Because gum health matters beyond the mouth
Interviewer: Gingivitis is not just about the teeth. It’s a window into your overall health. Dr. Daniel Thunell, a board-certified periodontist at the University of Utah Health School of Dentistry, joins us today to explore the critical, often overlooked connection between gum health and five of the most common health conditions that can affect long-term wellness.
Now, Dr. Thunell, before we get to your list, let’s start with just some of the basics of gingivitis. What is it and how common is it?
Dr. Tunnel: So, gum disease is inflammation and infection of the tissues that support your teeth. These tissues are specifically the bones and gums around your teeth. And interestingly, almost 50% of all adults have periodontal disease or gum disease.
Interviewer: Wow, 50%?
Dr. Tunnel: And 70% of adults over 65.
Interviewer: Amazing success. So why is basic gum health good? Why is it important for your teeth? I think we have a sense of that.
Dr. Tunnel: Well, after all, poor gum health can lead to tooth loss. We lose the bone, we lose the supporting structures around the teeth. They become loose and we risk losing them. Therefore, it is important to take very good care of our gums and teeth.
Risks of pregnancy and premature birth
Interviewer: But it’s not just dental health, I realized. So why don’t we reach some of these five health states? Let’s start with what is your number five medical condition that gum disease affects?
Dr. Tunnel: Number five is the risks of pregnancy and premature birth.
Interviewer: Amazing success. And how does gum disease affect this?
Dr. Tunnel: Thus, hormonal changes during pregnancy can increase the body’s susceptibility to gum disease primarily through inflammatory pathways. So, systemic inflammation can have an impact on your pregnancy and your baby during pregnancy.
Interviewer: And what does that look like?
Dr. Tunnel: Bacteria from gum disease can enter the bloodstream. It can affect the uterus, it can affect the placenta, and it can lead to premature birth or even low birth weight outcomes.
Interviewer: Therefore, oral health is very important for expectant mothers.
Dr. Tunnel: It is critical. We strongly encourage all expectant mothers to have regular dental checkups during pregnancy. Sometimes there is a myth or belief that you should not have dental work done during pregnancy, but this is not true. It is critical and safe to see your dentist and hygienist during pregnancy.
Cardiovascular diseases and Stroke
Interviewer: Ok. So, pregnancy and gum disease, there is a connection. Let’s move on to number four. What is the next medical condition?
Dr. Tunnel: Number four, cardiovascular disease. This is perhaps the most well-studied, well-researched relationship between gum disease and a systemic disease. And so with cardiovascular disease and gum disease, we see inflammation from gingivitis that leads to bacteria that travel through the bloodstream and get into the vessels, the vessels around the heart and increase arterial plaque that builds up and leads to heart problems.
Interviewer: I’ve probably seen it before. Heart blockages and things like that that come from these plaques, gum disease can cause that?
Dr. Tunnel: Right. So interestingly, there is a 30% higher chance of a heart attack in a person who has periodontal disease and up to a 2.5 times greater risk of stroke as well.
Interviewer: Because those are two of the, I guess, scariest things that we hear about what could happen to your health that can be connected to your oral health. This is crazy.
Dr. Tunnel: Right. This connection has been studied for decades and has proven to be quite strong.
The two-way relationship with diabetes
Interviewer: Ok. Now let’s go to number three.
Dr. Tunnel: Number three is diabetes. And so there is a two-way relationship between diabetes and gum disease. So diabetes can actually make gum disease worse and vice versa. Gingivitis can make your diabetes or blood sugar control worse. We have several studies that have shown that if you control your diabetes well, your periodontal health or gum health improves. And if you take good care of your gum health, it can improve your diabetes.
Interviewer: With diabetes, is there anything special they should do to make sure their gums are healthy?
Dr. Tunnel: Well, up to 75% of diabetics have periodontal disease. And therefore it is critical for diabetics. . . If you know you have diabetes, you should see your dentist, dental hygienist, dental care, gum care regularly to get the best possible results.
Emerging links to cancer risk
Interviewer: And what about number two?
Dr. Tunnel: Number two, cancers. So it’s not a link that you would naturally think of, whereas these others that we’ve discussed so far all have this common systemic inflammatory link. The relationship between periodontal disease or gum disease and cancer is not well understood or fully understood, but people with severe periodontal disease have been shown to have a nearly 25% increased risk of certain types of cancer, including pancreatic cancer, oral cancer, colon cancer, as well as lung cancer and breast.
Interviewer: I know we are still trying to fully understand the connection, but what could be connected between gum health and cancer?
Dr. Tunnel: Yeah, it’s hard because we don’t really understand it, but we think it has, again, something to do with chronic inflammation as well as these other conditions that we discussed earlier.
Gum disease and cognitive decline
Interviewer: And to top it off, what is the number one medical condition linked to gum health?
Dr. Tunnel: And so our last is dementia and Alzheimer’s disease. Now, these are somewhat newer on the scene, not conditions that have been studied as much or as extensively as some of the others we’ve discussed previously. But interestingly, recent research has shown that some of the bacteria that cause periodontal disease have been found in the brain tissue of Alzheimer’s patients. So we think there is a connection there.
In periodontal disease, we have what we call our red complex, or our primary bacteria that cause periodontal disease. And this red cluster consists of three bacteria — Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola. These are some wild names, but Porphyromonas gingivalis, or P. gingivalis as we refer to it, has been found in the brain tissue of Alzheimer’s patients.
Interviewer: Not only is there a possible link, but can good oral health be a modifiable risk factor?
Dr. Tunnel: Exactly. Also, tooth loss, a common consequence of periodontal disease, has been associated with poor cognitive function and an increased risk of dementia.
Recognizing the early signs of gum disease
Interviewer: There’s a lot of evidence that says there’s a link between gum disease and your overall health. So what can people do to prevent some of these things?
Dr. Tunnel: Well, as I mentioned before, first and foremost, we strongly encourage people to seek regular dental care with their dentist, with their hygienist and also get a proper periodontal checkup to see if they have signs of periodontal disease or gum disease and then seek proper treatment for that.
Interviewer: Now, what are some of these signs of gum disease? What should people watch out for?
Dr. Tunnel: The main signs will be bleeding gums, perhaps a dark purple tint to your gums and loose teeth. And gum disease also has a distinct smell. So, if you notice a constant, distinct odor in your mouth, this could also be a sign of periodontal disease or gum disease.
How to protect your gums and your health
Interviewer: Ok. So, as a periodontist, what is one thing you wish every person listening to this piece knew about gum disease and their health?
Dr. Tunnel: Well, I would say first and foremost, know that gum disease is a treatable disease, it can be treated, and you can live a long life with all your teeth and have gum disease as long as you seek regular care.
Here we learned that gum health greatly affects our overall health, so it is imperative that individuals maintain optimal oral health and visit their dentist regularly for checkups and cleanings.
