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Gum disease, initiated by a build-up of plaque bacteria is very common and when left untreated it can result in tooth loss and have a negative effect on your general health. It’s recognised that periodontitis, advanced gum disease, may trigger the development or progression of several bodywide diseases such as diabetes and cardiovascular disease.
This post discusses the diseases that gum disease causes and how plaque bacteria can have a direct and indirect effect on the progression of diseases far from the mouth.
Can Gum Disease Cause Disease Elsewhere in the Body?
Yes, it’s believed that the same bacteria that initiate gum disease, along with cells of the immune system which try to trap and eliminate the invading microbes travel through the bloodstream to distant organs and contribute to the initiation or progression of disease elsewhere in the body.
A connection between oral health and systemic disease has been suspected since the early 1900s. From the 1980s onwards, many scientific studies have investigated the relationship (1).
However, it is difficult to prove that plaque bacteria cause these diseases because
- Many of the risk factors for associated diseases are the same as those for the development of gum disease. Risk factors include age, gender, smoking, stress and obesity.
- Studies completed so far cannot determine if gum disease and other diseases develop because of a shared pathway or if one causes the other.
For this reason, scientists like to say that gum disease and other conditions are associated with each other rather than gum disease causes other body-wide conditions.
How Does Periodontal Disease Contribute to Disease Progression Elsewhere in the Body?
Plaque bacteria may be able to contribute to the development of many diseases in the body in two ways (1).
Direct Effect
As gum disease progresses, the gum tissue peels away from the teeth creating periodontal pockets. Ulcers can form. Bacteria can enter the blood circulation through these open sores and travel to organs throughout the body where it initiates or aggravates existing diseases.
Indirect Effect
As plaque bacteria accumulate the body’s immune system is activated and tries to rid the body of harmful bacteria. Inflammatory cells try to heal the gum tissue and trap and remove the bacteria.
However, unless the plaque bacteria is disrupted with manual brushing and professional gum health treatments the bacteria continue to trigger a response by the immune system.
The inflammatory cells continue to be produced, and along with their bi-products, they start to attack bone and ligaments that hold the teeth in place. The teeth get loose and are at risk of falling out.
The inflammatory cells and their bi-products also travel through the bloodstream and can have an indirect effect on any area of the body.
Chronic Inflammation is a known risk factor for several diseases including cardiovascular disease, type 2 diabetes, and rheumatoid arthritis. Untreated periodontal disease is a source of chronic inflammation that can contribute to the development of these inflammatory diseases.
Gum Disease is Associated With These Health Conditions
Gum disease has been associated with the following inflammatory conditions (5).
Atherosclerotic Cardiovascular Disease
There is an association between gum disease and cardiovascular disease which is independent of other risk factors.
Atherosclerosis is the thickening of artery walls by calcium and fatty materials that form plaques. The artery walls become hard and stiff. This can lead to angina, heart attack, stroke or an aneurysm depending on the location.
Plaque bacteria may directly or indirectly lead to the development of atherosclerosis and thus cardiovascular diseases.
Diabetes
This condition that results in abnormally high blood glucose levels can be made worse by severe gum disease and can also lead to gum disease. There is a bidirectional relationship between the two conditions.
Those with diabetes are more likely to develop gum disease and the more advanced the gum disease becomes the harder it can be to control blood sugar levels.
Diabetics also have an increased risk of developing other inflammatory conditions.
Pregnancy
Hormonal changes during pregnancy are known to cause pregnancy-related gingivitis which often gets better following the pregnancy if good standards of oral hygiene are maintained throughout pregnancy. Those with gingivitis before pregnancy may find it gets worse with hormonal changes.
Severe periodontitis is associated with adverse pregnancy outcomes including low birth weight, preterm birth and pre-eclampsia.
Inflammation during pregnancy increases the risk of preterm birth. As we have seen periodontal diseases cause inflammation. So it stands to reason, the worse the periodontitis, the greater the inflammation and the greater the risk of adverse pregnancy outcomes.
Other Systemic Diseases
Periodontal disease has been associated with several other inflammatory health conditions including
- Respiratory Disease – Chronic Obstructive Pulmonary Disease (COPD) and Pneumonia.
- Infective Endocarditis
- Bacterial Pneumonia
- Chronic Kidney Disease
- Rheumatoid Arthritis
- Cognitive Impairment eg Alzheimers
- Metabolic Syndrome
- Cancer – Periodontitis has been identified as a possible risk factor for pancreatic cancer and Orodigestive cancers (cancers in the oral cavity and pharynx, esophagus, stomach, pancreas, liver, colon, rectum or anus) (2)
Frequently Asked Questions
Does Gum Disease Show Up In Blood Tests?
Blood tests are not needed to diagnose gum disease as they can be seen by looking at the gums. The gums are characteristically red, inflamed and bleed when pressure is applied. A dentist can determine how advanced gum disease is by measuring the depth of periodontal pockets and using x-rays to detect bone loss.
Chronic inflammation can be measured using a blood test called a CRP (C-Reactive Protein) (3). If you have chronic periodontitis the likelihood is that you have a raised CRP. This test is not routinely used in dentistry.
Can Gum Disease Make You Tired?
Research into this is limited, however, it is known that persistent inflammation can result in pathophysiological fatigue. However, how inflammation causes fatigue is unknown (4). As inflammation increases and persists, fatigue may worsen.
If you have gum disease and are feeling tired there could be a link. Developing and maintaining oral hygiene will help reduce gum inflammation and may also reduce fatigue.
How Can You Prevent Periodontal Disease and Associated Health Conditions
If you want to prevent or control the progression of periodontal disease and reduce your risk of other health conditions initiated or made worse by your gum disease there are some simple steps you can take:
- Stop smoking
- Lead a healthy lifestyle
- Eat a nutrient-rich diet that is low in sugar and saturated fats. Mediterranean or paleo diets are suggested in the fight against many inflammatory diseases as they are high in vitamins and micronutrients.
- Control blood sugars
Have First Class Oral Hygiene
One of the most important things you can do for your oral and general health is to develop and maintain oral hygiene which is first class. This will prevent harmful inflammation on your mouth and body. Brush your teeth twice a day with an electric brush and clean the gum pockets with a Gum Pocket Brush. Using the correct technique is essential in the disruption of plaque bacteria.
Sources – What Diseases Can Gum Disease Cause
- Winning, L., Linden, G. Periodontitis and systemic disease. BDJ Team 2, 15163 (2015). https://doi.org/10.1038/bdjteam.2015.163
- Ansai, T., Takata, Y., Yoshida, A. et al. Association between tooth loss and orodigestive cancer mortality in an 80-year-old community-dwelling Japanese population: a 12-year prospective study. BMC Public Health 13, 814 (2013). https://doi.org/10.1186/1471-2458-13-814
- C-Reactive Protein (CRP) Test: MedlinePlus Medical Test
- Karshikoff, B., Sundelin, T., & Lasselin, J. (2017). Role of Inflammation in Human Fatigue: Relevance of Multidimensional Assessments and Potential Neuronal Mechanisms. Frontiers in Immunology, 8. https://doi.org/10.3389/fimmu.2017.00021
- Li, X., Kolltveit, K. M., Tronstad, L., & Olsen, I. (2000). Systemic Diseases Caused by Oral Infection. Clinical Microbiology Reviews, 13(4), 547-558. https://doi.org/10.1128/cmr.13.4.547-558.2000
