The Mouth-Body Connection

Research proves that there is a strong connection between periodontal disease and other chronic conditions such as diabetes, heart disease, and osteoporosis.

Some characteristics of periodontal disease are inflammation of the gum tissue, presence of disease-causing bacteria, and infection below the gum line. A host of problematic health issues may occur when infection and bacteria from the mouth spread throughout the body. By maintaining excellent oral hygiene and treating periodontal disease to reduce its progression, you can avoid other health issues besides preventing gum disease and bone loss.  Proper oral hygiene may help prevent serious medical conditions.

Diabetes and Periodontal Disease

Diabetes is a serious, incurable disease involving too much glucose (sugar), in the blood, thickening of blood vessel walls, and the reduced ability to fight infections. Individuals may experience diabetes in either one of two ways, Type I Diabetes, known as Insulin Dependent Diabetes Mellitus, or Type II Diabetes, known as Non-Insulin Dependent Diabetes Mellitus. Type II diabetes occurs when the body is unable to regulate insulin levels, meaning too much glucose remains in the blood. Type I diabetes occurs when the pancreas 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. Oftentimes, diabetes treatment focuses on controlling blood sugar levels, blood cholesterol levels, and blood pressure, which are known as the Diabetic Triad.

Medical and dental research has shown that people with diabetes are more likely to develop periodontal disease than people without diabetes. People with diabetes who struggle with controlling their blood sugar also develop periodontal disease more frequently and more severely than those who manage their diabetes well. One of the best tests for blood sugar control is the Hemoglobin A-1-C blood test.

The correlation between diabetes and periodontal disease is multifactorial.  Individuals with diabetes are more prone to experience all types of infections, including periodontal infections, since diabetes slows circulation thus reducing the natural cleansing of the blood vessel walls and allowing bacteria to colonize. Also, diabetes reduces the body’s resistance to infection and increases the probability of gum infections.

With increasing levels of periodontal disease, people with diabetes may experience elevated blood sugar levels thus increasing the amount of time their body functions with high blood sugars, making their ability to control their blood sugar more difficult. Dr. Noraian has had patients claim their blood sugar control has improved once their periodontal disease has been treated. Furthermore, the bacteria responsible for periodontal disease thrive in the presence of high blood sugar which in turn leads to high glucose levels in saliva and the periodontal pockets, which promote growth of the bacteria responsible for gum disease.

It is important to know that there is a tendency for blood vessels to thicken with diabetes. Think of blood vessels as the plumbing the body needs to bring nutrition and repair to the body’s tissues as well as to remove waste products from the body. As the vessels thicken, they become unable to efficiently provide nutrients and remove waste. As a result, the harmful waste products that are left in the mouth weaken the resistance of gum tissue, leading to infection and disease.

For years, periodontists have known that people who smoke or use tobacco damage their oral and overall health, and it is particularly harmful to people with diabetes. For example, people who 45 or older who smoke and have diabetes are 20 times more likely to develop periodontal disease than those who do not smoke.

As part of the protocol at Dr. Noraian’s office, he and his staff ask that you brush your teeth for two minutes at a time twice a day with a soft or extra soft toothbrush,and to floss your teeth every day, and to visit your dentist regularly; it is especially important for his patients with diabetes to practice these measures. If you do not brush your teeth, harmful bacteria consume the excess sugar and colonize beneath the gum line.

Heart Disease, Stroke and Periodontal Disease

When fatty proteins and plaque form on the walls of a person’s arteries, coronary heart disease sets in and causes the arteries to narrow, constricting blood flow which reduces the flow of oxygen that a persons body tissue requires to stay healthy. When oxygen is restricted to the heart, a person may experience shortness of breath, chest pain, and even heart attack.

People with periodontal disease are two times more likely to suffer coronary heart disease. Furthermore, periodontal disease may aggravate existing heart conditions, and patients with periodontal disease have a higher chance of stroke. A stroke happens when the blood flow to the brain stops, most commonly when a blood clot prevents blood from reaching the brain.

Periodontal disease is caused by bacteria, and these oral bacteria may enter the bloodstream and may attach to the fatty plaques in the coronary arteries. This attachment forms a blood clot and increases the risk of a variety of health issues including heart attacks.

Periodontal disease is involved with inflammation, which stimulates an increase in white blood cells and C-reactive proteins (CRP). CRP is a protein commonly associated with heart disease. When CRP increases in the body, it increases 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 give rise to heart attacks or strokes.

Coronary heart disease is the leading cause of death in the United States for both men and women. Good oral hygiene practice and receiving treatment for periodontal problems can help prevent the risk of developing coronary heart disease.

