Matthew Norman, DDS and Michelle Phillips, RDH
Many correlations exist between periodontal (gum) disease and systemic diseases such as heart disease, diabetes, respiratory diseases, and even pregnancy. The mouth is the gateway to the rest of the body, and it is becoming more and more evident that an infection in your mouth can affect the rest of your body.
Periodontal disease is infection of the gums. In a healthy mouth, gums are pink, firm and do not bleed when brushed and flossed. It is very important to brush your teeth twice a day, floss once a day, and to visit your dentist regularly. At a routine hygiene appointment, the dentist and dental hygienist review your medical history and evaluate your gums to screen for all forms of periodontal disease and gingivitis. Gingivitis is the lowest classification of periodontal disease, meaning inflammation of the gums. Remember, healthy gums don’t bleed!
Heart disease is probably the most commonly linked systemic disease to periodontal disease. Bacteria are present in bodies of all living creatures. Some bacteria are not harmful and actually help keep the body healthy, but some bacteria are harmful to your body. This same situation of helpful/harmful bacteria exists in your mouth. Any bacteria (good or bad) present in your mouth can be transmitted into your bloodstream, especially when the gums are bleeding due to unmanaged periodontal disease or gingivitis. Once in your bloodstream, bacteria can reach all other areas of your body, including your heart. When bacteria enter the bloodstream, it attaches itself to the fatty plaques in your heart vessel arteries (coronary arteries) and contributes to the formation of clots. One with coronary artery disease has thickened walls of the coronary arteries from the buildup of plaques and the blood clots can obstruct blood flow. This leads to a lack of oxygen needed for the heart to properly function, which can lead to a stroke and even a heart attack. Those with periodontal disease are more likely to suffer from coronary artery disease than those without periodontal disease. Also, unmanaged periodontal disease can worsen a preexisting heart condition.
Diabetes is a chronic systemic illness which is becoming more and more prevalent in the United States. The American Diabetes Associated estimated in 2011 that nearly 26 million people (8% of the total US population) have diabetes and this number continues to grow rapidly. A person with diabetes is more likely to have periodontal disease than a non-diabetic, especially one who doesn’t have their diabetes under control. The diabetic patient is more likely to develop infections and because their wound-healing ability is impaired, oral infection is more difficult to treat. The relationship between diabetes and periodontal disease has also been found to be two-directional, meaning that the worsening of one condition can cause the other to worsen. Therefore a diabetic patient, who also suffers from periodontal disease which is unmanaged, is more likely to lose control of their diabetes and suffer from diabetic complications.
Respiratory diseases are also directly linked to periodontal disease. The bacteria in your mouth can be drawn into your lungs to cause respiratory diseases like pneumonia. When you inhale, the bacteria in your mouth can settle into your lower respiratory tract and cause infection. Patients with Chronic Obstructive Pulmonary Disease (COPD) have a higher risk of experiencing complications, when unmanaged periodontal disease is also present.
Many people are unaware that a relationship exists between periodontal disease and pregnancy. When a woman is pregnant, it is common for her to develop a condition called Pregnancy Gingivitis. During pregnancy, a woman experiences changes in her normal hormone levels. These changes can cause the gum tissue to become much more sensitive food and plaque levels in the mouth, which lead to inflammation and bleeding in the gums. The hormonal changes can even make it easier for the bad bacteria that we discussed earlier to grow. Some bacteria have even been found to cause complications with pregnancy, such as pre-term births. It is very important for the pregnant patient to see their dentist and dental hygienist for routine hygiene visits to ensure their mouth is in a healthy condition.
In summary, it is crucial for everyone to visit their dentist regularly – especially those who have a systemic disease, which can increase their risk of developing periodontal disease. Your dentist and dental hygienist should be evaluating your periodontal health on a regular basis to ensure your mouth is in a healthy condition. Regular dental visits will allow the dental team to check for signs of gingivitis and periodontal disease, and recommend treatment if treatment is necessary. It is also important to be aware that a cure does not currently exist for periodontal disease. Those with periodontal disease must maintain their dental health with excellent home care and regular dental hygiene visits. As with any other disease, early detection is critical. The sooner the condition is discovered and treated, the better the outcome.