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Essential Science: Gum infections can lead to a range of other diseases

By Tim Sandle     Apr 11, 2016 in Science
Having a gum diseases can cause problems enough, leading to redness, soreness and discomfort. This, however, can be just the beginning. New research is connecting gum disease to a host of other infections.
The most serious type of gum-related disease is oral cancer. With this, there is evidence that chemicals released from the types of bacteria that cause gum disease can incite the growth of deadly lesions and tumors in the mouth, trigger oral cancer. Beyond specific diseases of the gums, there is growing body of evidence drawing connections between diseases of the gum and diseases elsewhere in the body, most notably heart disease.
A heart attack happens when a blood clot blocks coronary arteries  killing cardiac muscle.
A heart attack happens when a blood clot blocks coronary arteries, killing cardiac muscle.
Ravindra gandhi (gandhiji40)/
One reason for making these connections is because gum disease (periodontitis) is caused by an imbalance of certain pathogenic bacteria, or by bacteria that ordinarily do not cause a problem ending up in the a location within the mouth where they can cause harm. While this in itself is problematic, the pathogenic bacteria that cause gum disease do not simply remain in one place. Through activities like brushing teeth, the bacteria can enter into the bloodstream and here other diseases can manifest. A secondary reason for the connection between gum disease and ill-health effects is other is because such diseases might trigger a low grade inflammatory response throughout the body. With this, the formation of plaque in the arteries is triggered by similar inflammatory chemicals to the ones associated with gum disease.
Diseases of the gum can develop due to environmental and genetic factors. The most common reason remains failing to brush the teeth regularly or not brushing effectively. Failure to do so leads to bacterial communities forming in conjunction with organic matter, and here a biofilm is created and this becomes plaque. One of the foremost bacteria of concern is a species called Porphyromonas gingivalis (according to the journal Advanced Experimental Medical Biology - "Complement involvement in periodontitis: molecular mechanisms and rational therapeutic approaches.")
Once external factor that seems to ease the formation of a biofilm is smoking. Scientific research, published a few years ago in the journal Infection and Immunity, showed people who smoke regularly risk killing off 'good' bacteria and, in doing so, leave the body vulnerable to various diseases.
Never too late to quit smoking.
Never too late to quit smoking.
The primary risk between gum disease and other ailments appears to be with the heart. There are over 500 research papers that point to a connection between atherosclerosis and gum disease. Atherosclerosis describes the situation when an artery-wall thickens, as a result of invasion and accumulation of white blood cells, together with the proliferation of intimal-smooth-muscle cell creating a fibrofatty plaque. The build-up of plaque can block the artery, causing disruption of blood-flow, leading to a heart attack.
Research has shown those with persistent gum disease are more prone to blocked arteries (and hence the risk of heart attacks) than others. This is even when common risk factors for heart attacks - cholesterol or obesity - are accounted for.
While the connection between gum disease and atherosclerosis is clear, whether this is coincidental or causative remains a subject of medical and scientific debate. Here the American Heart Association, for instance, sees the connection and causality as "plausible." If, for example, high levels of pathogenic bacteria from the gums enter an artery, this would cause a white blood cell reaction and this could, in theory, lead to atherosclerosis.
Chart showing blood pressure and blood flow
Chart showing blood pressure and blood flow
Here the American Heart Association indicates there is "concern about possible links between periodontal disease (PD) and atherosclerotic vascular disease (ASVD) has intensified and is driving an active field of investigation into possible association and causality."
And in terms of what can be interpreted from scientific data to date: "observational studies to date support an association between PD and ASVD independent of known confounders. They do not, however, support a causative relationship."
The connection between heart disease and gum disease is not the only link to be made from oral health. Different research teams are investigating patterns between ailing gums and conditions like cancer, arthritis, diabetes and Alzheimer’s disease. At present, all connections are possibilities requiring further research. However, should even one connection be conclusively proved this would mean renewed medical and dental focus on the health of mouths and gums as a means to tackle one or more serious diseases.
As an example, a recent study from Guy's and St Thomas' NHS Foundation Trust (London, U.K.) compared patients on dialysis: those who received periodontal treatment matches with those who did not. It was discovered those who received treatment had a 30 percent lower risk of developing pneumonia. This research is published in the journal Medicine, in a paper succinctly called "Disorders of the mouth."
This article is one of Digital Journal's Essential Science columns. Each week we explore a topical and important scientific issue. Last week we examined the microbiome of seminal fluid, showing how research into this may one day be used to assess overall male health. The week before, we outlined how microbiologists had created the first semi-synthetic organism with the fewest number of genes.
More about Gum disease, Heart attack, Bacteria, Infection
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