WHAT IS PERIODONTAL DISEASE?
Periodontal treatment is necessary when various conditions affect the health of your gums and the regions of your jaw bone that hold your teeth in place. Retaining your teeth is directly dependent on proper periodontal care and maintenance.
DESTRUCTIVE NATURE OF GUM DISEASE
Healthy gums enhance the appearance of your teeth, like a frame around a beautiful painting. When your gums become unhealthy, they can either recede or become swollen and red. In later stages, the supporting bone is destroyed and your teeth will shift, loosen, or fall out. These changes not only affect your ability to chew and speak. They also spoil the natural beauty of your smile.
Periodontal diseases are ongoing infections of the gums that gradually destroy the support of your natural teeth. Periodontal disease affects one or more of the periodontal tissues: alveolar bone, periodontal ligament, cementum, or gingiva.
GINGIVITIS AND PERIODONTITIS
While there are many diseases that affect the tooth-supporting structures, plaque-induced inflammatory lesions make up the majority of periodontal issues and are divided into two categories: gingivitis and periodontitis. While gingivitis, the less serious of the diseases, may never progress into periodontitis, it always precedes periodontitis.
THE MOUTH-BODY CONNECTION
Research has recently proven what dentists have long suspected: that there is a strong connection between periodontal disease and other chronic conditions such as diabetes, heart disease, and osteoporosis.
Periodontal disease is characterized by inflammation of the gum tissue, the presence of disease-causing bacteria, and infection below the gum line. Infections and bacteria in the mouth can spread throughout the body and lead to a host of problematic health issues. Therefore, maintaining excellent oral hygiene and reducing the progression of periodontal disease through treatment will have benefits beyond preventing gum disease and bone loss. It can also save you from the chance of developing another serious condition.
GINGIVITIS
Dental plaque is the primary cause of gingivitis in genetically-susceptible individuals. Plaque is a sticky colorless film, composed primarily of food particles and various types of bacteria, which adhere to your teeth at and below the gum line. Plaque constantly forms on your teeth, even minutes after cleaning. Bacteria found in plaque produce toxins or poisons that irritate the gums. Gums may become inflamed, red, swollen, and bleed easily. If this irritation is prolonged, the gums separate from the teeth causing pockets (spaces) to form. Neglecting daily brushing and flossing allows plaque to harden into a rough, porous substance known as calculus (or tartar). This can occur both above and below the gum line.
PERIODONTITIS
If gingivitis progresses into periodontitis, the supporting gum tissue and bone that holds teeth in place deteriorates. The progressive loss of this bone, the alveolar, can lead to loosening and subsequent loss of teeth. Periodontitis is affected by bacteria that adhere to the tooth’s surface, along with an overly aggressive immune response to these bacteria.
Periodontal disease is dangerous in that it is often painless and symptomless. Eighty percent of Americans will be afflicted with periodontal disease by age 45, and 4 out of 5 patients with the disease are unaware they have it. It is important to maintain proper home oral care and regular dentist visits to reduce the risk of obtaining this disease.
PERIODONTAL DISEASE AND TOBACCO
You are probably familiar with the links between tobacco use and lung disease, cancer, and heart disease. Current studies have now also linked periodontal disease with tobacco usage. Cases of periodontal disease are more severe in smokers and tobacco users than those who do not use tobacco. There is a greater incidence of calculus formation on teeth, deeper pockets between gums and teeth, and a greater loss of the bone and fibers that hold teeth in your mouth. In addition, your chance of developing oral cancer increases with the use of smokeless tobacco.
Chemicals in tobacco such as nicotine and tar also slow down healing and the predictability of success following periodontal treatment. Quitting smoking and tobacco use can have numerous benefits for your overall and periodontal health.
PERIODONTAL DISEASE AND DIABETES
Diabetes is a serious, incurable disease characterized by too much glucose, or sugar, in the blood. Type II diabetes occurs when the body is unable to regulate insulin levels, meaning too much glucose stays in the blood. Type I diabetics cannot produce any insulin at all. Diabetes affects between 12 and 14 million Americans and can lead to a variety of health issues, such as heart disease and stroke.
Research has shown people with diabetes are more likely to develop periodontal disease than non-diabetics. Diabetics with insufficient blood sugar control also develop periodontal disease more frequently and severely than those who have good management of their diabetes.
