading to disease development.
How Does Gum Disease Initiate Heart Disease?
In periodontitis, deep periodontal pockets harbor millions of harmful bacteria. These bacteria or their antigenic byproducts can enter the bloodstream during activities like brushing, flossing, or dental scaling.
Once in the bloodstream, these bacteria can settle in the arteries, causing inflammation. The circulating blood can transport them to various organs, triggering acute inflammatory responses.
Within blood vessels, the inflammatory mediators produced in response to these bacteria destabilize circulating fats, causing them to adhere to vessel walls. Over time, this fat buildup, known as atheroma, narrows the arteries, impeding blood flow and leading to ischemic heart disease. Complete arterial blockage can result in myocardial infarction (heart attack).
Another mechanism involves the cross-reaction of antibodies produced against periodontitis-causing bacteria with vessel wall antigens. These antibodies bind to endothelial cells lining the vessels, forming antigen-antibody complexes that trigger an inflammatory response and damage the vessel walls.
Diseases Developing from Advanced Gum Disease
Arterial obstructions in different organs of the body can lead to various diseases. Here are a few conditions that can result from periodontitis:
- Stroke: Arterial obstruction in the brain can lead to a stroke.
- Heart Attack: A blocked coronary artery (artery supplying the heart) can lead to a heart attack.
- Autoimmune Disease: Antigen-antibody complex formation in the vessels can result in autoimmune disorders.
- Alzheimer’s and Parkinson’s Disease: Bacteria or their antigenic products can cross the blood-brain barrier, damaging glial cells responsible for removing waste from the brain, impairing neuronal function and connections. Gum disease also contributes to beta amyloid protein formation in the brain, leading to neurodegenerative diseases like Alzheimer’s and Parkinson’s.
- Cancer: Excessive free radical production due to prolonged inflammation can promote cancer development.
Can Gum Disease Kill You?
Yes, gum disease can be fatal. A systematic review of six case-control and cohort studies found a positive association between advanced gum disease and an increased risk of heart attack and stroke.
Gum disease increases the risk of stroke more than heart attack. Additionally, periodontitis has more life-threatening consequences in young males compared to older males (above 65) and women. Complete occlusion of small arteries supplying blood to the brain or heart can lead to stroke or heart attack, potentially causing death or lifelong disability.
Smoking and diabetes are significant risk factors for periodontitis. The risk of developing heart disease or stroke increases several folds in smokers and uncontrolled diabetics with periodontitis. Proper management of gum disease can help reduce the risk of these adverse events.
Diabetes and Gum Disease – A Two-Way Relationship
Diabetes and gum disease are closely linked, with each condition influencing the progression of the other. The likelihood of developing periodontitis is three times higher in individuals with uncontrolled diabetes.
Elevated blood glucose levels are associated with the development of periodontitis. Patients with an HbA1c level greater than 9% are at significantly higher risk for periodontitis. The average HbA1c level ranges from 4% to 5.6%, while levels of 6.5% or higher indicate diabetes.
In uncontrolled diabetes, persistently high blood sugar levels impair the function of white blood cells, delay healing, and increase the risk of infection.
Conversely, periodontitis exacerbates complications associated with diabetes, such as kidney disease, heart disease, and peripheral neuropathy. Diabetic patients with severe gum disease have a 3.2 times higher risk of death from heart attack and diabetic neuropathy combined. Additionally, the risk of end-stage kidney disease doubles in diabetic patients with periodontitis.
How Does Diabetes Injure Your Vessels?
Patients with uncontrolled diabetes develop complications earlier and more severely than those with controlled diabetes. Persistent or frequent elevations in blood sugar levels play a key role in the development of diabetic complications.
In diabetes, high blood sugar levels glycate or oxidize circulating proteins and fats, converting them into sticky, cross-linked molecules that clog small vessels in the brain, heart, eyes, and kidneys. These molecules are known as advanced glycation end products (AGEs).
Frequently asked questions (FAQ’s)
Is there only one form of Periodontitis?
Periodontitis, or gum disease, can manifest in various forms:
- Juvenile Periodontitis: Occurs in children and is uncommon.
- Adult Periodontitis: The most common type, occurring after age 35.
- Aggressive Periodontitis: Affects young adults and causes rapid tissue destruction.
- Periodontitis Associated with Systemic Diseases: Linked to conditions such as diabetes, hypothroidism, etc.
- Nectrotizing ulcerative periodontitis: Characterized by ulcers on the gums covered by a yellowish membrane, often affecting smokers or individuals under high psychological stress.
Is Gum Disease Curable?
Yes, gum disease is curable, especially in its early stages. Early gum disease can be reversed with proper oral hygiene and professional care. However, advanced gum disease with deep gum pockets and receding gum lines requires professional scaling and polishing, home care, and antibiotic therapy (oral and topical). Receding gum lines cannot be corrected without surgery.
Severe gum disease is assessed based on the degree of tooth mobility and the remaining periodontal support. Teeth with sufficient periodontal support can be saved with splinting, while those with poor prognosis and extreme mobility may need to be extracted.
Additionally, factors such as uncontrolled diabetes and smoking can decrease the success rate of treatment.
Read more: When is a tooth beyond saving?
Is Gum Disease Contagious?
Gum disease is not contagious. However, oral bacteria can transfer from one person to another through saliva, kissing, etc. The likelihood of developing gum disease primarily depends on your oral hygiene and oral microbiome (bacteria).