Periodontal Disease: What It’s All About and What It Means for Your Health

Key Points

• Periodontal disease: The nature of the beast
• So why should we listen to our mouths?
• How common is periodontal disease?
• What are the causes of periodontal disease?
• Risk factors and warning signs
• Periodontal disease can spell trouble for your body

 

For most of us, we use our mouths to tell others how we feel, what we want or need, and what’s going on. And, as we all know, although talking is important, listening is just as important. In terms of our oral well-being, however, most of us aren’t listening to what are mouths are telling us. And they’ve got a lot to say. In fact, our mouths can tell us a great deal not only about our oral health, but also about our whole-body health. So put on those listening ears because your mouth might be trying to tell you, “there’s a problem here," and that may indicate a bigger overall health concern.

Periodontal disease: The nature of the beast

Periodontal disease means an unhappy mouth. It involves infections and inflammation of the bone and gums around the teeth. You may recognize periodontal disease in its beginning stage when the gums are red, swollen, and bleeding. This is called gingivitis. When gingivitis becomes more serious, it is then called periodontal disease. During this stage, the gums typically pull away from the teeth causing pockets to form. Bacteria enter these pockets and cause infection, which can result in gum and bone loss or loose teeth. (1)

From Dr. Thomas E. Wright III

 

So why should we listen to our mouths?

We should pay attention to what’s going on in our mouth as periodontal disease suggests significant immune weakness, bone loss, and local tissue repair deficit. Overall, what’s going on in your mouth indicates the state of your total body health. (1)

How common is periodontal disease?

Periodontal disease is common. About 2 in 5 American adults aged 30 and older have it. (2) Unfortunately, it doesn’t get better with age. At age 65 or older, 70.1% of adults have periodontal disease (1) and more than 27% have no teeth remaining at all.

What are the causes of periodontal disease?

Periodontal disease occurs when bacteria from the mouth invades tissues around the teeth through the pockets that develop as gums recede. If our immune system is unable to control this bacteria, the tissue around the teeth can become inflamed and ultimately infected. (1)

 

Risk factors + warning signs

Risk Factors ·        Poor oral hygiene ·        Smoking ·        Stress ·        Diabetes ·        Genetics (hereditary) ·        Immunodeficiencies

Warning Signs ·        Bad breath or bad taste that won’t go away ·        Red or swollen gums ·        Tender or bleeding gums ·        Loose teeth ·        Sensitive teeth ·        Gums that have pulled away from teeth

 

 

Periodontal disease can spell trouble for your body

Like your skin, healthy gums provide a protective barrier. When this barrier is broken down and there are not enough protective antioxidants in the body, pathogens get the upper hand and infection sets in. This infection can go beyond the gum tissue into the rest of the body, which can lead to a systemic inflammatory response. (3)

There are numerous systemic inflammatory diseases related to periodontal disease, including many cardiovascular diseases, osteoporosis, diabetes and metabolic syndrome, immune weakness, autoimmune diseases, and an imbalanced microbiome. (4)

 

Cardiovascular Diseases

Periodontal disease is a known risk factor for cardiovascular disease. Pathogens from the mouth can be found, for example, in tissues of the cardiovascular system, including in the heart itself. (5)

One study found that having periodontal disease increased the chances of having hypertension and elevated blood pressure by 20%. (6) Also, the inflammatory response caused by periodontal disease can increase and then loosen plaque in the blood vessels which may lead to a heart attack or stroke, or even change the structure of the heart, which can cause heart failure. (3)

from Czesnikiewicz-Guzik et al. 2020

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Osteoporosis

Periodontal disease can destroy the bone that supports the teeth. In fact, patients with chronic periodontitis have been shown to have an increased risk for osteoporosis. (7)

Diabetes & Metabolic Syndrome

Periodontal disease has been found to be significantly more prevalent among individuals with diabetes. Additionally, diabetes can be greatly improved by treating periodontal disease. (5)

Because the body becomes inflamed from periodontal disease, it may promote metabolic syndrome. (8) In fact, in a study in Vietnam involving 412 participants, the prevalence of more severe periodontitis was found in the group with metabolic syndrome. (9)

Cancer

Some studies suggest an overall increased risk of cancer in those with periodontal disease, as well as an increased risk in certain specific types of cancer. (10)

One larger study of nearly 66,000 women aged 54 to 86 found that a history of periodontal disease was associated with an increased risk in cancer, including cancer of the breasts, esophagus, gallbladder, and skin. (11)

 

Time to listen up!

It’s time to listen to our mouth because the information it’s telling us is essential: happy gums mean a happy body! Caring for your periodontal health is truly caring for your entire body.

 

 

 

References:

1. CDC (Centers for Disease Control and Prevention). Basics of oral health: Periodontal disease. CDC Website.
2. NIDCR (National Institute of Dental and Craniofacial Research). Periodontal disease in adults (age 30 or older). NIH Website.
3. Carrizales-Sepúlveda, E. F., et al. 2018. Periodontal disease, systemic inflammation and the risk of cardiovascular disease. Heart, Lung and Circulation 27(11):P1327-P1334.
4. Hajishengallis, G., and T. Chavakis. 2021. Local and systemic mechanisms linking periodontal disease and inflammatory comorbidities. Nature Reviews Immunology 21:426-440.
5. Liccardo, D., et al. 2019. Periodontal disease: A risk factor for diabetes and cardiovascular disease. International Journal of Molecular Sciences 20(6):1414.
6. Czesnikiewicz-Guzik, M., et al. 2020. Understanding residual inflammatory risk sheds new light on the clinical importance of periodontitis in cardiovascular disease. European Heart Journal 41(7):818-819.
7. Mau, L.-P., et al. 2017. Patients with chronic periodontitis present increased risk for osteoporosis: A population-based cohort study in Taiwan. Journal of Periodontal Research 52(5):922-929.
8. Srivastava, M. C., et al. 2019. Metabolic syndrome and periodontal disease: An overview for physicians. Journal of Family Medicine and Primary Care 8(11):3492-3495.
9. Pham, T. 2018. The association between periodontal disease severity and metabolic syndrome in Vietnamese patients. International Journal of Dental Hygiene 16(4):484-491.
10. Nwizu, N., et al. 2020. Periodontal disease and cancer: Epidemiologic studies and possible mechanisms. Periodontology 2000 83(1):213-233.
11. Nwizu, N., et al. 2017. Periodontal disease and incident cancer risk among postmenopausal women: Results from the Women’s Health Initiative Observational Cohort. Cancer, Epidemiology, Biomarkers & Prevention 26(8):1255-1265.