Surprising Dangers of Gum Disease

(from Bottom Line's Daily Health News 07/05/2007)

Surprising Dangers of Gum Disease

There's an old saying that "the eyes are the window to the soul." Based on all the news I've been reading lately, I think I'd like to rewrite the phrase: "the gums are the window to your health" (though it's hardly as poetic). Research is growing that shows that symptoms of periodontal disease such as inflamed or bleeding gums -- and sometimes even loose teeth -- raise the risk of serious health problems elsewhere in the body, including heart disease, stroke, diabetes and more.

To learn more about the connection between oral health and overall health, and to obtain advice on how to prevent or reverse periodontal disease, I consulted dental experts Alan A. Winter, DDS, a periodontist in private practice and associate clinical professor of implant dentistry at the New York University College of Dentistry in New York City, and Tom McGuire, DDS, a holistic dentist based in Sebastopol, California, and author of Tooth Fitness: Your Guide to Healthy Teeth (St. Michael's Press).

INFLAMED GUMS = INFLAMED BODY

I asked our experts how periodontal disease leads to disease elsewhere in the body. As with many systemic problems, an inflammatory response is the underlying cause, explains Dr. Winter. In people with serious gum disease, bacteria and their irritating toxins enter into the bloodstream eliciting a systemic inflammatory response. The condition will do even more damage once the tissue that supports the tooth breaks down and the infection begins to destroy the bone. It is much less dangerous with minor gum infection/inflammation.

Many health problems, such as heart disease, are related to advanced gum disease. Inflammation triggers the liver to make C-reactive protein (CRP), which is considered a "marker" of inflammatory activity. According to Dr. McGuire, elevated CRP levels are associated with an increased risk of more serious health problems such as heart attack and stroke. Periodontal disease is also associated with an increased risk for diabetes, low birth weight and pre-term births and respiratory ailments. New evidence also links pancreatic cancer with periodontal disease. In addition, when your body has to work extra hard to fight infection and inflammation, it puts significant and undue stress on your immune system 24/7, and this constant stress can dramatically lower your resistance to other diseases.

THE COST OF IGNORING THE PROBLEM

With gum disease, it's not unusual for people to allow the infection and inflammation to go on for weeks, months or years, notes Dr. McGuire. He's surprised that people are willing to tolerate this state of affairs in their mouth, when they'd aggressively fight an equivalent infection that was eroding the soft tissue, bones and ligaments in an arm or leg. According to Dr. McGuire, a big part of this is fear -- approximately 30% of the population has fear or anxiety significant enough that they avoid going to the dentist until symptoms have progressed far along and caused disease. Cost is an impediment thanks to the lack of dental insurance for many people... and cost and fear can overlap. The third major factor, he says, is that far too many people aren't aware of the serious effect on their health from gum disease.

Signs of periodontal disease are frequently ignored. This puts not just your teeth but also your overall health at risk... the body functions as an integrated system, and infection in one place leads to problems in another -- and there is perhaps no more direct route than through the mouth.

How does treating periodontal disease help to prevent disease elsewhere in the body? According to Dr. Winter, if you extrapolate current findings, here is what may be gained by improved oral care...

• Fewer heart attacks.
• Fewer strokes.
• Better control of type I and type II diabetes.
• Less respiratory disease.
• Lower risk of pancreatic cancer.
• Reduced rate of premature births.
• Reduced rate of underweight newborns.

Prevention and treatment not only improve quality of life and life expectancy, they also save time and money, observes Dr. McGuire. More than 164 million work hours and 51 million school hours are lost each year due to dental disease or dental visits, according to the U.S. Department of Health and Human Services. One study, "The Effect of Periodontal Disease on Health Care Costs," showed that health care costs for people with moderate to severe gum disease were 21% higher than for those with no gum disease.

TROUBLE IS BREWING

How do you know if your gums are in trouble? Healthy gums are firm and pink. You know trouble is brewing when they grow red, tender, swollen and are prone to bleed when you brush. Even bad breath can be an early symptom. This can be early-stage gum disease, or gingivitis, and you should bring these symptoms to the attention of your dentist.

