How does periodontitis affect your overall health?
- Posted: 28 June 2021 | Authored by: Dr. Arlene Khaw Bee Hong | Reviewed by: Dr. Tan Wee Han
Periodontitis is an inflammatory disease that affects both the soft (gum) and hard tissues (bone) that support the teeth. It is caused by the build-up of bacterial plaque, leading to the detachment of your gums from the roots of your teeth. This will result in the formation of a gap between your gums and your teeth, which is known as the periodontal pocket.
The periodontal pocket is an area where your toothbrush cannot access. Therefore, bacterial plaque (from your food debris) will continually deposit below your gum line onto the roots of your teeth. Over time, the build-up will harden and become tartar, and attract even more plaque. Multiple studies have shown that the subgingival plaque (plaque beneath the gums) harbours large amounts of bacteria.
Early stages of periodontitis are often pain-less. As a result, many patients only seek “symptom-driven” care when their disease is at the advanced stage. Once a considerable amount of gum and bone has been lost, tooth migration (change in tooth position), tooth mobility (loose tooth) and tooth loss follow.
Poor chewing function, as the terminal stage of periodontitis, compromises your digestion, as well as your nutrition, often leading to poorer general health.
How Chewing Affects Digestion
Did you know that the food that you eat is digested in your mouth first before it enters your stomach? What?! Your saliva contains digestive enzymes (called amylase) which break down starches into simple sugars. So by chewing for one minute, up to half of the starch may be digested before you even swallow!
Your saliva also contains some fat digesting enzymes (called lipase) that help begin the process of breaking down the fats in your food. The act of chewing food triggers the production of your stomach acid and pancreatic juices further along the digestive tract, so that the system is primed for the whole digestive sequence.
Chewing well also breaks the food down into smaller pieces, so when you swallow the food, it mixes more thoroughly with your stomach acid. The more surface area is exposed to stomach acid, the more effectively it can do its job. Good chewing function also comes in handy further down the digestive tract. Thorough chewing means that less un- or partially-digested food matter enters your colon and that translates into less intestinal gas.
How Chewing Affects Nutrition
If you’re digesting your food better, does that mean that you get more nutrition from it? Yes! Longer chewing has been shown to increase the amount of protein your body can absorb from foods and put to use building muscle. It also makes some vitamins and minerals more available for absorption, especially from fresh fruits and vegetables.
In summary, chewing your food more thoroughly can improve your digestion and nutrition. And in order to chew your food well, you need a healthy set of pearly whites.
How Does Periodontitis Affect Your Overall Health
Substantial evidence points to the fact that periodontitis affects the body by haematogenous dissemination (spread via the bloodstream) of both bacteria and bacterial products (from the dental plaque), and inflammatory mediators (from the inflamed gum and bone). Say what?!
An easy way to understand this is to quantify the size of the periodontal wound in your mouth, and compare that to the size of a skin wound, say on your knee. An abrasion wound on your knee (say 30x30mm) would equate to an area of 900mm2. One recent study showed that individuals with severe periodontitis have an average periodontal inflamed surface area (PISA) of approximately 2300mm2 – 2.5 times wider!
An untreated periodontal wound forms an easy portal of entry for oral bacteria into your circulation, to your heart, lungs, joints etc. Several studies found the presence of oral bacteria in atherosclerotic plaque (the stuff that is responsible for narrowing your blood vessels).
Furthermore, as your body tries to get rid of these bacteria, it releases chemicals (called pro-inflammatory mediators) which may cause collateral damage to your organs. There is strong evidence that individuals with periodontitis have higher levels of C-reactive protein (CRP), a pro-inflammatory mediator (easily measured from a blood sample) compared to periodontally healthy individuals.
Harmful bacteria can enter your bloodstream through the gums (Dentistry and Oral Health)
The Role of Periodontal Therapy
So if periodontitis affects your general health, can treating periodontitis reverse your fate?
There is evidence on the effect of periodontal therapy in lowering the levels of CRP in cardiovascular disease. Periodontal therapy has also been shown to reduce the level of glycated haemoglobin, HbA1c (0.4-0.7%) in diabetic patients, and erythrocyte sedimentation rate, ESR in rheumatoid arthritis patients.
Therefore, periodontal therapy may not only help achieve and maintain a healthy smile into your twilight years, but may also help with the management of other chronic inflammatory conditions.
What Can You Do
With proper management, many systemic diseases can be well controlled – even if they can’t be fully cured. Likewise, periodontal disease deserves consistent attention and appropriate care. If you have questions or concerns about periodontal disease, your dentist can be a great source of information and help. You may also click here to find out more about the types of periodontal services available at Tan Dental Surgery.
References:
1. The Effect of Periodontal Therapy on the Composition of the Subgingival Microbiota (Periodontology 2000)
2. Protein Metabolism After a Meat Meal Is Influenced by Chewing Efficiency in Elderly Subjects (American Journal of Clinical Nutrition)
3. Particle size and nutrient bioavailability (Journal of Agricultural and Food Chemistry)
4. Effect of Bite Size and Oral Processing Time of a Semisolid Food on Satiation (American Journal of Clinical Nutrition)
5. Periodontal Inflamed Surface Area: Quantifying Inflammatory Burden (Journal of Clinical Periodontology)
6. Periodontal Inflamed Surface Area and Periodontal Case Definition Classification (Acta Odontologica Scandinavica)
7. Periodontal Pathogens in Atheromatous Plaques Isolated From Patients With Chronic Periodontitis (Journal of Periodontal Research)
8. Harmful bacteria can enter your bloodstream through the gums (Dentistry and Oral Health)
9. A Systematic Review and Meta-Analyses on C-reactive Protein in Relation to Periodontitis (Journal of Clinical Periodontology)
Updated: 2 Aug 2021
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