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Science and Dentistry

The Mouth-Body Connection

Research has recently proven what dentists have long suspected: that there is a strong connection between periodontal disease and other chronic conditions such as diabetes, heart disease and osteoporosis.

Periodontal Disease, Heart Disease and Stroke

Coronary heart disease occurs when fatty proteins and a substance called plaque build up on the walls of your arteries. This causes the arteries to narrow, constricting blood flow. Oxygen is restricted from traveling to the heart which results in shortness of breath, chest pain, and even heart attack.

The link between periodontal disease and heart disease is so apparent that patients with oral conditions are nearly twice as likely to suffer from coronary artery disease than those with healthy mouths. Periodontal disease has also been proven to exacerbate existing heart conditions. Additionally, patients with periodontal disease have been known to be more susceptible to strokes. A stroke occurs when the blood flow to the brain is suddenly stopped. This may occur, for example, when a blood clot prevents blood from reaching the brain.

One of the causes of the connection between periodontal disease and heart disease is oral bacteria entering the bloodstream. There are many strands of periodontal bacteria. Some strands enter the bloodstream and attach to the fatty plaques in the coronary arteries. This attachment leads to clot formation and increased risk to a variety of issues including heart attack.
Inflammation caused by periodontal disease creates an increase in white blood cells and C-reactive proteins (CRP). CRP is a protein that has long-been associated with heart disease. When levels are increased in the body, it amplifies the body’s natural inflammatory response. Bacteria from periodontal disease may enter the bloodstream, causing the liver to produce extra CRP, which then leads to inflamed arteries and possibly blood clots. Inflamed arteries can lead to blockage, which can cause heart attacks or strokes.
Coronary heart disease is the leading cause of death in the United States for both men and women. Enacting positive oral hygiene practices and obtaining treatment for periodontal problems can help prevent the risk of developing this unfortunate condition.

Periodontal Disease and Pregnancy

Pregnant mothers with periodontal disease expose their unborn children to a variety of risks and possible complications. Pregnancy causes many hormonal changes in women, which increase the likelihood of developing periodontal disease such as gingivitis, or gum inflammation. These oral problems have been linked to preeclampsia, or low birth weight of the baby, as well as premature birth. Fortunately, halting the progression of periodontal disease through practicing high standards of oral hygiene and treating existing problems can help reduce the risk of periodontal disease-related complications by up to 50%.

There are several factors that contribute to why periodontal disease may affect the mother and her unborn child. One is an increase in prostaglandin in mothers with advanced stages of periodontal disease, particularly periodontitis. Prostaglandin is a labor-inducing compound found in the oral bacteria associated with periodontitis. Because periodontitis increases the levels of prostaglandin, the mother may go into labor prematurely and deliver a baby with a low birth weight.

Another compound that has recently been linked to premature birth and low birth weights is C-reactive protein (CRP). CRP is a protein that has long-been associated with heart disease. Periodontal disease increases CRP levels in the body, which then amplify the body’s natural inflammatory response. Bacteria from periodontal disease may enter the bloodstream, causing the liver to produce extra CRP, which then leads to inflamed arteries and possibly blood clots. Inflamed arteries can lead to blockage, which can cause heart attacks or strokes. Although it is not completely understood why elevated CRP also causes preeclampsia, studies have overwhelmingly proven that an extremely high rate of CRP in early pregnancy definitely increases the risk.

Finally, the bacteria that invades and lives in the gum sockets in a diseased mouth, can travel through the bloodstream and affect other parts of the body. For pregnant women, research has shown that these bacteria may colonize in the internal mammary glands and coronary arteries.

If you are pregnant, it is important to practice effective home care for preventing gum disease. Drs. Ressler, Hirschl and Lelchuk can help assess your level of oral health and develop preventative measures and treatment plans to best protect you and your baby.

Periodontal Disease and Respiratory Disease

Respiratory disease occurs when fine droplets are inhaled from the mouth and throat into the lungs. These droplets contain germs that can spread and multiply within the lungs to impair breathing. Recent research had also proven that bacteria found in the mouth and throat can be drawn into the lower respiratory tract and cause infection or worsen existing lung conditions.

Bacteria that grow in the oral cavity and travels into the lungs can cause respiratory problems such as pneumonia. This occurs mostly in patients with periodontal disease. Periodontal disease has also been proven to have a role in the contraction of bronchitis and emphysema. Chronic obstructive pulmonary disease (COPD), a respiratory condition characterized by blockage of the airways, and caused mostly by smoking, has also been proven to worsen if the patient also has periodontal disease.