Pregnancy, Women’s Health Issues and Periodontal Disease

Women tend to take better care of themselves once they find out they are pregnant. Dental professionals have documented that when a pregnant woman has periodontal disease their unborn child may be exposed to a variety of risks and possible complications. Since pregnancy causes many hormonal changes in women, the likelihood of developing periodontal disease such as gingivitis increases. Most importantly, these oral problems have been linked to pre-eclampsia, or low birth weight of the baby, as well as premature birth.  A person can stop the progression of periodontal disease through proper oral hygiene and appropriate treatment. Simply by treating existing problems helps to reduce the risk of periodontal disease related complications by up to 50 percent.

There are several factors affecting how periodontal disease impacts the mother and her unborn child. Pregnant women with advanced stages of periodontal disease, particularly periodontitis have an increase in prostaglandin. Prostaglandin is a labor-inducing hormone found in the oral bacteria associated with periodontitis. Hence, mothers with periodontitis will have increased levels of prostaglandin, and they may go into labor prematurely and deliver a baby with a low birth weight.

The presence of C-reactive protein (CRP) is another compound linked to premature births and low birth weight babies, and it has also been associated with heart disease. Periodontal disease increases CRP levels in the body, which 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 health professionals don’t understand why elevated CRP also causes pre-eclampsia, studies prove that extremely high rates of CRP in early pregnancy increase the risk of pre-eclampsia.

Finally, the bacteria responsible for periodontal disease that invade and live in the gum pockets of a diseased mouth may travel through the bloodstream and affect other parts of the body. For pregnant women, research shows that these bacteria may colonize in the internal mammary glands and coronary arteries.

If you are pregnant, it is important to practice good oral hygiene to prevent gum disease. Dr. Noraian can help assess your level of oral health and develop preventative measures and treatment plans to help protect you and your baby.

Women may also experience hormone level changes during puberty, while taking birth control, or during hormone replacement therapy for the treatment of menopause. These increased hormone levels make the body more sensitive to the presence of bacteria without the patient even knowing about it. Increasing routine home care (brushing and flossing) and making sure to follow up with a dentist or periodontist regularly during these times are particularly important to help control periodontal disease. During these times of increased circulating hormones, women may discover that their regular routine for personal oral hygiene is not sufficient to keep good periodontal health.

Respiratory Disease and Periodontal Disease

When people inhale fine droplets of liquid into their mouths, throats, or lungs it may cause respiratory disease, particularly when these droplets contain germs that can spread and multiply within the lungs and impairs breathing. Recent research also shows that bacteria found in the mouth and throat can settle into the lower respiratory tract and cause infection or worsen existing lung conditions.

For example, pneumonia may occur when the bacteria that grow in the oral cavity travel into the lungs causing respiratory problems. This type of pneumonia occurs mostly in people with periodontal disease. Also, people with periodontal disease are more susceptible to bronchitis and emphysema. People with chronic obstructive pulmonary disease (COPD), which is caused mostly by smoking, and is a respiratory condition characterized by blockage of the airways becomes worse for people with periodontal disease.

Lowered resistance, or lowered immunity, is one of the reasons for the connection between respiratory problems and periodontal disease. People experiencing respiratory problems generally have low immunity, which allows periodontal bacteria to grow easily above and below the gum lines without protection from the body’s immune system. Respiratory issues progress and worsen in people who have periodontal disease.

There is also a link to inflammation of the oral tissue and respiratory problems. 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 can pass freely through the lungs.

If you are diagnosed with respiratory disease or periodontal disease, it is possible that Dr. Noraian will work with your physician to plan how to best treat both conditions and eliminate further complications.

Osteoporosis, Aging and Periodontal Disease

For a long time, osteoporosis was a condition affecting mostly women.   Today, more and more men have symptoms of this potentially debilitating affliction, characterized by the thinning of bone tissue and loss of bone density. Think of your body as a series of chemical reactions, some that build up your body and some that break down your body. 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 levels in menopausal women, or a drop in testosterone levels among men.  People who suffer from osteoporosis must take extra care in daily activities, as they are at increased risk for bone fractures. Elderly people have challenges surviving bone fractures late in life due to poor healing from osteoporosis.

Health professionals have studied the two diseases for possible connections since periodontal disease contributes to bone loss. Research 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. Furthermore, this research showed that post-menopausal women who suffer from osteoporosis are 86 percent more likely to develop periodontal disease.

One of the reasons for the connection between osteoporosis and periodontal disease is an estrogen deficiency. Low estrogen levels speed up the progression of both oral bone loss and other bone loss. It also accelerates the rate of loss of fibers and tissues that keep the teeth stable. Tooth loss occurs when these fibers are destroyed.

Low mineral bone density is one of the several causes of osteoporosis. The inflammation from periodontal disease weakens bones. This is why periodontitis progresses faster in people with osteoporosis.

If you are diagnosed with osteoporosis, it is important to take preventative measures against periodontal disease to protect your teeth and oral bones and it is a good idea to see Dr. Noraian to have a baseline assessment of your periodontal status so that he may compare it with your future examinations.