Periodontitis and systemic health

September 24, 2016

Representational image

Periodontitis/Periodontal disease refers to the inflammatory process that occurs in the tissue surrounding the teeth in response to bacterial accumulation or dental plaque on the teeth.

Progressive bacterial infection of the gums leads to bone destruction and loss of tissue attachment to the teeth.

There are different forms of periodontal disease:

1. Gingivitis: It is mildest form of periodontal disease, which causes gums to become red, swollen and bleed easily. There is usually little or no discomfort at this stage. It is reversible with professional treatment and good oral home care.

2. Periodontitis: Untreated gingivitis can advance to periodontitis. With time, plaque can spread and grow below the gum line. The toxins produced by bacteria irritate the gums and stimulate a chronic inflammatory response and the tissues and bone supporting the teeth are broken down and destroyed. Gums separate from the teeth, forming pockets. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. Eventually, teeth become loose and have to be removed.

Periodontitis has some risk factors, as given below.

Plaque: biofilms that contain organisms which if left on the tooth surface for longer times can induce disease progression; age: ageing is associated with increased incidence of periodontal disease; smoking: associated with twofold to sevenfold increase in periodontitis compared with nonsmokers, with a pronounced risk in young smokers; genetics: certain racial/ethnic groups have a higher risk of developing periodontitis compared with others; stress: reduces the efficiency of body to resist infections; medications: people on certain medications such as immunosuppressants (cyclosporine), anticonvulsants (phenytoin) and antihypertensives (amlodipine and nifedipine) drugs are more prone to gum hypertrophy; clenching/grinding of teeth:  abnormal forces produced can be detrimental to teeth and the surrounding tissue; poor nutrition: people with vitamin C deficiency are at increased risk of gingivitis and systemic diseases: such as diabetes, HIV and leukemia predispose individuals to periodontitis.

Research has shown that the inflammation present due to periodontitis is the factor that links periodontitis to other diseases in the body.

Diabetes and periodontal disease

There is a bidirectional relationship. People with diabetes are more likely to have periodontal disease than people without diabetes probably because they are more susceptible to contracting infections. Those who do not have their diabetes under control are especially at risk. Periodontal disease may make it more difficult for diabetics to control their blood sugar. Severe periodontal disease can increase blood sugar, contributing to increase periods of time when body functions with high blood sugar putting people at increased risk for diabetic complications.

Periodontitis and heart disease

Periodontal disease increases the risk of heart disease. Periodontal disease can also exacerbate existing heart conditions; therefore, patients at risk for infective endocarditis may require antibiotics prior to dental procedures. People diagnosed with acute cerebrovascular ischemia were found more likely to have an oral infection.

Other systemic diseases are as follows:

Respiratory diseases: Bacteria which grow in the oral cavity can be aspirated into the lungs to cause respiratory disease such as pneumonia and lung abscesses, especially in people with periodontal disease.

Cancer: Researchers have found out that men with gum diseases were 49 per cent more likely to develop kidney cancer, 54 per cent were more likely to develop pancreatic cancer and 30 per cent were more likely to develop blood cancer.

Gum disease and women

Increased levels of progesterone and oestrogen during puberty cause increased blood circulation to gums, which causes increased sensitivity and leads to a greater reaction to any irritation. Some may also experience menstruation gingivitis, which occurs right before a women’s period and clears up once her period has started.

Pregnant women who have periodontal disease may be more likely to have a baby that is born too early and too small with low birth weight.
Women who are menopausal/post-menopausal may experience changes in their mouth. They may notice discomfort in the mouth, dry mouth, pain and burning sensation in gums with altered taste. In addition, menopausal gingivostomatitis  affects a small percentage of women.