Gum disease opens up the body to a host of infections.
Adam Rifkin stashed this in Microbiome
Gum health affects cancer, Alzheimer's, heart disease, the microbiome, and inflammation.
When Salomon Amar, a periodontal specialist at Boston University, began exploring links between oral bacteria and heart disease in animal studies in the late 1990s, reactions were lukewarm. “Many cardiologists thought we were a bit crazy,” he says. Skepticism still abounds, but the same molecular tools that have dramatically changed understanding of the gut microbiome are now allowing scientists to track and examine bacteria in the mouth. Advocates of a connection between the artery disease atherosclerosis and microbes are hoping to find convincing proof of their suspicions, while exploring links between ailing gums and other conditions, including cancer, arthritis, diabetes and even Alzheimer’s disease.
The work has profound implications for public health, given that more than 65 million American adults are thought to have periodontal disease, which occurs when bacterial overgrowth inflames the gums and can lead to erosion of gums and bone. If it turns out that periodontal decay drives other diseases, doctors would have a new, and relatively simple, means of prevention.
Wenche Borgnakke, a dental researcher at the University of Michigan in Ann Arbor, has been making this case for years, citing “solid evidence that periodontal treatment has an effect on systemic disease.” She points to a study published last year in the journal Medicine comparing patients on dialysis who received periodontal treatment with those who did not. Those getting treatment had an almost 30 percent lower risk of pneumonia and hospitalization from infections. Another study published earlier this year found that gum disease is associated with a roughly 10 percent higher mortality over 10 years among patients with kidney problems.
Researchers working in the field often point out that about half of all deaths from atherosclerosis occur in people who do not have any classic risk factors, such as high cholesterol or obesity. Something else — something as yet unknown — is also contributing to heart disease. Even the root cause of many cancers is largely unexplained. Most women with breast cancer, for instance, have no risk factors other than older age. Says Jean Wactawski-Wende, a cancer epidemiologist at the State University of New York at Buffalo: “The more I work on oral health and cancer, the more I think, ‘Oh my gosh, I’ve got to keep my teeth clean.’ ”
Live bacteria needn't circulate. The endotoxins from the anaerobic, Gram-negative flora which dominate in periodontitis may be sufficient. Gentle chewing is enough to release endotoxins into the bloodstream and as endotoxins are a primary way of inducing experimental inflammation, a good deal is known about about their effects. For example, they impair endothelial function in humans for hours and accelerate atherosclerosis in rabbits. Systemic endotoxemia is associated with carotid atheriosclerosis and cardiovascular events.
I'm mostly fascinated with this due to the work on the gut microbiome, which is discovering that postprandial inflammation may be due to increased intestinal permeability to endotoxins with some food components. But all props to the dentists who discovered this phenomenon decades ago.