One of the reasons for the connection between respiratory problems and periodontal disease is low immunity. Patients who experience respiratory problems generally have low immunity, meaning bacteria can easily grow above and below the gum lines without being confronted by the body’s immune system. Once periodontal disease is contracted in this way, it will only progress and worsen respiratory issues.

Inflammation of the oral tissue has also been linked to respiratory problems. Oral bacteria causing the irritation can travel to the lungs, and contribute to the inflammation of the lung lining. This creates respiratory problems because it limits the amount of air that can be passed freely through the lungs.

If you are diagnosed with respiratory disease or periodontal disease, it is possible Drs. Ressler, Hirschl and Lelchuk will work with your physician to plan how to best treat both conditions and eliminate further complications.

Periodontal Disease and Osteoporosis

Osteoporosis is a condition common in older patients, and particularly women, which is characterized by the thinning of bone tissue and loss of bone density over time. Osteoporosis occurs when the body fails to form enough new bone, or when the body absorbs too much old bone. The leading cause of osteoporosis is a drop in estrogen in menopausal women, or a drop in testosterone among men. Sufferers of osteoporosis must take extra care in daily activities, as they are at increased risk for bone fractures.

Because periodontal disease can also lead to bone loss, the two diseases have been studied for possible connections. Research found that women with periodontal bacteria in their mouths were more likely to have bone loss in the oral cavity and jaw, which can lead to tooth loss. Studies conducted over a period of 10 year also discovered that osteoporosis patients could significantly reduce tooth loss by controlling periodontal disease. Further, it was found that post-menopausal women who suffer from osteoporosis are 86% more likely to also develop periodontal disease.

One of the reasons for the connection between osteoporosis and periodontal disease is an estrogen deficiency. Estrogen deficiency speeds up the progression of both oral bone loss and other bone loss. It also accelerates the rate of loss of fibers and tissues which keep the teeth stable. Tooth loss occurs when these fibers are destroyed.

Low mineral bone density is one of the several causes of osteoporosis. The inflammation from periodontal disease weakens bones more prone to break down. This is why periodontitis can be particularly detrimental and progressive to patients with osteoporosis.

If you are diagnosed with osteoporosis, it is extremely important to take preventative measures against periodontal disease to protect your teeth and oral bones.

Periodontal Disease & Tobacco

You are probably familiar with the links between tobacco use and lung disease, cancer, and heart disease. Current studies have now also linked periodontal disease with tobacco usage. Cases of periodontal disease are more severe in smokers and tobacco-users than those of non-users of tobacco. There is a greater incidence of calculus formation on teeth, deeper pockets between gums and teeth, and a greater loss of the bone and fibers that hold teeth in your mouth. In addition, your chance of developing oral cancer increases with the use of smokeless tobacco.

Chemicals in tobacco such as nicotine and tar also slow down healing and the predictability of success following periodontal treatment. Quitting smoking and tobacco-use can have innumerous benefits for your overall and periodontal health.

Women and Periodontal Health

Throughout a woman’s life, hormonal changes affect tissue throughout the body.

Fluctuations in hormonal levels occur during puberty, pregnancy and menopause. At these times, the chance of periodontal disease may increase, requiring special care of your oral region.

Puberty

During puberty, there is increased production of sex hormones. These higher hormone levels increase gum sensitivity and lead to greater irritation from plaque and food particles. The gums can become swollen, turn red, and feel tender.

Menstruation

Similar symptoms occasionally appear several days before menstruation. Bleeding of the gums, bright red swelling between the teeth and gum, or sores on the inside of the cheek may occur. These symptoms generally clear up once the period has started.

Pregnancy

Your gums and teeth are also affected during pregnancy. Between the second and eighth month, gums may also swell, bleed, and become red or tender. Large lumps may appear as a reaction to local irritants. However, these growths are generally painless and not cancerous. They may require professional removal, but usually disappear sometime after delivery. Periodontal health practices should be part of your prenatal care. Any infections during pregnancy, including periodontal infections, can place a baby’s health at risk.

Oral Contraceptives

Swelling, bleeding, and tenderness of the gums may also occur when you are taking oral contraceptives, which are synthetic hormones.

You should always mention any prescriptions you are taking, including oral contraceptives, prior to medical or dental treatment. This will help eliminate the risk of drug interactions, such as antibiotics with oral contraceptives, which lessens the effectiveness of the contraceptive.

Menopause

Changes in the look and feel of your mouth may occur if you are menopausal or post-menopausal. They include: feeling pain and burning in your gum tissue and salty, peppery, sour tastes, and “dry mouth.” Careful oral hygiene at home and professional cleaning may relieve these symptoms. There are also saliva substitutes to treat the effects of dry mouth.

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