THE CONNECTION
The connection between diabetes and periodontal disease results from a variety of factors. Diabetes sufferers are more susceptible to all types of infections, including periodontal infections. This is because diabetes slows circulation, allowing bacteria to colonize. Diabetes also reduces the body’s overall resistance to infection, which increases the probability of the gums becoming infected.
BLOOD SUGAR
Moderate to severe cases of periodontal disease elevate sugar levels in the body, increasing the length of time the body functions with high blood sugar. Diabetics with periodontitis are most likely to suffer from increased levels, making it difficult to keep control of their blood sugar. Further, high glucose levels in saliva promote the growth of gum disease-causing bacteria.
THICKER BLOOD VESSELS
Blood vessel thickening is another concern for diabetics. Blood vessels function by providing nutrients and removing waste products from the body. When they become thickened by diabetes, these exchanges are unable to occur. As a result, harmful waste is left in the mouth and can weaken the resistance of gum tissue, leading to infection and disease.
ISSUES WITH SMOKING
Smoking and tobacco use are detrimental to anyone’s oral and overall health, but it is particularly harmful to diabetics. Diabetic smokers 45 and older are in fact 20 times more likely to develop periodontal disease than those who do not smoke.
It is very important for everyone to brush teeth effectively, floss daily, and visit the dentist regularly, but it is especially essential that diabetics practice these measures. When teeth are left un-brushed, harmful bacteria can ingest the excess sugar and colonize beneath the gum line.
PERIODONTAL DISEASE, HEART DISEASE, AND STROKE
Coronary heart disease occurs when fatty proteins and a substance called plaque build up on the walls of your arteries. This causes the arteries to narrow, constricting blood flow. Oxygen is restricted from traveling to the heart which results in shortness of breath, chest discomfort, and even heart attack.
THE CONNECTION
The link between periodontal disease and heart disease is so apparent that patients with oral conditions are nearly twice as likely to suffer from coronary artery disease than those with healthy mouths. Periodontal disease has also been proven to exacerbate existing heart conditions. Additionally, patients with periodontal disease have been known to be more susceptible to strokes. A stroke occurs when the blood flow to the brain is suddenly stopped. This may occur, for example, when a blood clot prevents blood from reaching the brain.
BACTERIA ENTERING THE BLOODSTREAM
One of the causes of the connection between periodontal disease and heart disease is oral bacteria entering the bloodstream. There are many strands of periodontal bacteria. Some strands enter the bloodstream and attach to the fatty plaques in the coronary arteries. This attachment leads to clot formation and increased risk to a variety of issues including heart attack.
INCREASE IN WHITE BLOOD CELLS AND C-REACTIVE PROTEINS (CRP)
Inflammation caused by periodontal disease creates an increase in white blood cells and C-reactive proteins (CRP). CRP is a protein associated with heart disease. When levels are increased in the body, it amplifies the body’s natural inflammatory response. Bacteria from periodontal disease may enter the bloodstream, causing the liver to produce extra CRP, which then leads to inflamed arteries and possibly blood clots. Inflamed arteries can lead to blockage, which can cause heart attacks or strokes.
Coronary heart disease is the leading cause of death in the United States for both men and women. Enacting positive oral hygiene practices and obtaining treatment for periodontal concerns can help prevent the risk of developing this unfortunate condition.
PERIODONTAL DISEASE AND PREGNANCY
Pregnant women with periodontal disease expose their unborn children to a variety of risks and possible complications. Pregnancy causes many hormonal changes in women, which increase the likelihood of developing periodontal diseases such as gingivitis, or gum inflammation. These oral concerns have been linked to preeclampsia, or low birth weight of the baby, as well as premature birth.
Fortunately, halting the progression of periodontal disease through practicing high standards of oral hygiene and treating existing concerns can help reduce the risk of periodontal disease-related complications by up to 50%.
THE CONNECTION
There are several factors that contribute to why periodontal disease may affect the mother and her unborn child. One is an increase in prostaglandin in mothers with advanced stages of periodontal disease, particularly periodontitis. Prostaglandin is a labor-inducing compound found in the oral bacteria associated with periodontitis. Because periodontitis increases the levels of prostaglandin, the mother may go into labor prematurely and deliver a baby with low birth weight.
