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Most people think of their medical doctor as the one that minds their overall health while their dentist takes care of their teeth. However, it might surprise you to learn that what is happening in your mouth often indicates other health conditions you might have.

Research has been building the case for decades now that there is a link between periodontal disease and systemic issues. Therefore, you should consider your dentist as part of the overall health team specializing in oral health. At Smile Generation, we call this the Mouth-Body Connection®

So, what is the link between periodontal disease and other health issues? Research shows that the connection is evident in many serious conditions, including 

  • Osteoporosis 
  • Cancer
  • Cardiovascular disease
  • Rheumatoid arthritis
  • Diabetes
  • Alzheimer's
  • Adverse pregnancy outcomes

Other evidence explores the connection between periodontal disease and respiratory disease. Let's look at each link between periodontal disease and systemic health conditions. 

Periodontal Disease and Osteoporosis

Osteoporosis and periodontal disease have an association that is significant but still inconclusive. However, gum disease and osteoporosis have considerable links regarding tooth loss. In a systematic review, where researchers look at several studies in an area of research to determine a collective conclusion from them all, researchers saw a strong correlation between the two conditions when you compare X-rays. The researchers concluded that there is a "specific mechanistic relationship" between the two. [1]  

It probably should not be a surprise. Both periodontal disease and osteoporosis involve the person losing bone, which can upset the equilibrium necessary for the body to replace bone tissue, balance hormones, and respond to inflammation. They also share risk factors. In addition, research is beginning to reveal how the two conditions' interactions impact the patient. More study is needed to solidify the relationship between these two conditions, but a link is something upon which the researchers agree. 

Periodontal Disease and Cancer

Perhaps the most concerning discovery in the Mouth-Body Connection regarding gum disease and health issues is the research that links periodontal disease and cancer. A recent study out of Oxford indicates a 24 percent increase in the risk of developing cancer for people with severe gum disease compared to people with mild or no gum disease. The two highest cancer risks for people with gum disease were lung cancer and colorectal cancer. [2]  

Researchers are still working on the reason for the association. Some studies indicate inflammation and periodontal bacteria might create an association between the presence of gum disease and an increased risk for specific cancers. However, researchers believe more exploration is warranted in this area, perhaps urgently. [3]

The American Academy for Periodontology (the AAP, the professional organization for the dental specialty for dentists who concentrate on gum health) also believes that gum disease increases risks for certain cancers. For example, they have research that shows men with gum disease were 49 percent more likely than those without gum disease to develop kidney cancer and 54 percent more likely to develop pancreatic cancer. The AAP also found that these men were also 30 percent more likely to develop blood cancers, too.[4]

Does this mean that if you have gum disease, you will automatically develop lung, colorectal, or kidney cancer? It doesn't, but it might mean that your risks are higher than someone who doesn't have gum disease. If you find out you have periodontal disease, it would be good to make an appointment to see your doctor to find out if you need any testing for these conditions. 

Periodontal Disease and Cardiovascular Disease

The AAP also says that a lot of research shows a link between periodontal disease and cardiovascular disease. Cardiovascular diseases are conditions of the heart and blood vessels. The connection between periodontal disease and heart health could be the inflammation from gum disease.[5]  Everydayhealth.com explains that the connection comes from research showing that a protein in our blood plasma, CRP (c-reactive protein), is elevated in people with gum disease. The CRP level might rise more when responding to inflammation.[6]

Also, gum disease can make heart conditions worse. The AAP also cautions patients who are at risk for infective endocarditis, an infection of one or more of the heart valves, to talk to the doctor before undergoing dental treatment as antibiotics might be necessary beforehand.[7]

A reason that periodontal disease and heart health are associated is that the gum disease bacteria could travel to other parts of the body through the bloodstream. This bacterium causes inflammation and the formation of arterial plaque. In 2010, a study found significant evidence that oral bacteria contributed to the development of atherosclerosis. In this condition, arteries have a thick layer of fats and cholesterol along the arterial walls.[8]

However, a lot of research indicates other associations in the Mouth-Body Connection. Both gum disease and heart disease have common risk factors, like smoking and being overweight, which might be why they are closely associated. In 2012, researchers reported that the bacteria present in dental plaque, which is present in people who have gum disease, triggers blood clots. A 2013 study suggested a relationship between periodontal disease and stroke. The following year, a 2014 study showed treating gum disease reduced the adverse consequences of heart disease and other chronic conditions.[9]

Around this same time, an observational study of African hospitals further indicated a relationship between periodontal disease and heart health. The researchers screened 558 patients in Cameroon from January 2013 to December 2015. Around 29 percent had cardiovascular diseases (predominantly hypertension or high blood pressure), and 13 percent had diabetes. However, 77 percent had periodontal disease, with 62 percent in the early stage of periodontal disease (gingivitis) and 15 percent in the late stage (periodontitis). Of these cases, the researchers found a statistical correlation between gingivitis and periodontitis, and cardiovascular disease. [10]

Periodontal Disease and Rheumatoid Arthritis

One relationship discovered in the Mouth-Body Connection studied for decades is the one between gum disease and rheumatoid arthritis. Although research suggested the relationship 40 years before, it wasn't until 2015 that a systematic review revealed a tangible link between these two inflammatory conditions. Following that, another study suggested that people with periodontal disease were more likely to develop rheumatoid arthritis. A common symptom of people suffering from gum disease who also have rheumatoid arthritis is sensitive teeth.

