Periodontal (gum) disease, though it may be invisible to everyone but your dentist, can have a powerful effect on your entire body. Not only is it dangerous to your teeth and jaws, but it can increase your risk of heart attack and stroke, cause preterm births in pregnant women, and affect blood sugar control in diabetics.

Diabetics are our subject for today. Symptoms of diabetes include abnormally high levels of glucose (a form of sugar) in the blood, leading to frequent urination, excessive thirst, blurred vision, unexplained weight loss, and loss of energy. The disease can also cause severe complications in various parts of the body.

Normally, glucose, your body's main energy source, is kept under control by a hormone called insulin, which is made by an organ called the pancreas. In type 1 diabetes, a person's pancreas does not produce enough insulin to deal with all the glucose in his or her blood. In type 2 diabetes — a condition related to increased age, physical inactivity, overweight, and heredity — the pancreas may produce enough insulin, but the body is not able to use it effectively. This condition is called insulin resistance.

People with type 1 diabetes need insulin to survive. Type 2 may be treated with exercise, diet, medications, and insulin supplements.

Serious complications of diabetes range from kidney failure, blindness, and nerve damage to infections that do not heal, gangrene and amputation of limbs.

Diabetes and periodontal disease seem to have reciprocal effects on each other. Diabetics are more likely to have periodontal disease than non-diabetics; and those with periodontal disease are likely to face worsening blood sugar control over time.

Periodontal disease (from “peri”, meaning around and “odont”, meaning tooth), is caused by dental plaque — a film of bacteria that settles on your teeth and gums every day. It's what you remove with daily brushing and flossing. Any bacteria that remain cause inflammation, which can lead in the worst cases to loss of bone and eventual loss of teeth.

The close relationship of diabetes and periodontal disease probably results from changes in the function of immune cells responsible for healing. Inflammation is a part of normal wound healing — but chronic or prolonged inflammation can destroy the tissues it was meant to heal. This may be a major factor in the destructive complications of diabetes.

Many of these complications begin in the blood vessels. Like the eyes and the kidneys, gum tissues are rich in blood vessels. Gum tissues are also under constant attack from bacteria. If you are a diabetic, effective plaque control, along with regular professional dental cleaning, can have positive effects not only on periodontal disease, but also on control of your blood glucose level.

Contact us today to schedule an appointment to discuss your questions about periodontal disease and its connections with diabetes. You can also learn more by reading the Dear Doctor magazine article “Diabetes & Periodontal Disease.”

Did you know that studies have shown a relationship between gum disease and heart disease?

The common link is inflammation. This means that if you reduce inflammation caused by gum disease (periodontal disease), you also reduce your risk for heart attacks and strokes. The methods we stress for good dental hygiene — consistent effective brushing and flossing, regular professional cleanings by a hygienist, and dental treatment when needed — are also important for the maintenance of a healthy cardiovascular system (from cardio, meaning heart, and vascular, meaning blood vessels).

Here's how it works. Dental plaque is a film of bacteria that settles on your teeth near the gum line every day. When you brush and floss, you remove as much of this bacterial film, or biofilm, as you can. Bacteria that are not removed multiply and produce acid products that begin to dissolve the enamel of your teeth. They also irritate your gum tissues.

Your immune system tries to remove the bacteria and their byproducts through inflammation, your body's way of attacking substances that shouldn't be there (such as bacteria). However, long-term inflammation can be harmful to your own tissues as well. Inflammation in your gums, a symptom of periodontal disease, can destroy gum tissue, bone and the ligaments that hold your teeth in place.

Ongoing inflammation can also increase your risk for heart disease and stroke. Bacterial byproducts of periodontal inflammation have been shown to cause the liver to manufacture a protein called CRP (C-reactive protein) that spreads the inflammation to the arteries, where it promotes formation of blood clots.

Of course, other factors are also related to an increased incidence of cardiovascular disease. These include smoking, diabetes, obesity, high blood pressure, and physical inactivity. Family history and depression can also influence gum disease and heart disease.

Diet is another factor. You have probably heard of “good” cholesterol (HDL) and “bad” cholesterol (LDL). The bad one, low-density lipoprotein or LDL, is found in animal fats. It can cause an accumulation of fat breakdown products (also called plaque, but a different substance from dental plaque) inside your arteries. The arteries become narrow, so that they can be easily blocked, resulting in heart attacks and strokes. Studies have shown that inflammation of the lining of the blood vessels accelerates this effect.

If tests show that you have high levels of LDL, your doctor may advise you to modify your diet and take specific medication to reduce arterial plaque. You will also be advised to make lifestyle changes to reduce your risk factors. Lowering your weight, getting more exercise, and stopping smoking can have a positive effect on your heart health — and so can improving your dental hygiene to combat periodontal disease.

Contact us today to schedule an appointment to discuss your questions about the relationship between gum disease and heart disease. You can also learn more by reading the Dear Doctor magazine article “The Link Between Heart & Gum Diseases.”

Gum disease, also called periodontal disease (from the roots for “around” and “tooth”) starts with redness and inflammation, progresses to infection, and can lead to progressive loss of attachment between the fibers that connect the bone and gum tissues to your teeth, ultimately causing loss of teeth. Here are some ways to assess your risk for gum disease.

Your risk for developing periodontal disease is higher if:

1. You are over 40.
   Studies have shown that periodontal disease and tooth loss correlate with aging. The longer plaque (a film of bacteria that collects on your teeth and gums) is allowed to stay in contact with your gums, the more you are at risk for periodontal disease. This means that brushing and flossing to remove plaque is important throughout your lifetime. To make sure you are removing plaque effectively, come into our office for an evaluation of your brushing and flossing techniques.
2. You have a family history of gum disease.
   If gum disease seems to “run in your family,” you may be genetically predisposed to having this disease. Your vulnerability or resistance to gum disease is influenced by genetics. The problem with this assessment is that if your parents were never treated for gum disease or lacked proper instruction in preventative strategies and care, their susceptibility to the disease is difficult to accurately quantify.
3. You smoke or chew tobacco.
   Here's more bad news for smokers. If you smoke or chew tobacco you are at much greater risk for the development and progression of periodontal disease. Smokers' teeth tend to have more plaque and tartar while also having them form more quickly.
4. You are a woman.
   Hormonal fluctuations during a woman's lifetime tend to make her more susceptible to gum disease than men, even if she takes good care of her teeth.
5. You have ongoing health conditions such as heart disease, respiratory disease, rheumatoid arthritis, osteoporosis, high stress, or diabetes.
   Research has shown a connection between these conditions and periodontal disease. The bacteria can pass into the blood stream and move to other parts of the body. Gum disease has also been connected with premature birth and low birth weight in babies.
6. Your gums bleed when you brush or floss.
   Healthy gums do not bleed. If yours do, you may already have the beginnings of gum disease.
7. You are getting “long in the tooth.”
   If your teeth appear longer, you may have advancing gum disease. This means that infection has caused your gum tissue to recede away from your teeth.
8. Your teeth have been getting loose.
   Advancing gum disease results in greater bone loss that is needed to support and hold your teeth in place. Loose teeth are a sign that you have a serious problem with periodontal disease.

Even with indications of serious periodontal disease, it can still be stopped. Make an appointment with us today to assess your risks. You can also learn more by reading the Dear Doctor magazine article “Assessing Risk for Gum Disease.”