Health Issues & Gum Disease
Gum disease affects more than just your teeth and gums. Because oral infections can move deeper into the body and cause a host of problems that includes severe inflammation, they have been tied to other serious physical ailments. Unfortunately, because the early signs of gum disease seem fairly routine and mild, most people don’t realize they have a problem until this preventable and treatable oral condition causes other problems throughout the body. Here are some risk factors for gum disease and an explanation of how periodontitis is tied to other systemic illnesses.
Risk Factors for Gum Disease
Are you at a higher risk for gum disease? Talking with Dr. David Scharf, a board certified periodontist, can help you better understand your risk. Here are a few conditions and habits that could increase your risk.
The most significant risk factor for gum disease is smoking; in fact, smokers are more than three times more likely than nonsmokers to lose their teeth as a result of periodontal disease. Nicotine in the bloodstream decreases the body's ability to defend itself against gum disease, which in turn impairs the body's ability to repair itself. To complicate matters, periodontal therapy is less effective with smokers than nonsmokers. Pockets of infection tend to reform more quickly, and regenerative therapy is not as successful. Quitting smoking is not easy, but it can add decades to the life of your teeth.
During puberty, the levels of sex hormones increase. This causes the gums to become more reactive to bacteria and other irritants in the mouth, often causing the gums to feel tender and bleed easily. During puberty, it is important to practice good oral hygiene and have frequent professional cleanings. If periodontal health is not addressed, the bone and gum surrounding the teeth may be compromised.
Many diabetics don't know about the relationship between diabetes and gum disease. A diabetic has a greater risk of periodontal disease if the diabetes is not well controlled, and periodontal disease can in turn make diabetes worse.
An infection like periodontal disease can raise blood sugar levels. This means it is important for diabetics to maintain good periodontal health. If your physician is having difficulty controlling your blood sugar due to ongoing infection, controlling periodontal disease may help stabilize your blood sugar levels and even allow you to reduce the amount of medication you take to manage your diabetes. Dr. Scharf will work very closely with your physician to coordinate your care and improve your overall health.
Not all people get periodontal disease at the same rate or the same degree of severity. Both environmental factors (bacteria) and genetics can influence periodontal disease. A gene has been isolated that is thought to be an indicator of whether or not an individual is at increased risk for gum disease, and a simple, inexpensive test can be performed to determine if the gene is present.
Individuals who test positive for the gene have a 6 to 19 times greater risk of developing severe periodontal disease. (Smokers who test positive are even more at risk.) Information about the gene's presence in a patient can help us design a preventive program to ensure that they are not undertreated for periodontal disease.
The test is done by collecting a small sample of saliva, which is sent to the lab for DNA analysis. The lab report will tell us whether you are positive or negative for the gene that causes the body to overreact to bacteria involved in periodontal disease. This information can then be used to determine your overall risk profile and to tailor your individual treatment plan. Many of our patients ask to have their children tested for this gene so they can be started on the right preventive program before gum disease develops.
Gum irritation is very common during menstruation. This is due to increased hormone levels, which can cause increased irritation, sensitivity, and bleeding just before a period. Good oral hygiene and periodontal health can minimize or eliminate these symptoms.
It's a myth that teeth will be lost with each pregnancy because the baby takes calcium from the mother. However, the gums can be adversely affected by pregnancy, again due to increased hormone production. This rising level of hormones begins in the second month, increases steadily through the eighth month, and can cause a disease called pregnancy gingivitis. This condition is marked by red, swollen, tender, or bleeding gums.
To prevent pregnancy gingivitis, it is important to make sure your gums are healthy before becoming pregnant. An existing periodontal problem can be greatly exacerbated during pregnancy and can even result in tooth loss. Dr. Scharf can work with your OB/GYN to tailor a preventive maintenance program to keep both your gums and your baby healthy during the pregnancy.
