Problems with your gums pose a risk to your overall health

The Medicine Cabinet

Q: I recently had my usual teeth cleaning. My gums are a bit inflamed with gingivitis. The dentist said if it gets worse, it could affect my overall health. What can happen and why?

A: Gum disease begins when sticky, bacteria-laden plaque builds up around the teeth. Gingivitis is the mild form of gum disease. But left untreated, this condition can turn into periodontal disease, which can lead to swollen, red, or tender gums that bleed easily.

Periodontal disease has long been known as the leading cause of tooth loss in adults. But the damage isn't confined to the mouth. Gum disease has also been associated with threats to our health.

Like our intestines, our mouths house complex ecosystems of bacteria, known as the oral microbiome. And as in the gut, different types of bacteria compete for space. When all the species are in balance, the gums are protected from disease-causing bacteria. Disturbing this balance provides an opening for pathogens to invade, causing periodontal disease, which further disrupts the bacterial balance.

Pathogenic bacteria initiate periodontal disease. But the real damage to the gums is caused by the inflammatory response to the bacteria. That is, the disease-causing bacteria trigger a response from the body's immune system. The white blood cells summoned to eradicate them produce substances that not only destroy bacteria but also damage gum tissue.

Periodontal disease creates a state of low grade inflammation throughout the body. When inflammation persists, it's associated with a higher risk of multiple medical problems, including heart disease, diabetes, dementia and some cancers. It's not clear that periodontal disease actually causes these health problems; or if people with chronic health issues have more difficulty taking care of their teeth and gums.

Take these steps to help prevent gum disease and heal gingivitis before it progresses to periodontal disease. Brush your teeth at least twice a day, and floss before bedtime. Don't smoke. Eat foods that help suppress inflammation -- vegetables and vegetable oils, fruits, legumes, nuts and fatty fish. Get regular dental check-ups and cleanings, at least one every 6 to 12 months. Your dentist may recommend that you have them more frequently.

(Howard LeWine, M.D. is an internist at Brigham and Women's Hospital in Boston and assistant professor at Harvard Medical School. For additional consumer health information, please visit www.health.harvard.edu.)

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