Health Leader, Healthy Gums

STORY BY

Phil Montgomery & Karen Krakower

If the eyes are the windows to the soul, then the gums are the binoculars to the rest of your body.

Since the early 90s, the American Academy of Periodontology has been stressing the link between gum disease and systemic illness, such as diabetes, heart attacks, strokes, and even the birth of premature, low-weight babies.

"There is a correlation between the health of your mouth and the health of your whole body," says dentist and former assistant professor of periodontics, Antonio Moretti at the University of Texas Dental Branch at Houston. "The fact that you have infection in your mouth, which is what gum disease is, may trigger other parts of your body to respond improperly."

What is gum disease?

There are two main forms of gum disease, both of which are caused by bacterial plaque. Bacterial plaque is a combination of saliva and bacteria that forms a sticky substance that accumulates on teeth. The first form of gum disease is gingivitis, which is caused by plaque and generally characterized by inflammation of the gums. Some forms of gingivitis are mild while others cause severe inflammation.

The second and more severe form of gum disease is periodontitis. As in gingivitis, bacterial plaque is the cause, Moretti says. Periodontitis affects not only gums but also deteriorates the bone surrounding the teeth. Much like a wobbly picket fence that has pulled away from the ground, bone loss diminishes support for the teeth, which causes them to drift out of alignment and loosen.

Sick gums, sick body

Researchers have discovered that gum disease-causing bacteria or the chemical by-products from bacteria and inflammation are carried throughout the body by the blood stream. Those by-products may exacerbate or contribute to health problems in the far reaches of your body.
“There is increasing evidence that there's a lot in common between infections in your mouth and other systemic problems that may happen in your body, such as diabetes, heart disease and stroke, respiratory diseases, and even the birth of premature low-weight babies,” Moretti says.

Gum disease and pregnancy

Premature, low-weight babies is a serious health problem. Risk factors such as smoking, alcohol and drug abuse may lead to a premature low-weight birth, but in the last 10 years researchers have studied the correlation between infection in the mouth and premature births.

"The results are intriguing," Moretti says. "Research has shown that a woman with gum disease is seven times more likely to have a premature baby. We don't understand this correlation completely yet. Similarly to other mouth and body correlations, bacteria and chemical by-products from gum disease are the main culprits."

Research centers all over the world are also reporting on the correlation between gum disease and problem pregnancy, he says.

"If you have gum disease and you get pregnant, you are at high risk," Moretti says. "If gum disease gets worse during pregnancy, then the risk for having a low-weight premature baby gets even higher."

Diabetes connection

The link between gum disease and diabetes is especially strong, Moretti says. If a patient has diabetes, he is already at increased risk to develop gum disease. Periodontitis is the sixth leading complication of diabetes, and a diabetic is four times more likely to develop gum disease.

"Diabetes is like a two-way street," Moretti says. "If you have diabetes, you may have periodontal disease, but periodontal disease makes it more difficult for people with diabetes to control their blood sugar."

Studies have shown though that some diabetics who have been treated for gum disease decrease their insulin medication after treatment.

Straight to the heart

Medical researchers have two main theories to explain the link between gum disease and heart disease and stroke.

One theory is that the bacteria from periodontal disease enter the blood stream and stick to the blood vessels, creating a thickening of the walls, which may end up clogging these vessels. The second theory is that the chemical by-products from gum disease cause the same clogging effect. The chemicals may come from the by-products of the bacteria or from the chemicals produced by the body's own immune system.

Periodontitis may affect stroke, which is basically the same blocking of blood vessels in the brain instead of the heart. Either the bacteria or chemical by-products help to clog blood vessels in the brain.

Prevention

"Simple prevention is the easiest and least expensive way to avoid gum disease," Moretti reminds us.

Basically, with about two to three minutes of proper tooth brushing all around the teeth—inside and outside—and most importantly, correct flossing, Moretti says, one can prevent serious dental problems.

"I know that it is not easy to floss properly, especially the back teeth. But most of the problems with decay and gum disease are found in between the teeth only because it is hard to remove the plaque that accumulates in these hard-to-reach areas," Moretti says.

He says that proper training from your dentist, together with a fluoride therapy that works for you will go a long way to keep the whole body safe.

Smoking, which already is one of the leading causes of stroke, heart disease and low-weight births is also a serious risk factor for periodontitis. "Depending on the study, on average, smokers are four or more times as likely to have periodontitis as compared to persons who never smoked. It is also estimated that about 40 percent of periodontitis cases are due to current smoking.

The bottom line is simple, Moretti says, "If you really want to be healthy, your mouth needs to be healthy."

UPDATED: 5-09-2007