Most dental health professionals know that periodontal disease can affect their patient’s overall health. But if your patient asks you to explain how, exactly, does gum disease cause systemic illness, do you have an answer? I’m offering a very simplified response that may help both oral health professionals and their patients understand the basic mechanisms by which periodontal disease can contribute to total body illness:
Current research has determined three ways in which periodontal (gum) disease may affect systemic (overall) health. First, bacteria from your gums can be transported through saliva. From saliva, the bacteria may be inhaled in water droplets within the air you breathe. These bacteria can be aspirated into the lungs, potentially causing pneumonia or other pulmonary infections. This is especially dangerous for the elderly and others who may have weakened immune systems, such as people with chronic obstructive pulmonary disease.
The second way that periodontal disease can cause systemic disease is by bacteria associated with periodontal disease entering the body’s circulatory system through ulcerated periodontal tissues that we call periodontal pockets. These bacteria can travel through the blood stream to remote parts of the body, causing secondary infections or contributing to diseases in various organ systems or tissues. In particular, one specific periodontal pathogen, Fusobacterium nucleatum (Fn), causes increased permeability in the arterial walls, allowing invasion of other periodontal bacterium, contributing to the development of arterial plaque. If this build up occurs in the carotid arteries, the end result could be a cerebrovascular accident (CVA) or stroke. If it occurs in the coronary arteries, the end result could be a myocardial infarction (MI) or heart attack.
The third way that periodontal disease can affect systemic health is that inflammation associated with periodontal disease may stimulate a systemic inflammatory response within the body. This secondary systemic inflammation may contribute to or complicate other disease processes such as cardiovascular disease, diabetes, kidney disease, rheumatoid arthritis, orthopedic implant failure, and other inflammation based diseases.
Kathryn Gilliam’s interest in the medical side of dentistry led her to years of advanced study into the oral-systemic link, including graduating from the prestigious Bale Doneen Preceptorship. Her company, PerioLinks, LLC, was born out of her desire to train dental teams to transform their practices to care for the total health of their patients through comprehensive periodontal treatment.