Why your gums are so important to your health

Periodontal disease may increase the risk of diabetes, heart disease, and dementia.


Regular flossing and brushing are key to preventing periodontal disease.

Photo: Canstock

Periodontal disease (periodontitis) has long been considered the leading cause of tooth loss in adults. But the damage isn't limited to the mouth. Gum disease is also associated with an increased risk of severe degenerative disease.

How gum disease starts

Just like our guts, our mouths have a complex ecosystem of bacteria called the oral microbiome. Just like in the gut, different types of bacteria compete for space. When all species are in balance, the gums are protected from disease-causing bacteria. Disruption of this balance provides an opportunity for pathogen invasion, leading to periodontal disease, which further disrupts the bacterial balance.

Pathogenic bacteria cause periodontal disease; however, they are not the only—or even the primary—culprits. Yesterday we thought bacteria destroyed tissue; now we think bacteria destroy tissue. Today, scientists understand that this is inflammation caused by bacteria that destroy tissue. That is, disease-causing bacteria trigger a response from the body's immune system, and the white blood cells summoned to destroy them produce substances that not only destroy the bacteria but also damage the gum tissue.

The systemic effects of gum disease

The effects of periodontal disease range from mild redness and swelling of the gums (gingivitis) to complete destruction of the bone supporting structures of the teeth (advanced periodontitis), resulting in tooth loss.

Over the years, people with periodontal disease have been found to be at increased risk of cardiovascular disease, diabetes, chronic respiratory disease, pregnancy complications, and dementia. We don’t yet know if periodontal disease actually causes other health problems, or if people with chronic health problems have more difficulty taking care of their teeth and gums. This is an association, not a proven cause and effect. But inflammation, which plays a role in all of these conditions, appears to be the link.

Furthermore, the association may be bidirectional. For example, diabetes research has determined that successfully treating periodontitis can reduce the severity of diabetes and vice versa.

Prevent periodontal disease

The following methods can help prevent bacterial infections or reduce inflammation and are still the best ways to reduce the risk of gum disease.

Brush and floss. Brush your teeth at least twice a day and floss before bed. If you have a dental bridge, dental implants, or have large gaps between your teeth, you may need to use an interdental brush (a toothpick-like tool with tiny bristles on one end) to remove trapped food.

do not smoke. People who smoked half a pack of cigarettes a day were almost three times more likely to develop periodontitis than non-smokers; people who smoked more than a pack and a half of cigarettes a day had almost six times the risk.

healthy diet. A diet rich in vegetables and vegetable oils, fruits, legumes, nuts and fatty fish not only provides all the essential nutrients but also helps to curb inflammation. There is evidence that people whose diets are rich in omega-3 fatty acids (found in fatty fish) have a lower risk of periodontal disease.

Get regular dental checkups and clean. Your dentist or dental hygienist can remove plaque that contains bacteria and detect the first signs of periodontal disease.

Get treatment as soon as signs of gum disease appear. Swelling and bleeding gums; pustules; or gums pulling away from the teeth are the most obvious symptoms of periodontal disease. Subtle changes, such as wider spaces between teeth and bridges or partial dentures that no longer fit as well as they once did, can also be signs of periodontitis.

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