Though your personal health history (including heredity) may also be a factor, gum disease often develops due to poor oral hygiene, when a lack of brushing and flossing causes a sticky layer of bacteria or plaque to coat the teeth, and inflammation to develop along the gum lines. Certain medications, such as Dilantin for epilepsy, as well as smoking and chewing tobacco, definitely exacerbate gum disease. Left uncared for, the plaque hardens to become tartar or calculus, building up over time. If the plaque and calculus further irritate the gums and lead to nasty pockets of infection, you have a serious problem -- periodontal disease, characterized by infection and inflammation that now is destroying bone and supporting tissue.

SOMETHING TO SMILE ABOUT

The good news is that early periodontal disease can be treated and usually reversed. Once the infection has been cleared up you can prevent any further gum disease with diligent home care and regular dental check-ups.

Daily Health News contributing editor Andrew L. Rubman, ND, says gum hygiene should include antiseptic oral rinses such as Listerine, which is formulated to target oral bacteria. This can help prevent the plaque from further damaging the gums and leading to those pockets of infection. In many cases it is actually chronic oral yeast infection that predisposes the gum tissue to become secondarily colonized by bacteria which can produce both plaque deposits and dissolve enamel, says Dr. Rubman. He adds that Listerine and other oral rinses also effectively treat yeast and other micro-organisms.

To find out if you're facing potential problems, ask your dentist whether you have any periodontal pockets and how deep they are, advises Dr. Winter. One to three millimeters is considered normal. Once pockets reach a depth of four millimeters, you have a problem that must be attended to. Other factors your dentist may take into consideration are bleeding, loose teeth and bone loss. People with implants must be very diligent about their oral hygiene as poor oral hygiene is a leading cause of failed implants.

In Dr. Winter's opinion, in addition to twice-yearly visits to your regular dentist, your best bet is to see a periodontist for periodic exams. If you have no signs of periodontal problems, good for you -- but make sure to have another check-up in five to 10 years. The severity of the disease determines the course of treatment, which may range from a thorough cleaning all the way to gum surgery. In Dr. McGuire's view, a dentist and hygienist can take care of most gum disease, although he refers patients with advanced gum disease to a periodontist (especially when surgery is required). "I also recommend a check up at least once per year to look for symptoms of other diseases that can show up in the mouth, particularly oral cancer," says Dr. McGuire.

AS MOM ALWAYS SAID...

Regardless of whether you already have gum disease or are just doing your best to prevent it, good oral hygiene is a must. For healthy teeth and gums, Dr. McGuire recommends...

• Brush. Use a soft-bristle brush to clean teeth and gums in the morning, after eating, and before you go to bed. Replace the brush every three to four months, and soak it in an antibacterial rinse like Listerine overnight after you've been sick with a cold or flu. The brand of toothbrush does not really matter, according to Dr. McGuire. Check with your hygienist, regardless of what type of toothbrush you use, and ask her if you are getting the job done.
• Floss. Do this at least once a day, and always brush first.
• Use mouthwash. When you have gum disease, you should use an antimicrobial mouthwash, such as Listerine, after every brushing and flossing session. Once the infection has been eliminated, you can switch to a more natural product (anything you find in a health food store that contains natural ingredients). You can also use a warm salt water rinse.
• Consider a water irrigator. These are especially effective at reaching between teeth to remove food. For people with severe disease, this is a must, along with brushing and flossing.
• Stay away from sugar, refined and processed foods as much as possible. When you allow yourself the occasional indulgence, be sure to brush, floss or at least rinse well afterward.
• See your dentist for an exam and cleaning every six months.
• Avoid smoking. It irritates gum tissue, stresses the immune system and lowers the body's resistance to infection of any kind.

Source(s):

Tom McGuire, DDS, a leading authority on dental wellness, mercury amalgam fillings and mercury poisoning. Dr. McGuire is president of the Dental Wellness Institute, founder of the International Association of Mercury Free Dentists (IAMFD), and author of Mercury Detoxification: The Natural Way to Remove Mercury from Your Body (The Dental Wellness Institute) and Tooth Fitness: Your Guide to Healthy Teeth (St. Michael's Press). Visit his Web site at www.dentalwellness4u.com.

Alan A. Winter, DDS, a periodontist in private practice and associate clinical professor of implant dentistry at the New York University College of Dentistry, both in New York City. Dr. Winter has published several medical journal articles on gum disease.

American Dental Association, www.ada.org

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