Gum Disease Increases the Risk for Alzheimer's
The nervous system includes the brain, spinal cord, neurons and nerves, which send messages back and between your brain and your body. Gum inflammation, present in gum disease, may contribute to brain inflammation, cognitive loss and Alzheimer’s disease, all affecting the nervous system.
Armed with 20 years’ worth of data, researcher at New York University found that people with periodontal inflammation are at a risk of lower brain function than those with little or no inflammation. People in the study were nine times more likely to test in the lower range of the IQ-type test if they had gum disease than their peers without periodontal disease. Researchers also found that subjects with Alzheimer’s disease had significantly higher antibodies and bacteria in their blood associated with gum disease compared to healthy people1.
1. New York University. “Gum inflammation linked to Alzheimer’s disease.” ScienceDaily, August 4, 2010. Web January 21, 2013.
Bacteria Attack Tooth Enamel
and Cause Decay
Although oral health affects every system in the body, we begin with what most people think of: TEETH, part of the SKELETAL system. Tooth decay, also known as dental caries, begins when destructive bacteria that live in the mouth attach themselves to teeth, forming that fuzzy-feeling film on teeth called plaque. These bacteria feed on sugar and excrete an enamel-busting acid onto teeth, which eventually leads to holes or “cavities.”
Plaque can be removed with good oral hygiene habits, including brushing after meals and flossing. Plaque that is not removed forms tartar, and the longer plaque and tartar are on teeth, the more damage they do, leading to inflammation called “gingivitis”, a mild form of gum disease that can usually be reversed with good oral care. When gingivitis is not treated, periodontitis, or gum disease, results. This is when the gums become inflamed, pockets between the gums and teeth become infected, and the body’s IMMUNE SYSTEM kicks in to fight the bacteria that grow below the gum line.
Autoimmune conditions like rheumatoid arthritis are linked to gum disease
When gingivitis is not treated, it can lead to “periodontitis”, a term for gum disease that means “inflammation around the tooth.” This swelling is the body’s immune system doing its job2. The bacterial infection and the body’s natural response to infection start to break down the bone and connective tissue that hold the teeth in place. Evidence indicates that periodontal disease is an autoimmune disorder, in which the body’s immune system attacks the person's own cells and tissue, in this case, the gums3.
Rheumatoid arthritis is an inflammatory disease that is similar in the way the soft and hard tissues are destroyed from the body’s immune response to the infection. Researchers have identified a specific toxin that is in the blood when inflammation is present in the body. This toxin can start new infections or aggravate areas where inflammation already exists.
2. National Institute of Dental and Craniofacial Research. “Periodontal (Gum) disease: causes, symptoms, and treatments.” Web January 25, 2013.
3. University of Maryland Medical Center. “Periodontal disease – causes, the autoimmune and inflammatory response.” Web January 25, 2013.
Immune System & Dental Health (Continued)
Understanding that periodontitis and rheumatoid arthritis are linked, researchers discovered that people who suffer from gum disease and also have a severe form of rheumatoid arthritis were able to reduce their arthritic pain, number of swollen joints and the degree of morning stiffness when they treated their dental issues. Eliminating infection and inflammation in the gums improved signs and symptoms of rheumatoid arthritis4.
More research is needed to determine a definitive association between gum disease and autoimmune diseases, as we are just starting to understand this relationship. Other autoimmune conditions, like Crohn's disease, multiple sclerosis, lupus erythematosus, and CREST syndrome, have also been associated with a higher incidence of periodontal disease. Research suggests that periodontal disease may even play some causal role with autoimmune disease5.
4. Case Western Reserve University School of Dental Medicine and University Hospitals of Cleveland. “Treating gum disease helps rheumatoid arthritis sufferers.” Medical News Today, May 30, 2009. Web January 25, 2013.
5. University of Maryland Medical Center. “Periodontal disease – risk factors, diseases associated with periodontal disease.” Web January 25, 2013.
Pancreatic cancer and diabetes are linked to gum disease.
