Periodontal disease - a risk for some serious diseases
A new study recently conducted reveals that toothless heart disease patients are nearly twice as likely to die as those who have all their teeth. This was an observational study so it cannot be concluded that gum disease directly causes adverse events in heart patients. But tooth loss could be an easy and inexpensive way to identify patients at higher risk, who need more intense prevention efforts.
Loss of teeth (edentulism) is a biochemically complex process as it involves teeth, gums, jaws, and oral mucosa, which are changing over time. Apart from congenital absence, and trauma, the most important cause of tooth loss is periodontal disease. In reality, it is the number one cause of tooth loss.
The word periodontal is composed of “perio” that means around and “donto’ refers to teeth. So, periodontal disease is caused due to infections of the structures around the teeth, which include the gums, periodontal ligament and alveolar bone. In the earliest stage of periodontal disease, gingivitis that is the infection of the gums takes place. In more severe forms of the disease, all of the tissues are involved. However, it is important to note that all gingivitis doesn’t lead to periodontal disease. Periodontal disease is caused by bacteria in dental plaque, the sticky substance that forms on the teeth a couple of hours after you have brushed. In an effort to eliminate the bacteria, the cells of the immune system release substances that cause inflammation and destruction of the gums, periodontal ligament or alveolar bone. This leads to loosening of the teeth that is a sign of severe periodontitis, an advanced stage of disease.
The prevalence of periodontal disease in adults is as follows:
- 8.52% of adults age 20 to 64 have periodontal disease.
- Older adults, Black and Hispanic adults, current smokers, and those with lower incomes and less education are more likely to have periodontal disease.
The prevalence of severe periodontal disease in adults is as follows:
- 5.08% of adults 20 to 64 have moderate or severe periodontal disease.
- Older adults, Black and Hispanic adults, current smokers, and those with lower incomes and less education are more likely to have moderate/severe periodontal disease.
The prevalence of periodontal disease in seniors (age 64 and over) is as follows:
- 17.20% of seniors age 65 and over have periodontal disease.
- Older seniors, Black and Hispanic seniors, current smokers, and those with lower incomes and less education are more likely to have periodontal disease.
The prevalence of severe periodontal disease in seniors is as follows:
- 10.58% of seniors 65 and over have moderate or severe periodontal disease.
- Older seniors, Black and Hispanic seniors, current smokers, and those with lower incomes and less education are more likely to have moderate/severe periodontal disease.
The above statistical data about the prevalence of periodontal disease in adults indicates that it contributes significantly to the incidence of cardiovascular disease in people since many studies point to the existence of a link between them.
Periodontal disease and inflammation -
It has been found that people with poor oral health have more heart attacks, but it doesn’t mean that poor oral health leads to them. There are plausible reasons that dental health and heart health are intertwined because inflammation is a common factor in both the diseases. Hardening of the arteries (atherosclerosis) has a strong component of inflammation leading to its causation. Gum disease also produces considerable inflammation, thereby forming a common link between two.
The cardiologists, periodontists and other health professionals agree across the board that there exists a link between gum disease and heart disease. The following research indicates towards this –
- A review of several published studies finds that gum disease is, by itself, a risk factor for coronary heart disease.
- Analysis of the large National Health and Nurition Examination Survey (NHANES) found that gum disease is an important risk factor for diseases of the blood vessels and the arteries that supply the brain, especially strokes involving insufficient blood to the brain. Data from another study of more than 50,000 people found that those with fewer teeth and more gum disease had a higher risk of stroke. However, other studies have uncovered no association between gum disease and stroke.
- Other research found a direct link between clogged arteries in the legs and gum disease.
The above observations indicate that inflammation caused as a result of periodontal disease is associated with heart disease and stroke. While a cause and effect relationship has not been established, the research points out that periodontal disease increases the risk of heart disease. In addition, periodontal disease can exacerbate the existing heart conditions. Sometimes periodontal disease might be an early sign of cardiovascular problems.
Inflammation and cardio-vascular disease –
The body’s natural response to an infection is inflammation. The build-up of inflammatory substances in the blood seems to worsen heart disease, diabetes and other chronic conditions. Inflammation plays a critical role in cardiovascular disease as the inflammatory cascade is particularly important in the atherosclerotic process. Therefore, eliminating the gum infection may dampen the harmful effects of inflammation.
Common tips for prevention of periodontal disease –
Below are enumerated some tips for the prevention of periodontal disease, which are not difficult to follow but simply require discipline on the part of an individual -
- The best way to brush is by placing your toothbrush at a 45-degree angle against your gums and gently moving it in a circular motion, rather than a back-and-forth motion. Grip the toothbrush like a pencil so you won't scrub too hard.
- Brush your teeth when you get out of bed after sleep in the morning and before going to sleep at night. That’s because saliva, which keeps cavity-causing plaque off teeth, dries up at night, so it’s best to have all plaque cleaned off the teeth before sleep. It’s also important to brush first thing in the morning to brush off plaque and bacteria (morning breath!) that may have built up as you slept.
- Use fluorinated toothpaste because fluorine helps to harden enamel and reduces risk of tooth decay.
- One major cause of bad breath is the buildup of bacteria on the tongue, which a daily tongue scraping will help banish. In fact, using a tongue scraper is more effective than brushing your tongue with a toothbrush.
- Change the toothbrush or head of electric toothbrush every two to three months. Otherwise, you will transfer bacteria to your mouth.
- Gargle with apple cider vinegar in the morning and then brush as usual. The vinegar helps remove stains, whiten teeth, and kill bacteria in your mouth and gums.
- You can also use salt as alternative toothpaste. Just be sure to spit it out so it doesn't count as sodium intake! Also, if your gums start to feel raw, switch to brushing with salt every other day. Now many brands of toothpaste are available with added salt.
- Floss your teeth everyday using slow and gentle sawing motion.
- Foods that are firm and crisp clean teeth when eaten. Such foods include apples (otherwise known as nature’s toothbrush), raw carrots, celery and popcorn. Make such foods the final food you eat in your meal if you know you won't be able to brush your teeth right after eating.
- Limit acidic drinks such as soft drinks etc. because they soften tooth material and dissolve the minerals in tooth enamel, causing holes (cavities or caries). In severe cases, teeth may be ‘eaten’ right down to the gum.
- Limit sugary foods because bacteria in dental plaque change sugars into acids.
- Avoid using your teeth for anything other than chewing food. If you use them to crack nuts, remove bottle tops or rip open packaging, you risk chipping or even breaking your teeth.
- See your dentist for regular check-ups. You should also visit your dentist if you have a dental problem such as a toothache or bleeding gums.
Besides above preventive measures for periodontal disease, below are enumerated some common tips for general physical wellbeing that will generally help prevent the disease –
- Try to eat healthy food. Starchy and sugary foods increase plaque, and only a healthy diet provides the nutrients necessary (vitamins A and C, in particular) to prevent gum disease.
- Avoid cigarettes and smokeless tobacco, which may contribute to gum disease and oral cancer.
- Exercise regularly to increase general fitness and keep the immune system toned up.
- Diabetics must manage their disease effectively because diabetes makes them more susceptible to oral infections.
The bottom line -
Studies have found an association between periodontal disease and several serious illnesses including heart disease, stroke and lung cancer. Now, new research finds that women with this common dental condition may be at increased risk of breast cancer. Though this needs further validation, still new findings carry a significant weight.
We all have to be cognizant of the potential association of periodontal disease and some serious diseases so that we can take preventative measures to prevent the onset periodontal disease.