Low Birth-Weight Babies
Recent studies suggest that those who have periodontal disease and who are pregnant may be at risk for having a premature, low birth-weight baby. Common risk factors for low birth weight and premature birth include smoking, alcohol use, drug use, and infections—and now periodontal disease is being seriously considered as a factor as well. Pregnancies in those who have periodontal disease could be up to seven times more likely to result in a baby that is born too early or is dangerously small at birth.
If you are planning to become pregnant or are at risk for periodontal disease, be sure to include a periodontal exam as part of your prenatal care. Healthy gums can contribute to a healthier body—and a healthy baby!
Those taking oral contraceptives (birth control pills) may experience the same changes in the gums as those caused by pregnancy due to the fluctuations in hormone levels. If you are taking oral contraceptives and notice bleeding, reddened, or sensitive gums, please contact our office to schedule a periodontal workup.
Many take hormone replacement therapy during menopause. Some studies show that estrogen supplements may improve oral health, but there is a chance that they can cause your gums to become more sensitive to local irritants like plaque and calculus. Regular periodontal care can reduce or eliminate these symptoms.
Problems Tied To Periodontal Disease
Study after study has tied the damaging effects of periodontal disease to serious physical ailments. Read this section to learn why periodontal disease is so damaging, and how it might be affecting the rest of your body.
While this isn’t life-threatening, over 25 million Americans suffer with chronic bad breath. Many resort to mints or sprays to mask the odor, but these products do not address the cause of the problem, which can come from several different sources. Dr. Scharf first performs a thorough examination to discover the cause of the problem and then devises a treatment plan to address it.
While certain medical conditions, such as lung infections, diabetes, and digestive imbalances, can cause bad breath, most cases of halitosis originate in the mouth itself. Certain bacteria that cause gum disease release gases called volatile sulfur compounds. These gases are often responsible for bad breath.
Proper diagnosis of halitosis consists of a detailed review of your medical history and a thorough dental examination to discover the cause, followed by a recommended course of treatment to address the problem. In most cases, results are quick and dramatic, with bad breath being resolved in a manner of weeks or even days.
Scientists now believe that people with gum disease are at a greater risk for respiratory problems, because bacteria can travel from the oral cavity into the lungs to cause infection and respiratory diseases such as pneumonia.
Bacterial respiratory infections are thought to be caused by aspiration (inhaling) of fine droplets from the mouth and throat. These droplets contain germs that can travel into the lungs to breed and multiply, causing damage to the delicate lung tissue. Recent research suggests that bacteria found in the throat and mouth can be easily drawn into the lower respiratory tract, causing infections or worsening existing lung conditions.
This is even more true of smokers and those with chronic obstructive pulmonary disease. COPD can cause persistent obstruction of the airways. The commonest cause of this disease is thought to be long-term smoking, as chemicals from smoke or air pollution irritate the airways to cause obstruction. Further damage to the tissue and working function of the lungs can be prevented, but already damaged tissue cannot be restored, and untreated or undetected COPD can result in irreversible damage. Patients with COPD typically also suffer from compromised immune systems, making it difficult to eliminate bacteria from their lungs. Scientists believe that bacteria aspirated from the throat and mouth into the lungs can cause frequent bouts of infection in patients with COPD. Studies are now in progress to determine how poor oral hygiene and periodontal disease may be associated with increasingly frequent bouts of respiratory disease in COPD patients.
New research is revealing evidence that people with periodontal disease may be more at risk for heart disease than patients without periodontal disease. One study showed that heart disease was 25 percent more common in people with gum disease. Men under the age of 50 who had gum disease had a 75 percent greater risk of heart disease than men with healthy gums. Another study demonstrated that men with gum disease had twice the death rate from heart disease of men without gum disease. These studies suggest that gum disease could be as strong a risk factor for heart disease as smoking (which is blamed for 40,000 heart-related deaths per year).
