Gum disease (periodontitis) can be a silent killer of oral health. But did you know they can affect more than just your oral health? The entire body acts like a single machine. A faulty part A can affect parts Y and Z. One’s overall wellness is closely connected with dental health. Chronic gum disease can cause uncontrolled diabetes, poor gut health, sudden heart attacks, dementia and more.

In any human body there are around 30 trillion human cells, but our microbiome is an estimated 39 trillion microbial cells including bacteria, viruses and fungi that live on and inside us. These microbial cells inhabit nearly all parts of our body, from our head to feet. The areas that have the largest numbers of microbial cells are the oral and gut microbiomes.

Gingivitis (commonly seen as bleeding gums) is an early-stage infection of the gum line caused by the bacteria that live there naturally and create irritation.

Periodontitis is a more advanced stage of gum disease. It’s a severe form of gingivitis that only develops if you have gingivitis for a really long time. If left untreated, it can eventually lead to other dental and jawbone problems, like loose teeth, difficulty in chewing, bad breath and change in alignment of teeth.

Symptoms of gum disease include redness, swelling, tenderness, bleeding when brushing or flossing, a shiny gum surface and bad breath.

A Case Study

Mrs Biswas was reluctant to have a hearty laugh with friends. The bad breath issue was getting worse with time. Though she had decent food habits, drank enough water and added citrus foods to her diet, nothing seemed to change. Despite a recent dental appointment for teeth cleaning, the bad breath lingered. Searching for ways to, she visited us. We met Mrs Biswas at her lowest, when she was in despair and almost afraid of speaking or laughing in public. On examination, we diagnosed advanced gum disease that was aggravated by her uncontrolled blood sugar levels (diabetes type 2). With medical clearance from her diabetologist, we sequentially treated her gum disease with dental lasers, deep teeth cleaning and home care. Undoubtedly, with time, her bad breath was gone and sugar levels were under control. She also follows a diligent sugar control regimen.

Effect on Health

Humans are in symbiosis with millions of bacteria. Within control, these bacteria are not harmful. However, if you don’t take good care of your teeth, plaque and tartar can accumulate, allowing uncontrolled bacterial growth. Certain comorbidities like diabetes, autoimmune conditions, hormonal changes, pregnancy, stress, and heart issues can worsen gum diseases.

The bacteria overload begins to produce toxins that cause inflammation in the body. As gum inflammation worsens, you may feel gum bleeding, discomfort and sensitive gums (gingivitis), cavities, toothaches, an unpleasant taste, and bad oral breath (halitosis). This bacterial excess can trigger a process known as ‘bacteremia’, in which germs enter your saliva. They can eventually travel from the saliva via your bloodstream to other parts of the body, including your heart, gut and lungs.

Long-term HAZARD

Medical issues can impact dental health, and vice versa. In fact, the mouth can be a source for the early diagnosis of other medical issues. Let’s take a look at a few common health conditions.

 Heart Health: A study revealed that periodontitis is a risk factor for coronary heart disease (CAD) that includes angina (mild heart pain), heart attack, strokes and other peripheral vascular issues like high blood pressure. It was seen that gum disease increases the risk of heart issues by 19 per cent. Also, people with lingering gum disease have a higher risk of developing heart problems with age.

 Mental Health and Cognitive Functions: Dementia (issues of memory loss) is believed to be caused by three factors — ongoing inflammation, free radical stress, and toxins. And periodontitis is chronic gum inflammation. For similar reasons, gum problems have also been linked to poor cognitive functioning such as learning, thinking, reasoning, remembering, problem solving, making decisions and concentration, among others. Porphyromonas gingivalis bacterium, which destroys gum tissue — and the enzyme which it produces, known as gingipains — are specifically linked to Alzheimer’s disease, after both were discovered in the brain tissue of those suffering from Alzheimer’s.

 Gut Health: Gum disease leads to the increased presence of harmful oral bacteria in the mouth. When these harmful bacteria build up, they are then ingested and travel to the stomach as you eat, drink and swallow saliva.

 Diabetes: Diabetes and periodontitis have a bi-directional relationship. Studies have identified periodontitis as linked to insulin resistance, a chronic condition implicated in metabolic disease and type 2 diabetes. Diabetics should also watch out because the illness can cause blood vessels to thicken, reducing blood flow to the gums and bones. This can weaken the gums and bones, making them more susceptible to infection. Also, high blood sugar levels promote bacterial growth in the mouth and lead to gum disease. Further, both diabetes and some diabetes medications can reduce saliva production and increase the risk of tooth decay and other mouth problems.

 Kidney Disease: Gum treatment has shown to improve outcomes in people battling kidney problems. A recent study has showed that a 10 per cent increase in gum inflammation reduces kidney function by 3 per cent. In this group of patients, the 3 per cent worsening in kidney function would translate to an increase in the risk of kidney failure over a five-year period by 32-34 per cent.

 Lung Disease: Chronic obstructive pulmonary disease (COPD) patients are at a higher risk of developing periodontitis. Studies have shown that oral and periodontal bacteria have been found in bacterial pneumonia. Periodontal disease also has been connected to lung problems such as emphysema, bronchitis and COPD.

 Cancer: According to newer research, periodontal disease increases cancer risk, with the chances of tongue cancer increasing 5.23 times with each millimeter loss of jaw bone that supports the teeth.

Preventive steps

Modern research has come a long way in proving that good gum conditions form the bedrock of good oral health. The mouth is the doorway for nutrition and water in the body. Quite naturally, a dirty doorway (the mouth) leads to an unhealthy house (the body). The following preventive measures can help.

 Brush and mouthwash: Brush your teeth twice a day with fluoride toothpaste and floss daily to remove plaque and debris. Usage of a mouth wash for two-four weeks is okay but long-term usage can cause teeth staining and affect taste sensation.

 Superfloss and water floss: These are special flosses to be used under an artificial dental bridge in the mouth. Water floss is an effective remedy to replace traditional flossing for both normal and artificial fixed teeth.

 See a dentist: Get regular dental checkups and cleanings, at least once a year. If you have symptoms, you should see a dentist more often.

 Quit smoking: Smoking weakens your immune system and makes it harder to fight off gum infections.

 Manage diabetes: If you have diabetes, manage it to reduce your risk of gum disease.

 Choose better foods: Adopt a balanced diet rich in fruits, vegetables, whole grains, and probiotic-rich foods to nourish beneficial bacteria.

 Limit sugary foods and drinks: Avoid foods and drinks with excess sugar and alcohol. After eating sugary foods, you can rinse your mouth with water or brush your teeth to help flush out sugar.

 Get enough vitamin C: Vitamin C deficiency is a leading cause of gum disease. You can get vitamin C from fruits, but you should be careful about the sugars in them.

 Use a soft-bristled toothbrush: Use a toothbrush with a small head and soft bristles. The technique of brushing is more important than the type of toothpaste used.

 Clean dentures: If you have dentures, clean them every day.

Early forms of gum disease, like gingivitis, can be cured with a healthy oral hygiene routine and regular dental cleanings.

Dr Kamlesh Kothari, MDS, DNB, DICOI, is a dental implant specialist, cosmetic dentist and maxillofacial surgeon and founder of Aesthetica, 2/7 Sarat Bose Road. He can be contacted at 9830183000, +913340035900, www.aesthetica.co.in and @drkamleshkothari on Instagram. Send your queries to drkamleshkothari@gmail.com