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Why Oral Health Is the Key to Total Health

Gum disease can spread illness throughout the body, but it's not too late for prevention

By Erica Manfred

Gum disease is a silent scourge that not only affects your mouth but also your entire body, in insidious ways, often before you have any idea that it’s happening.
How do I know? It happened to me.

By the time I turned 40, I had severe periodontal disease and had started losing my teeth. I was also a heavy smoker, and I had developed Type 2 diabetes. At the time, more than 20 years ago, I had no idea that these things were all related, but research has since proven that smoking and periodontal disease are risk factors for diabetes, and that diabetes and smoking make the effects of periodontitis worse. As my own diabetes worsened, so did my gum disease, until I wound up with dentures.
How Gum Disease Affects Your Total Health

About 3 out of 4 Americans suffer from some form of gum disease, according to the American Academy of Periodontology. Many have gingivitis, an infection and inflammation of the gums caused by a buildup of plaque and tartar at the base of the teeth. Others have the more severe periodontitis, which typically occurs when gingivitis goes untreated or when its treatment is delayed, and the infection and inflammation spread to the ligaments and bones that support the teeth, eventually causing them to loosen and fall out.

There is mounting scientific evidence of a link between gum disease and cardiovascular disease, as well as stroke, rheumatoid arthritis, pancreatic cancer and even Alzheimer’s disease. The key is inflammation, the body’s natural reaction to injury or infection. Generally, inflammation is beneficial, even life saving. But untreated chronic inflammation of the type that characterizes gum disease can spread and lead to more severe health complications.

“Inflammation is a major risk factor for heart disease, and periodontal disease may increase the inflammation level throughout the body," Dr. Kenneth Kornman of the American Academy or Periodontology said in a statement announcing a joint effort between periodontists and cardiologists to raise awareness of the link and seek new clinical approaches. "Since several studies have shown that patients with periodontal disease have an increased risk for cardiovascular disease ... you will now see cardiologists and periodontists joining forces to help our patients.” More cardiologists now evaluate patients for signs of gum disease, for example, and many periodontists can be expected to ask patients if they have a family history of cardiovascular disease.
As we get older, the likelihood that we will develop periodontal disease increases, partly because of naturally occurring bone loss after age 40. Also, as we age our mouths produce less saliva, which can lead to xerostomia, or dry mouth, and hamper our ability to wash away the bacteria that sticks to our teeth. Lifestyle and disease can take a heavy toll on the mouth as well. "A history of smoking, diabetes and high blood pressure round out the top three causes of periodontitis," says Dr. Shehzad Sheikh, a dentist in Washington, D.C. Genetics can be a factor as well.

Only 3 percent of Americans who have gum disease seek treatment, according to the American Academy of Periodontology. In many cases, treatment may be as simple as having plaque removed by a dental hygienist, but sometimes a dentist or periodontist will need to perform the procedure known as flap surgery to remove tartar deposits in deep pockets of your gums. Fortunately, the soft-tissue lasers used in this procedure today are far less painful than traditional cutting and stitching. (The lasers seal up the gums, so there's no need for stitches.) When significant bone or gum tissue loss has occurred, however, bone or tissue grafts may be necessary.


It's Not Too Late to Prevent Gum Disease

Lifetime, vigilant home care is critical to preventing gum disease. Dentists like to say you don’t have to floss all your teeth, only the ones you want to keep. If I had paid attention the first time a dentist told me to floss my teeth more, I might have more teeth to take care of today. But even if you've long neglected your teeth and gums, you can start taking better care of them now. If you find traditional floss uncomfortable or difficult to use, you can talk to your dentist about alternatives like floss picks and interdental brushes.

Wendy Wynberg, a social worker from Woodstock, N.Y., found out that she had periodontal disease when she was 52. "I was always very lax about brushing and flossing," she says. "When I noticed my gums were bleeding I went to a periodontist and right away he told me I needed gum surgery. I wasn’t willing to do that. It was too expensive, too painful, and I’d heard about side effects like sensitive teeth. So I went back to my dentist and he said, 'Why don't you just try to be really vigilant about cleaning?' I knew the only way that would work for me was if I became obsessive about it. Every night I floss and then I use the Waterpik, and then I brush and use mouthwash."

The new focus has worked, and Wynberg has been able to avoid surgery. "It sounds extreme, but my gums have stopped bleeding and the hygienist tells me how great I’m doing at each cleaning," she says. "I don’t allow myself to say no to my bedtime teeth cleaning routine. It's too easy to slide. It helps me if I create a mental picture of my teeth not being clean. Now it's gotten to the point where I find it’s unpleasant to go to bed with dirty teeth.”

Erica Manfred is a freelance writer and the author of "He’s History, You’re Not; Surviving Divorce After 40." Read More
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