Periodontal Disease: The Oral, Systemic Link

by Dr. Julie Melbinger-Wagner
ORIGINALLY PUBLISHED IN THE MEQUON BEACON

For many, being informed by your oral health care provider that you have a gum infection that may cause you to eventually lose your teeth may be of little concern. However, if it was common knowledge that this bacterial infection is associated with diabetes, heart disease, or Alzheimer’s disease more patients would have cause for concern.

Periodontal disease, the most common of disease known to mankind, is chronic inflammation of gum tissues from a bacterial infection. If left untreated, this disease causes destruction of bone surrounding the tooth eventually leading to tooth loss. Studies have proven that it can be directly related to diabetes, heart disease, cancer, and dementia.

Patients with periodontal disease are 2-3 times more likely to develop a heart attack, stroke, or cardiovascular event. Patient’s with a history of cardiovascular disease develop atherosclerotic plaques. These plaques are a build-up of fats, cholesterol and other substances on the arteriole wall which cause blockage of major arteries of the heart leading to a heart attack. If these plaques break off into the blood stream patients may succumb to a stroke. Studies have found that the bacterial content within these atherosclerotic plaques contain several types of bacteria that have also been identified as periodontal disease pathogens, bacteria only found in diseased gum tissues, such as Porphyromonas gingivalis and Treponema Denticola.

Periodontal disease and diabetes have been found to have a “two-way relationship”; severe periodontal disease co-exists with severe diabetes, and susceptibility to periodontitis is increased almost three-fold in these patients. Studies have found that metabolic control of diabetes is far more complicated when a patient has a chronic gum infection, and vice-versa, if periodontal disease is severe a patient will have poorly controlled diabetes. The reason for this “two-way relationship” is due to inflammatory markers that are found elevated in both Type 1 and Type 2 diabetes. Hyperglycemia and the elevated inflammatory state in diabetics result in the activation of other inflammatory pathways; most specifically the activation of C-reactive protein. Elevated levels of C-reactive protein are found to increase the presence periodontal disease, insulin resistance, and cardiovascular disease.

The relationship of chronic inflammation associated with gum disease has also been found to be linked to Alzheimer’s disease. A study completed by the National Institute of Aging not only found that the cascade of inflammatory events not only allows inflammatory molecules to reach the brain, but bacteria from gum infections to reach the brain. The hallmark presentation of a patient with Alzheimer’s is the presence of plaques of beta amyloid-proteins on brain tissue. Recent studies have found these plaques to be riddled with Porphyromonas gingivalis; bacteria only found in infected gum tissue pockets.

Treatment for periodontal disease is complex and must be a coordinated with your dentist and other healthcare professionals to prevent other potential systemic diseases. To learn more about periodontal disease, contact us today!