That pain in your mouth may also be hurting your heart.
In 2009, researchers released the results of a study that took many people by surprise.
Scientists from the University of North Carolina found that nearly 30 percent of the genes found in the human body are expressed differently during the onset and healing process associated with gingivitis (infected and inflamed gums). Those associated with the immune system were the main ones activated, as well as those involved in wound healing, neural processes, and skin turnover.
“The study’s findings demonstrate that clinical symptoms of gingivitis reflect complicated changes in cellular and molecular processes within the body,” said Steven Offenbacher, D.D.S., Ph.D. and the study’s lead author.
Scientists have long suspected that dental health problems may affect the rest of the body. Here’s more about what we know so far.
According to a 2006 study review published in the Journal of the American Dental Association, the association between diabetes and inflammatory periodontal diseases (inflammation around the teeth) has been studied for more than 50 years. A large amount of evidence suggests diabetes is associated with an increased prevalence, extent, and severity of gingivitis and periodontitis.
Researchers believe both are related to inflammation in the body, and that periodontal disease, because of its prominent inflammatory component, can make diabetes more difficult to control. For example, a two-year study found a six fold increased risk of worsening glycemic control in patients with type 2 diabetes who had severe periodontitis compared with those who did not.
Another study published in 2005 found similar results—that patients with type 1 diabetes who had gingivitis developed an earlier and higher inflammatory response than those with gingivitis who did not have diabetes.
Bottom line: If you have diabetes, you are more at risk for gingivitis and other dental problems, and these problems may be more severe when they do occur than in patients without diabetes. Dental care becomes critical in the diabetic patient.
2. Heart Disease
According to the Mayo Clinic, studies have linked periodontitis with an increased risk of heart attack. A 1999 study in the British Medical Journal, for example, showed a correlation between dental disease and stroke, heart disease, and diabetes. Researchers concluded that people who had periodontal disease had a higher incidence of heart disease, stroke, and premature death.
A 2011 study that compared heart attack victims to healthy volunteers found that heart patients had higher numbers of bacteria in their mouths. An earlier study in 2004 concluded that poor oral health is associated with coronary heart disease.
Not everyone agrees with the idea that there is a connection between the two, however. In fact, in April 2012, the American Heart Association (AMA) came out with a statement that surprised a lot of people—that there is no proof gum disease causes heart disease or stroke.
“The data that’s available right now would suggest there’s no direct relationship there,” Peter Lockhart, the statement author, told CBS. The statement, which appeared in the journal Circulation (April 18, 2012), said that although studies support an association between periodontal disease and coronary artery disease, they do not support a “causative” relationship. In other words, there’s no proof yet that one causes the other.
The AMA stated that many of the previous studies were flawed, in that they were not designed well or were undersized. It seems the AMA’s intention was to redirect people’s attention back to important factors that are known to reduce the risk of heart disease, such as lowering cholesterol and blood pressure. Because there is no proof that treating gingivitis will reduce the risk of heart disease, the AMA wanted to put the issue to rest, so to speak, and get back to focusing on the other problems known to cause heart disease, like smoking, obesity, and poor diet.
If you’re someone interested in protecting your overall health, however, the studies that connect heart disease to gingivitis are worth paying attention to. The problem seems to come back to the immune system. As a person accumulates pathogens in one part of the body, these pathogens tax the immune system—spreading it thin, in a way. Therefore, the immune system may no longer be able to effectively protect the rest of the body, allowing pathogens to spread to the heart and arteries. It may also be that the microbes in the mouth simply spread to other parts of the body, but studies haven’t confirmed that yet.
Some studies have linked gingivitis with an increased risk of developing dementia. Recent research from the University of California, for example, found that elderly people who did not brush at least once a day were up to 65 percent more likely to develop dementia than those those who brushed three times a day.
Researchers observed 5,500 elderly people for an 18-year study, and published their results in the Journal of the American Geriatrics Society. As before, the research didn’t prove a direct cause and effect, but did raise a red flag on the issue.
