Healthy Gums = Healthy Body
Originally, people thought that oral health care only affected gum health, cavities and loose teeth, without being aware how it might also address larger health concerns. But in recent years significant links have been discovered.
If you had a chronic infection of the small intestines that went unchecked for years, you probably wouldn’t be surprised if eventually a serious disease cropped up even in another part of the body. Well, like the intestines, the gums are mucous membranes, and 40% of all adults and 75% of people over 40 years old are carrying chronic infections in their gums, known generally as gum disease and, more specifically, as gingivitis and periodontal disease. And in recent years, a lot of scientific evidence has been accumulating linking gum disease to serious diseases throughout the body.
People with gum disease were shown to be twice as likely to have a heart attack, three times as likely to have a stroke and twice as likely to develop pancreatic cancer. In addition, gum disease (which is easier for diabetics to acquire) makes it harder for diabetics to control their blood sugar and make it more likely for them to have serious complications. On the other hand, diabetics who improved the health of their gums showed significant restoration of blood vessel function and improved blood sugar control.
Studies are still ongoing to understand the exact mechanics of how gum disease can cause these results. Leading theories center on the effects of the chronic inflammation. When the plaque-producing bacteria infect the gums, the body’s immune system responds by trying to destroy the invaders, trying to remove the resulting dead cells and trying to help the tissue to heal. This response is called inflammation. There are a lot of things going on during inflammation. The immune system produces chemicals (cytokines) that draw other cell-destroying and cell-devouring immune cells to the site of the infection. The vascular system moves blood plasma to the infection site, and swelling often occurs. More heat is usually generated that helps speed up the production of immune system cells.
Inflammation first tries to kill or isolate the invader and to remove the byproducts of the cellular-microbial battle, and this is known as acute inflammation. This inflammation typically subsides when the harmful invader has been either destroyed (as in the case of bacteria) or isolated by scar tissue from the rest of the body (as in the case of splinters or bits of metal).
But when invading bacteria continue to infect the body despite the defensive measures of acute inflammation, the body settles in for a long siege and changes tactics. Different types of immune cells are sent to the infection site and the body shifts from acute inflammation’s all-out attack on the invader to a more balanced destruction of infected cells and creation of new replacement cells. The body is attempting to keep its tissue alive while combating the invader long term. This is known as chronic inflammation.
Once the plaque-causing bacteria have settled in, they alter their surroundings to provide themselves with safe environments where they can multiply, either in gum pockets or under calcified calculus (tartar). From there they can safely thrive, reproduce at least as fast as the immune system destroys other members of the colony and sustain an ongoing infection for years or even decades.
We humans don’t do well under unending chronic inflammation. The localized area of infection eventually suffers the destruction of tissue (for gums, tooth-supporting ligaments and jaw bones, that’s known as periodontal disease) while the rest of the body has to deal with the continual dispersal of bacteria, cell-destruction residue and immune-system-markers designed to activate cell destruction (cytokines).
Scientists’ recent and ongoing studies have gathered evidence that as the cytokines course through blood vessels throughout the body, they trigger the cell-destruction activities of inflammation in other parts of the body, especially areas that already have some vulnerability. Diabetes, heart disease, and stroke are three diseases of particular interest to researchers studying linkage to the inflammation response in the gums.
But it’s not just the inflammation response of the gums that worries researchers. The chronic infection (continuing intrusion by bacteria into the gums) seems to allow the oral bacteria themselves to enter into the bloodstream. The same bacteria that produce plaque and calculus on the teeth and gums have also been found living in the plaque attached to the walls of arteries. Whether the bacteria act in the same way within the arteries as they do in the mouth is being studied.
We don’t need to wait for the researchers to fully understand the mechanics that link gum disease to heart disease. The wise course is to take control of our gum health now, because gum disease is so pervasive and because heart disease is a leading cause of death for both women and men.
Gum disease is also associated with stroke. A study in 2003 showed a direct link between periodontal disease and stroke, even in people who had never smoked. And a study published in 2005 in the journal Circulation showed that older adults with higher levels of periodontitis-causing bacteria in their mouths also had thicker neck arteries supplying the brain, a predictor of heart attack and stroke. The clogged arteries of the heart that are typical of heart attacks are mirrored by clogged arteries of the brain that are typical of strokes.
An interesting discovery is that improved gum health correlates with improved blood vessel function. The results of the study at the University College London and the University of Connecticut show that improving the health of the gums potentially reduces the risk of heart attacks and stroke.
Gum disease and diabetes can be a vicious cycle. People with diabetes are twice as likely to develop gum disease, and after getting it, the periodontal bacteria gets into the bloodstream, making it harder for diabetics to regulate their blood sugar. If the diabetes isn’t well managed, it leads to a faster degradation of mouth health. Chronic infection of the gums and alveolar (tooth-supporting) bone affect the whole body’s ability to heal.
An eleven year study of patients with Class II diabetes reported that patients with even moderate gum disease had over 5 times the risk of cardio-renal (combined kidney and heart failure) mortality compared with the patients with no periodontal disease. The patients with severe gum disease had nearly 8 times the risk of those without gum disease.
But health practitioners found that diabetics who first got their gum disease under control found it much easier to get their blood sugar under control. If you have diabetes, it’s worthwhile to consider using all the oral health practices at your disposal. (We recommend adopting healthful habits and natural supplementation as described elsewhere on this website.)
Another health risk associated with gum disease is pancreatic cancer. Researchers from the Harvard School of Public Health studied more than 51,000 male health professionals and found that those with periodontal disease had a two-fold increase in the risk of pancreatic cancer, even when they had never smoked. Some of the researchers speculate that the chronic inflammation of gum disease increased the levels of carcinogenic compounds picked up and spread throughout the body.
Gum disease is also associated with the development of osteoporosis, and this topic is addressed in the pages on Menopause and Gum Disease.
Good-Gums can help you achieve healthy gums which in turn can help you achieve a healthy body!