For years, doctors have suspected a link between a person's oral and cardiovascular health, though there's evidence the connection might be greater than anyone ever imagined. A study published in 2012 showed not only that half of American adults aged 30 and over have periodontal disease, but that those with gum disease have a much higher likelihood of also having a chronic condition, such as heart disease or diabetes. Even as doctors acknowledge the connection between the body and oral hygiene, there are still questions about how it affects the rest of your body and why the most basic habits - like brushing your teeth - can boost your overall health.
What Is Gum Disease?
Every day you perform routine tasks to keep your mouth free and clear of bacteria. Brushing and flossing prevent buildup that can lead to gum infection. If you fall short on dental duty and an infection develops, your immune system attacks the infection, causing the gums to become inflamed, which can continue unless you get the infection under control. Having one infection, though, leaves you susceptible to getting sick in other ways.
Melisande Wolff, DMD, FAGD, dentist at Presidential Dental Center in West Palm Beach, FL, explained gum disease as follows: "Typically every 24 hours, we form a biofilm on our teeth and gums that we know as dental plaque. If we don't brush and floss, what happens is these bacteria cause inflammation underneath the gums." Chronic gum disease is known as periodontitis, she said, and it leads to destruction of the bone. It's non-reversible but can be treated. Gingivitis, on the other hand, is inflammation at the top edge of the gums that can be cured. "It's almost like a precursor to longterm chronic gum disease," she said.
Periodontitis is typically diagnosed when your dentist sees considerable pocketing in the gums that indicates bone loss, Dr. Wolff said. If there's no bone loss, it's strictly gingivitis. Something we should note is that gum disease usually doesn't come with any pain - it's not like a cavity that hits your nerve, Dr. Wolff pointed out - but it does come with bad breath, a bad taste in your mouth, and bleeding when you brush your teeth. And, once you have bone loss, you can start losing your teeth.
Long-term inflammation can lead to damage to the gums and bone structure and cause problems throughout the body. There's evidence that gum disease can impact rheumatoid arthritis, pregnancy, Alzheimer's, and, most recently, erectile function. But, we mapped out some of the most researched and talked-about health concerns associated with gum disease ahead.
How Gum Disease Has Been Linked to Heart Disease, Diabetes, and Declining Bone Health
There is a strong link between heart disease and oral health. In part, this is because the two share several risk factors, including unhealthy eating, being overweight, and smoking. But there's also speculation that gum disease actually increases a person's risk for developing heart disease because it creates inflammation in the blood vessels. In addition to affecting the blood's ability to flow through the body, there is also an increased chance fatty plaque will break off and move to the brain, which can trigger a stroke or heart attack (Dr. Wolff said researchers have found the same bacteria that causes gum disease in the plaque blocking our arteries).
"People who have tooth loss, even if they're missing a couple of teeth, due to gum disease, they're more likely to have some form of heart disease," Dr. Wolff told POPSUGAR. She also pointed out that bacteria enters the bloodstream through our gums and damages the inner lining of our blood vessels, which can lead to that high blood pressure.
There is evidence, too, that gum disease is linked to diabetes. "People who do have diabetes, whether it's type 1 or type 2, actually have three times more risk of getting periodontitis, or gum disease," Dr. Wolff said. Diabetes leads to abnormalities in blood vessels, as well as high levels of inflammatory chemicals such as interleukins, which significantly increase the risk for gum disease. High levels of triglycerides - common in type 2 diabetes - also affect periodontal health. The relationship between gum disease and diabetes goes both ways, too. Having high blood sugar makes you more prone to diabetes because it creates an ideal environment for infections. Not to mention, high blood sugar levels have been associated with severe periodontal disease in people without diabetes.
Weight plays a role in heart health and whether or not a person has diabetes, and studies have linked gum disease and obesity. According to researchers, periodontitis tends to progress faster, with deeper pockets, the higher a person's body fat is.
There's more: Your bone health is also likely linked to your dental health. Gum disease and osteoporosis both cause bone loss, according to research from the National Institutes of Health Osteoporosis and Related Bone Diseases National Resource Center. With periodontitis, you're losing bone in your jaw, Dr. Wolff said, and "if you already have osteoporosis, low bone density, it'll actually speed up the effects of the gum disease."
Gum Disease Prevention and Treatment
So what does all of this mean? According to doctors who have studied the link between oral health and overall health, it means you need to invest time and energy into caring for all parts of your body. It's just as important to exercise and eat right as it is to brush, floss, and see a dentist on a routine basis. It's also a good idea to share your overall health history with your dentist and your dental history with your general physician. This way, your healthcare providers fully understand your risk factors.
In terms of assessing your risk for gum disease, Joyce Kahng, DDS, of Orange + Magnolia Dental Studio, told POPSUGAR, "What I do is I take measurements of the gum and then if the pockets are looking a certain way or if there's a lot of bleeding, we start looking into genetics." That's because gum disease, she said, is genetic. If you're more prone to gum disease because of family history, she'll take a preventative approach. "If you're developing a lot of plaque much more quickly than the person next to you, then we need to put you on the appropriate recall like every three months, every four months, instead of just every six months, which is what insurance dictates." (Note: recall, meaning regular checkups.)
If you end up having gum disease, it's all about longterm maintenance. You may need further treatment with antibiotics when your infection flares up, Dr. Wolff noted, but generally, the treatment process depends on the person. If you haven't been to the dentist in a long time, Dr. Kahng said she'll do a deep cleaning to assess the severity of the gum disease, then have you back a few weeks later to measure pocketing in the gums to see if there's any improvement. Regular cleanings are encouraged to get rid of tartar buildup, and she may refer you to a gum specialist, called a periodontist, who might take a surgical approach. As pocketing gets deep, it's harder to reach from the outside and clean them, Dr. Kahng explained. "Think of it like in your pants. There [are] pockets in your pants and there's lint at the bottom. If that pocket gets really deep, it's harder to get the lint out the bottom."
Here are some general tips for maintaining good oral hygiene:
- Brush at least twice a day, preferably after meals.
- Floss before you brush (though some dentists say flossing after is just as effective).
- To get more of a deep clean, use a Waterpik or similar tool.
- Go to the dentist for regular cleanings (this may be once or twice a year for some people, or more than that for others).
- Additional reporting by Sam Brodsky