However, the connection between the two is not as straightforward as some might hope. Moreover, there is no proven causal relationship. 

That said, research does indicate that some patients are more susceptible to both conditions. Further, if a person from this subset develops them both, the two inflammatory diseases seem to be associated closely. The researchers suggest that inflammation is the commonality that will make it easier to identify whether people are part of this vulnerable group.[11]

Periodontal Disease and Diabetes

One of the most researched links between systemic illness and gum disease is periodontal disease and diabetes. The AAP explains that people with diabetes are more likely than people without diabetes to have gum disease, partly because people with diabetes are at risk for all infections. When the patient's diabetes is not under control, it compounds the danger. Moreover, this relationship is circular in that diabetes makes people more prone to gum disease and gum disease makes it harder to control blood sugar.[12]

Moreover, many people with periodontitis don't always know they have type 2 diabetes. Research suggests that one in five people with periodontitis are unaware they also have type 2 diabetes. This lack of awareness further enforces the circular relationship between the two conditions because the inflammatory response to the plaque associated with gum disease makes it more difficult for people with type 2 diabetes to control their blood sugar. With this relationship so well-established, many experts agree that dental checkups might be an excellent opportunity to screen people for diabetes.[13]

Periodontal Disease and Alzheimer's

Gum disease has also been linked to Alzheimer's disease. The connection is the bacteria typical of gum disease. Per the AAP, studies show that the bacteria in the oral cavity can travel to the brain and hasten the onset of Alzheimer's disease.[14]

People with gum disease are also at a higher risk for developing dementia. The New York Times reported that the risk for developing dementia is 22 percent higher in patients with periodontitis and 26 percent higher for patients who have lost their teeth.[15] Building upon that, a 2020 literature review upheld these findings and concluded that the inflammation from gum disease could be a biological risk factor for Alzheimer's.[16]

Periodontal Disease and Pregnancy

A lot of pregnant women develop periodontal disease. The CDC estimates for pregnant women that 60 to 75 percent of pregnant women have gum disease.[17]

This statistic is alarming because of the adverse effects untreated gum disease can have on pregnancy. Research shows an association between periodontal disease and preterm births and low birth weight. Also, a 2017 study indicates that gum disease is a risk indicator for adverse pregnancy outcomes.[18]

The American Dental Association (ADA) describes Pregnancy Gingivitis as a mild form of gum disease that occurs as early as month two and through month eight. Symptoms of Pregnancy Gingivitis are red, swollen, and tender gums that may sometimes bleed.[19] Some women might experience gum recession or have bad breath.[20] Also, pregnant women that have a history of gum disease before getting pregnant are more likely to develop Pregnancy Gingivitis. [21]

Therefore, pregnant women with gum disease should get treatment for the condition. Not only is treatment safe during pregnancy, but it also reduces inflammation in the mother's body and improves her oral health. [22]  

Early Detection is Key in Periodontal Disease

The bottom line with the Mouth-Body Connection is that a gum infection can affect your whole body. There is no part of your body that the bacteria and inflammation from gum disease cannot influence, even your brain. Moreover, the inflammatory load gum disease adds to the mix decreases the resources your body needs to fight off infections and inflammation in other body parts. In that way, gum disease has a terrible effect on your overall health. It does nothing to help your body heal or protect itself against systemic conditions and their symptoms. 

It is important to note that no evidence shows that gum disease causes systemic conditions. These relationships are associations or correlations, not causal links. However, the research is detailed that taking care of your overall health requires taking care of your oral health. That means brushing your teeth twice a day for at least two minutes per cleaning with fluoride toothpaste, flossing daily, and seeing your dental care professional team twice a year for cleanings and examinations. 

Another essential principle of the Mouth-Body Connection is that it is also imperative to catch gum disease early before the symptoms progress and lead to tooth loss or other serious effects like supporting bone loss. Early detection means early intervention, which can make all the difference to your oral and overall health.

Find a Dentist Near You

If you are looking for a trusted dental team for your regular dental care and related health screenings for other systemic conditions, why not find a Smile Generation Dentist? Our dental professionals are all well versed in the Mouth-Body Connection. They can assess your oral health and can also take your health history and determine if you are at risk for some of these serious and associated health conditions. They can even provide salivary diagnostics which can give you insight into your glucose levels. Use our Find a Dentist Tool to Find a trusted dentist near you.

 

 

Sources:

[1] Wang CJ, McCauley LK. Osteoporosis and Periodontitis. Curr Osteoporos Rep. 2016;14(6):284-291. doi:10.1007/s11914-016-0330-3

[2] Links Between Periodontal Disease and Systemic Health Issues. Professional.sunstargum.com. https://professional.sunstargum.com/news-events/news/links-between-periodontal-disease-and-systemic-health-issues.html. Published 2021. Accessed March 21, 2022.