Several theories exist to explain the link between periodontal disease and heart disease. Oral bacteria can affect the heart when it enters the bloodstream, attaching to fatty plaques in the coronary arteries (heart blood vessels) and contributing to clot formation. Coronary artery disease is characterized by a thickening of the walls of the coronary arteries due to the buildup of fatty proteins. Blood clots can obstruct normal blood flow, restricting the amount of nutrients and oxygen required for the heart to function properly and increasing the chances of a heart attack.
In addition, inflammation caused by periodontal disease increases plaque buildup, which may contribute to swelling of the arteries. Researchers have found that people with periodontal disease are almost twice as likely to suffer from coronary artery disease as those without periodontal disease. Periodontal disease can also exacerbate existing heart conditions. Patients at risk for infective endocarditis may require antibiotics prior to dental procedures. Your periodontist and cardiologist will be able to determine if your heart condition requires antibiotics to be administered before a dental procedure.
Several prominent studies have pointed to a possible connection between periodontal disease and stroke. In one study that investigated oral infection as a risk factor for stroke, people diagnosed with acute cerebrovascular ischemia were found more likely to have an oral infection than the members of the control group (who had no ischemia).
Exposure to inflammation early in life quadruples an individual's risk of developing Alzheimer's disease, researchers reported at the first Alzheimer's Association International Conference on Prevention of Dementia. One common source of inflammation is chronic periodontal disease. Since this is a 100 percent treatable infection, controlling it may help reduce the risk of Alzheimer's disease later on.
The molecular and cellular mechanisms responsible for Alzheimer's disease have not been defined, but inflammation in the brain is considered to be a component of Alzheimer's disease. Studies suggest that inflammation in the rest of the body may contribute to inflammation in the brain. Chronic periodontal disease contributes to the overall level of inflammation in the body and can be considered a risk factor—but it is a factor that can be easily eliminated through proper periodontal care.
Maintaining oral health is an important part of any overall health care regimen. A recent study linked periodontal disease in men to an increased risk for several types of cancer. Research published in the Lancet Oncology found that men with a history of gum disease are 14 percent more likely overall to develop cancer than men with healthy gums. They may also be:
- 49% more likely to develop kidney cancer.
- 54% more likely to develop pancreatic cancer.
- 30% percent more likely to develop blood cancers.
This means it is particularly important for men to maintain good oral health, particularly if they smoke or have other preexisting risk factors for cancer.
Chronic Kidney Disease
According to the National Kidney Foundation, one out of nine Americans suffers from chronic kidney disease (CKD), and millions more are at risk. CKD is a debilitating disease that can affect blood pressure and bone health and can eventually lead to heart disease or kidney failure. A study published in the Journal of Periodontology indicates that the effects of untreated periodontal disease may be linked to chronic kidney disease. This suggests that preventive oral care could possibly reduce the prevalence of chronic kidney disease in the U.S. population. The study also indicates that adults with no teeth may be more likely to have CKD than adults with teeth.
While additional research is needed to fully understand why tooth loss is associated with higher risk for chronic kidney disease, the destructive nature of chronic inflammation may play a role. Both periodontal disease and chronic kidney disease are considered inflammatory conditions, and previous research has suggested that inflammation may be the common link between these diseases. Since untreated periodontal disease is one of the leading causes of tooth loss, patients without teeth may in many cases have been exposed to chronic oral inflammation.
Proper periodontal care can minimize or eliminate gum disease along with the accompanying inflammation, reducing the risk of associated inflammatory diseases.
Schedule A Periodontal Exam Today
With over 120 systemic diseases showing symptoms in the mouth, it is crucial to have your teeth and gums checked yearly by Dr. Scharf. Periodontists receive an additional three years of training outside of traditional dental school, studying advanced dental concepts such as how to use cutting-edge treatments to stop gum disease and how to place dental implants effectively. The American Academy of Periodontology recommends visiting your periodontist once a year for a Comprehensive Periodontal Evaluation, or CPE, to have your mouth carefully inspected for the early signs of gingivitis. By taking a proactive approach to your dental care, you can keep your entire body healthy. Contact us today to make an appointment.