Roughly half of all adults over the age of 30 have gum disease and that number shoots up to 70% among adults over the age of 65. Why isn’t this information being screamed from the mountaintops? If this disease is in fact so prevalent, why aren’t all of us constantly up in arms about this? In my mind, the answer to that question is actually quite simple. Gum disease (more formally titled periodontal disease) is largely a silent disease. With a few exceptions, there is no associated pain. Until it reaches a certain severity, the teeth affected are not sensitive or mobile. While there is often a bad taste or smell with gum disease, the onset is so slow that people don’t often notice the poor taste. It usually takes the comment of a friend or family member to let the afflicted individual know that their breath stinks.
Another reason why people aren’t necessarily afraid of gum disease is that they don’t fully understand the repercussions of it. When I tell a patient, “You have a severe case of gum disease,” it doesn’t land with the same amount of force as their doctor telling them, “You have heart disease.” I have had many patients throughout the years say things like, “So what? My gums are a little red and inflamed. What does that matter?”
In an attempt to address this question, I am going to spend the rest of this article explaining why treating gum disease for the health of your mouth is important, but also why treating gum disease for the health of your whole body is even more critical.
First, let’s take a look at what happens in the mouth as a result of gum disease. When harmful bacteria settle under the gum tissue surrounding each tooth, the initial response is that the gums become inflamed. This inflammation causes the pocket between the tooth and the overlying gums to increase in depth. This is concerning because the tools you have at home (toothbrush and floss) can really only properly flush out pocket depths of 1-3mm. This means if the gums swell and the pocket depth increases to 4mm+ you can brush and floss five times a day and not actually address the root of the problem.
Following inflammation, the next thing that happens if the initial gum disease is not properly treated is the bacteria at the base of the gum pocket starts to eat away at the attachment of the gums to the tooth and/or bone. This further deepens the pocket, giving the harmful bacteria (which thrives without oxygen) the ideal environment to propagate. As the process continues to work its way down the tooth, eventually the bacteria starts to destroy the bone around each individual tooth. If left unchecked for extended periods of time, the destruction reaches a point where the only option is to extract the teeth. So, swollen gums might not seem like a big deal, but smiling, eating, talking, kissing, and so many other things that we enjoy are dependent on a full set of teeth.
So, as previous highlighted, even if the only negative results of gum disease were the bad outcomes seen in the mouth, it should be enough to motivate any one of us to treat it as soon as we’re made aware of it. Even more concerning than what can be seen in the mouth, are the negative impacts that gum disease has on the health of the overall body. Before we detail exactly what those impacts are, it’s important to acknowledge that we currently don’t know everything that occurs in the body as a result of gum disease. New research seems to come out every couple of years that links yet another general health issue with gum disease. Let’s take a look at the current list of general health issues.
Heart: When bacteria settles in the pocket of gum tissue around a tooth, the tissue swells and so do the tiny blood vessels within the tissue. This dilation of the vessels creates a wide-open highway for bacteria to enter the general blood circulation. The first and most apparent damage that oral bacteria inflicts is on the heart. Due to the bacteria and the effects it has on heart tissue and surrounding blood vessels, a person with gum disease has two to three times the risk of having a heart attack, stroke, or other major cardiovascular event.
Lungs: A similar disease process happens with the lungs. Since every drop of our blood runs through our heart and lungs, it stands to reason that these would be the first organs to see negative effects from the harmful oral bacteria in our blood due to gum disease. In the lungs specifically, a person with gum disease is more likely to develop COPD, emphysema, bronchitis, and pneumonia.
Brain: The next major organ to experience negative outcomes related to gum disease is the brain. This is particularly fascinating because the brain contains a structure known as the blood-brain barrier, which is specifically designed to keep bacteria from crossing over from the blood into the brain. However, one harmful bacteria that originates in the mouth, known as P. Gingivalis, has a unique ability to slip past this blood-brain barrier. Once inside the brain, P. Gingivalis secretes a byproduct known as gingipains which destroys neurons and can lead to dementia and/or Alzheimer’s Disease.
While diseases of the heart, lungs, and brain are the main negative outcomes related to gum disease, there are several others including complications with diabetes, irritable bowel disease, erectile dysfunction, and increased cancer risk. The list goes on and on.
It’s apparent that, while gum disease, its symptoms, and the other disease processes that it facilitates are largely silent, they should nevertheless be extremely concerning. If you want to keep your teeth and avoid the many general health issues that come along with gum disease, the time to start taking better care of your teeth and gums is now. Schedule an appointment with your dentist, complete any necessary treatment, and ask your hygienist for recommendations for home care products (toothbrush, flosser, paste, rinse, etc.). Your future self will thank you!