They say the eyes are the windows to the soul, but could it be that the mouth is the window to the body? It’s a slightly more rudimentary analogy, but emerging research shows that the condition of your teeth and gums does have a bearing on overall health.
“On a very basic level, if patients are not maintaining good home care – brushing, flossing and cleaning between the teeth – that will increase the potential to develop periodontal disease,” says Dr Ian Dunn, a dentist and specialist periodontist.
To get some terminology out of the way first, periodontal disease, or gum disease, occurs when inflammation is produced in reaction to bacteria that builds up on teeth. “That inflammation subsequently damages bone,” says Dunn, which can lead to bone loss, teeth becoming loose and gums shrinking. Not a pretty picture.
But do the effects of periodontal disease go beyond the mouth? “In the past decade, there’s been quite a lot of research on periodontal disease and its effect on systemic health,” says Dunn. Indeed, diabetes, cardiovascular disease, Alzheimer’s, rheumatoid arthritis and liver disease have all been the subject of studies looking at their links to gum disease. “The one we have the most data for, where there seems to be quite a strong interaction, is diabetes. So what we know is that if you have unstable periodontal disease, you are more likely to have unstable diabetes if you are a diabetic patient,” says Dunn.
Right, rewind. What is unstable periodontal disease? Basically, when it goes untreated. We’re talking bleeding gums, inflammation and deep pockets around the teeth. Interestingly, Dunn says that having unstable diabetes – where blood sugar is not managed – also increases the likelihood of developing periodontal disease. “We’ve got evidence of what we call a bi-directional effect: poor gum health, poor glycaemic control; poor glycemic control, poor gum health.”
So, in effect, gum disease can worsen the condition of someone who is already diabetic. But does it increase the likelihood of developing diabetes in the first place? The answer is yes. “Although there are bigger risk factors – things like being overweight, being over a certain age, a sedentary lifestyle, and also genetics – unstable gum disease can be considered a risk factor for type two diabetes.”
Cardiovascular disease also appears to have a connection to gum disease, research has found. It’s been more challenging to ascertain the link, as the groups most prone to periodontal disease – generally those over 40 who smoke or have a poor diet – are also more prone to cardiovascular disease. But there still seems to be a link, says Dunn. It’s all related to circulating inflammation, he explains. “If you’ve got inflammation in one part of the body, that inflammation will raise inflammatory markers within the bloodstream. That circulating inflammation can then have negative impacts elsewhere, including blood vessel linings within the heart that can potentially lead to cardiovascular problems.”
It’s beginning to sound quite concerning, and Dunn is clear that the links are real. “If you were to ask a cardiologist to list the risk factors for cardiovascular disease, it would be a very long list and it’s fair to say that periodontal disease would be relatively near the bottom,” he says. “But that said, we’ve got the linkages that show that it has an impact.”
In terms of Alzheimer’s, a study published last year in the Journal of Alzheimer’s Disease examined whether gum disease and oral bacterial infections were linked to dementia diagnoses and death. They found that older adults with signs of gum disease were more likely to develop Alzheimer’s during the 26-year study period, however, the authors concluded that more analysis was needed.
Besides poor oral hygiene, genetics is another influencing factor when it comes to how likely you are to find your teeth and gums in a bad way. “About 10% of the population are truly resistant to gum disease,” says Dunn. “They can get away with sub-optimal cleaning and not lose bone. But the majority of the population have a level of susceptibility. And about 10% are highly susceptible to severe disease – lots of tooth loss.” That leaves most of us somewhere in the middle and, really, without an excuse for sub-par oral hygiene.
So what can you do to ward off gum disease and its associated risks to your general health? Most of us know the answer already but it’s worth a reminder: brush at least twice a day for at least two minutes, clean between the teeth every day using interdental brushes or floss, and consider using an electric toothbrush. Most importantly, go for regular checkups and discuss any signs, symptoms or concerns you have with your dentist. Red flags include bleeding gums, blood in the sink when you spit after cleaning, bad breath, receding gums and loose teeth, says Dunn.
And it’s important not to get complacent: gingivitis (a mild form of gum disease and the precursor to periodontal disease) is reversible but once it progresses you’re stuck with it. The good news, however, is that it can be managed. “Once [a patient] is stable, the theory is that there’s no further progression of disease. So bone loss – which is the main consequence of periodontal disease – stops. And tooth and gum health can be maintained for many years; tooth loss in stable patients is very, very low.”
So grab your toothpaste and get brushing – your brain, body and all its complex systems will thank you.
Healthy gums don’t bleed – if yours do, it’s time to take action. Brushing with Corsodyl toothpaste twice a day is clinically proven to help stop and prevent bleeding gums – so that’s one thing off your to-do list. To find out more, head to corsodyl.co.uk/products/toothpaste