C-REACTIVE PROTEIN (CRP)
Another compound recently linked to premature birth and low birth weights is CRP. As mentioned earlier, CRP is a protein that has long been associated with heart disease. Periodontal disease increases CRP levels in the body, which then amplifies the body’s natural inflammatory response. Bacteria from periodontal disease may enter the bloodstream, causing the liver to produce extra CRP, which then leads to inflamed arteries and possibly blood clots. Inflamed arteries can lead to blockage, which can cause heart attacks or strokes. Although it is not completely understood why elevated CRP also causes preeclampsia, studies have overwhelmingly proven that an extremely high rate of CRP in early pregnancy definitely increases the risk.
BACTERIA IN THE BLOODSTREAM
Finally, the bacteria that invade and live in the gum sockets in a diseased mouth can travel through the bloodstream and affect other parts of the body. For pregnant women, research has shown that these bacteria may colonize in the internal mammary glands and coronary arteries.
If you are pregnant, it is important to practice effective home care for preventing gum disease. can help assess your level of oral health and develop preventative measures and treatment plans to best protect you and your baby.
PERIODONTAL DISEASE AND RESPIRATORY DISEASE
Respiratory disease occurs when fine droplets are inhaled from the mouth and throat into the lungs. These droplets contain germs that can spread and multiply within the lungs to impair breathing. Recent research had also proven that bacteria found in the mouth and throat can be drawn into the lower respiratory tract and cause infection or worsen existing lung conditions.
THE CONNECTION
Bacteria that grow in the oral cavity and travels into the lungs can cause respiratory concerns such as pneumonia. This occurs mostly in patients with periodontal disease. Periodontal disease has also been proven to have a role in the contraction of bronchitis and emphysema. Chronic obstructive pulmonary disease (COPD), a respiratory condition characterized by blockage of the airways, and caused mostly by smoking, has also been proven to worsen if the patient also has periodontal disease.
LOW IMMUNITY
One of the reasons for the connection between respiratory concerns and periodontal disease is low immunity. Patients who experience respiratory concerns generally have low immunity, meaning bacteria can easily grow above and below the gum lines without being confronted by the body’s immune system. Once periodontal disease is contracted in this way, it will only progress and worsen respiratory issues.
TRAVELING BACTERIA
Inflammation of the oral tissue has also been linked to respiratory concerns. Oral bacteria causing the irritation can travel to the lungs, and contribute to the inflammation of the lung lining. This creates respiratory problems because it limits the amount of air that passes freely through the lungs.
If you are diagnosed with respiratory disease or periodontal disease, it is possible will work with your physician to plan how to best treat both conditions and eliminate further complications.
PERIODONTAL DISEASE AND OSTEOPOROSIS
Osteoporosis is a condition common in older patients, particularly women, that is characterized by the thinning of bone tissue and loss of bone density over time. Osteoporosis occurs when the body fails to form enough new bone, or when the body absorbs too much old bone. The leading cause of osteoporosis is a drop in estrogen in menopausal women or a drop in testosterone among men. Sufferers of osteoporosis must take extra care in daily activities, as they are at increased risk for bone fractures.
THE CONNECTION
Because periodontal disease can also lead to bone loss, the two diseases have been studied for possible connections. Research has found that women with periodontal bacteria in their mouths were more likely to have bone loss in the oral cavity and jaw, which can lead to tooth loss. Studies conducted over a period of 10 years also discovered that osteoporosis patients could significantly reduce tooth loss by controlling periodontal disease. Further, it was found that post-menopausal women who suffer from osteoporosis are 86% more likely to also develop periodontal disease.
ESTROGEN DEFICIENCY
One of the reasons for the connection between osteoporosis and periodontal disease is an estrogen deficiency. Estrogen deficiency speeds up the progression of both oral bone loss and other bone loss. It also accelerates the rate of loss of fibers and tissues which keep the teeth stable. A loss of too many fibers results in tooth loss as well.
LOW MINERAL BONE DENSITY
Low mineral bone density is one of the several causes of osteoporosis. The inflammation from periodontal disease weakens bones more prone to break down. This is why periodontitis can be particularly detrimental and progressive to patients with osteoporosis.
If you are diagnosed with osteoporosis, it is extremely important to take preventative measures against periodontal disease to protect your teeth and oral bones.