The endocrine system consists of hormones and glands responsible for the body’s metabolism and growth. The pancreas, an organ that produces insulin to trigger the body’s cells to allow glucose to enter them so that the cells can have energy to perform necessary body function, is part of the endocrine system. Diabetes is a condition where the body does not use glucose properly, either because insulin production is low or because the body’s cells don’t respond as they should to insulin.
People with diabetes are twice as likely to develop serious gum disease as those without diabetes, and 95% of people living with diabetes have some form of gum disease6. Gum disease also increases pancreatic cancer risk by 63%7.
6. Colgate Total, American Diabetes Association. “This November Colgate Total is raising their hand to stop diabetes to encourage people living with diabetes to make an appointment with their dentist.” PR Newswire, November 15, 2011. Web January 25, 2013.
7. Brown University. “Plasma antibodies to oral bacteria and risk of pancreatic cancer in a large European prospective cohort study.” Gut, September 18, 2012. Web January 25, 2013.
Endocrine System & Oral Health (Continued)
Though the reasons for why people with diabetes are more likely to suffer from periodontal disease are still being discovered, there are several important factors, including:
- The immune system may not function properly in people with diabetes, increasing the risk of periodontal disease.
- Extra body fat in obese people with diabetes may produce chemicals which make the gums more likely to become inflamed.
- Damage to capillaries (the small delicate blood vessels) in the gums may reduce the blood supply to the gums, limiting the actions of defense cells.
- Wound healing is impaired in diabetes, so healing in the gums is also reduced8.
8. Diabetes Research & Wellness Foundation. “Periodontal disease and diabetes.” Web January 25, 2013.
Gum Disease in the mother affects growing babies in utero.
Expectant mothers with gum disease are seven times more likely to deliver low birth weight, premature babies9. Babies born with low birth weight or prematurely can have anemia , respiratory issues, jaundice, malnourishment, learning disabilities or other issues. Therefore, it’s important for expectant mothers with gum disease to share this information with their obstetrician.
Expectant mothers should see their dentist at least once during their pregnancy for a cleaning and exam but should avoid x-rays until after the baby is born if possible.
9. University of Zulia, Maracaibo, Venezuela. “Relationship between periodontal disease in pregnant women and the nutritional conditions of their newborns.” Journal of Periodontology, October, 2002. Web January 25, 2013.
Gum disease-causing bacteria can enter the blood stream and travel to all parts of the body.
The inside of the body is a “bacteria free” zone, except for the areas that have “windows” to the outside, including the mouth, stomach and lungs. Bacteria live on the outside of the epithelial, or “skin” layer, until something weakens this layer, allowing bacteria to enter110
More than 600 known bacteria grow in the average person’s mouth, and each person caries different amounts of each. Scientists have identified four bacteria that are believed to be involved in causing periodontal, or gum, disease. In patients with gum disease, the bacteria break through the epithelial layer and travel throughout the body via the circulatory system, or blood stream.
10. S. E. Gould. “How bacteria sneak into your blood through your mouth.” Scientific American, January 4, 2012. Web January 25, 2013.
Circulatory System & Oral Health (Continued)
Scientists have found that people who have the four types of periodontal-disease-causing bacteria in their mouths also have thicker carotid arteries, a strong predictor of stroke and heart attack11. Cartoid arteries are the large blood vessels in a person’s neck that carry oxygen-rich blood to the brain. When these arteries thicken, they lose their elasticity allowing plaque to build up and the artery to become blocked.
Periodontal disease and heart disease share common risk factors, such as smoking, age and diabetes. Studies have found an association between the two diseases that cannot be explained by the common risk factors alone. More research is needed to understand how they are related. In the meantime, the key to preventing mouth bacteria from entering the blood stream is to prevent gum disease with good oral care12.
11. National Institute of Dental and Craniofacial Research. “Study finds direct association between cardiovascular disease and periodontal bacteria.” February 7, 2005. Web January 25, 2013.
12. American Dental Association. “Setting the record straight.” ADA News, July 16, 2012. Web January 25, 2013.