[3] Links Between Periodontal Disease and Systemic Health Issues. Professional.sunstargum.com. https://professional.sunstargum.com/news-events/news/links-between-periodontal-disease-and-systemic-health-issues.html. Published 2021. Accessed March 21, 2022.

[4] Gum Disease and Other Diseases - American Academy of Periodontology. Perio.org. https://www.perio.org/for-patients/gum-disease-information/gum-disease-and-other-diseases/. Accessed March 21, 2022.

[5] Gum Disease and Other Diseases - American Academy of Periodontology. Perio.org. https://www.perio.org/for-patients/gum-disease-information/gum-disease-and-other-diseases/. Accessed March 21, 2022.

[6] Hall K, Sanjai Sinha M. What Gum Disease Can Mean for Your Overall Health. EverydayHealth.com. https://www.everydayhealth.com/periodontal-disease/what-gum-disease-can-mean-your-overall-health/. Published 2018. Accessed March 21, 2022.

[7] Gum Disease and Other Diseases - American Academy of Periodontology. Perio.org. https://www.perio.org/for-patients/gum-disease-information/gum-disease-and-other-diseases/. Accessed March 21, 2022.

[8] Hall K, Sanjai Sinha M. What Gum Disease Can Mean for Your Overall Health. EverydayHealth.com. https://www.everydayhealth.com/periodontal-disease/what-gum-disease-can-mean-your-overall-health/. Published 2018. Accessed March 21, 2022.

[9] Hall K, Sanjai Sinha M. What Gum Disease Can Mean for Your Overall Health. EverydayHealth.com. https://www.everydayhealth.com/periodontal-disease/what-gum-disease-can-mean-your-overall-health/. Published 2018. Accessed March 21, 2022.

[10] Belinga LEE, Ngan WB, Lemougoum D, et al. Association between periodontal diseases and cardiovascular diseases in Cameroon. J Public Health Afr. 2018;9(1):761. Published 2018 Jul 6. doi:10.4081/jphia.2018.761

[11] Links Between Periodontal Disease and Systemic Health Issues. Professional.sunstargum.com. https://professional.sunstargum.com/news-events/news/links-between-periodontal-disease-and-systemic-health-issues.html. Published 2021. Accessed March 21, 2022.

[12] Gum Disease and Other Diseases - American Academy of Periodontology. Perio.org. https://www.perio.org/for-patients/gum-disease-information/gum-disease-and-other-diseases/. Accessed March 21, 2022.

[13] Hall K, Sanjai Sinha M. What Gum Disease Can Mean for Your Overall Health. EverydayHealth.com. https://www.everydayhealth.com/periodontal-disease/what-gum-disease-can-mean-your-overall-health/. Published 2018. Accessed March 21, 2022.

[14] Gum Disease and Other Diseases - American Academy of Periodontology. Perio.org. https://www.perio.org/for-patients/gum-disease-information/gum-disease-and-other-diseases/. Accessed March 21, 2022.

[15] Links Between Periodontal Disease and Systemic Health Issues. Professional.sunstargum.com. https://professional.sunstargum.com/news-events/news/links-between-periodontal-disease-and-systemic-health-issues.html. Published 2021. Accessed March 21, 2022.

[16] Kamer AR, Craig RG, Niederman R, Fortea J, de Leon MJ. Periodontal disease as a possible cause for Alzheimer's disease. Periodontol 2000. 2020;83(1):242-271. doi:10.1111/prd.12327

[17] Pregnancy and Oral Health – Centers for Disease Control. Cdc.gov. https://www.cdc.gov/oralhealth/publications/features/pregnancy-and-oral-health.html. Accessed March 25, 2022. 

[18] Turton M, Africa CWJ. Further evidence for periodontal disease as a risk indicator for adverse pregnancy outcomes. Int Dent J. 2017;67(3):148-156. doi:10.1111/idj.12274

[19] Women's Hormones and Dental Health - American Dental Association. Mouthhealthy.org. https://www.mouthhealthy.org/en/az-topics/h/hormones. Accessed March 25, 2022.

[20] Marcin A. Pregnancy Gingivitis: Prevention and Treatment. Healthline.com. https://www.healthline.com/health/pregnancy/gingivitis#what-is-it. Published 2016. Accessed March 25, 2022.

[21] Committee Opinion: Oral Health Care During Pregnancy and Through The Lifespan. Acog.org. https://www.acog.org/-/media/project/acog/acogorg/clinical/files/committee-opinion/articles/2013/08/oral-health-care-during-pregnancy-and-through-the-lifespan.pdf. Published 2013. Accessed March 25, 2022.

[22] Committee Opinion: Oral Health Care During Pregnancy and Through The Lifespan. Acog.org. https://www.acog.org/-/media/project/acog/acogorg/clinical/files/committee-opinion/articles/2013/08/oral-health-care-during-pregnancy-and-through-the-lifespan.pdf. Published 2013. Accessed March 25, 2022.