4. Rheumatoid Arthritis
As if to support the theory that gingivitis is associated with a taxed immune system, a study out of India found that two-thirds of participants who had rheumatoid arthritis (RA)—an autoimmune disease—also showed signs of gum disease, compared with 28 percent among healthy people.
A 2001 Australian study found that those with RA were twice as likely to have periodontal disease than those without RA.
Other studies published in 2008 also found a connection. In a group of U.S. veterans with RA, scientists found that periodontal disease was more common and severe in people with RA compared with people who had osteoarthritis—the most common type of arthritis not caused by an immune system disorder.
Scientists theorize that there may be many reasons for the connection. Some of the problem may be dry mouth, which many RA patients have. (A lack of saliva can increase oral bacteria.) But as expected, research has also found that certain antibodies (immune cells) specific to RA were more plentiful in people with both RA and gingivitis.
So many of our modern diseases and ailments come back to the immune system. If you’re seeing signs of inflammation in your mouth, it’s likely that your immune system is working to correct it, and that could leave you vulnerable in other areas of your health.
Likewise, if your body is already fighting other health conditions, such as RA or diabetes, you’re more at risk for other problems related to a tired immune system. Your best bet for staying healthy is to do as much as you can to maintain a healthy mouth, and to maintain the strongest immune system you can.
Find more tips on boosting the immune system here!
Have you found that your oral health seems connected to other health issues? Please share your thoughts.
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Liz Bryan, “Study shows nearly 1/3 of human genome is involved in gingivitis,” University of North Carolina at Chapel Hill, Press Release, December 7, 2009, http://www.eurekalert.org/pub_releases/2009-12/s-ssn120709.php.
Brian L. Mealey, DDS, MS, “Periodontal Disease and Diabetes: A Two-Way Street,” JADA October 2006, Vol. 137, 26S-31S, http://www.ada.org/sections/professionalResources/pdfs/Perio_diabetes.pdf.
Salvi Ge, et al., “Experimental gingivitis in type 1 diabetics: a controlled clinical and microbiological study,” J Clin Periodontol 2005 Mar;32(3): 310-6, http://www.ncbi.nlm.nih.gov/pubmed/15766376.
Morrison HI, Ellison LF, Taylor GW Periodontal disease and risk of fatal coronary heart and cerebrovascular diseases. J Cardiovasc Risk. 1999;6:7-11. http://www.ncbi.nlm.nih.gov/pubmed/10197286.
Andriankaja O, Trevisan M, Falkner K, Dorn J, Hovey K, Sarikonda S, Mendoza T, Genco R Association between periodontal pathogens and risk of nonfatal myocardial infarction. Community Dent Oral Epidemiol. 2011;39:177-85. http://www.ncbi.nlm.nih.gov/pubmed/21375559.
Stephanie Stahl, “Health: New Research Says No Proof Gum Disease Linked to Heart Disease,” CBS News, April 18, 2012, http://philadelphia.cbslocal.com/2012/04/18/health-new-research-says-no-proof-gum-disease-linked-to-heart-disease/.
“Poor Oral Health Linked with Coronary Heart Disease,” The Journal of the American Dental Association, April 2004, vol. 135, no. 4: 416, http://jada.ada.org/content/135/4/416.1.full.
Sue Hughes, “AHA: No Evidence that gum disease causes CHD,” theheart.org, http://www.theheart.org/article/1386809.do.
Dorset Bournemouth, “New Studies Link Gum Disease to Dementia and Arthritis,” August 29, 2012, http://www.prweb.com/releases/gum/disease/prweb9834333.htm.
“Research Update, Top 10 Arthritis Events of 2008,” Arthritis Foundation, January/February 2009, http://www.arthritis.org/topten2008.php#advance_9.
Relationship between rheumatoid arthritis and periodontitis. Mercado FB et al. Journal of Periodontology. June 2001.?http://www.joponline.org/doi/abs/10.1902/jop.2001.72.6.779.