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Cardiovascular disease, diabetes, pregnancy complications, respiratory infections, osteoporosis... What do all these have in common? Well, they can all start in the mouth! Indeed, periodontal disease can pose serious risks to our oral health, but did you know this can also facilitate the progression to more serious health conditions? Yet there is good news: a saliva test could assess your risk.
Curious? Click on to find out more.
Periodontal disease is also popularly known as gum disease. It’s an inflammatory condition that affects the structures that support teeth, as well as the gums.
Have you ever had red or swollen gums that easily bleed? People that experience this chronically are usually diagnosed with gingivitis.
Gingivitis is usually considered the first stage of periodontal disease. The buildup of plaque can cause bacterial overgrowth in the mouth, leading to infection. This can cause the gums to become inflamed.
Untreated gingivitis can develop into periodontitis, a more advanced form of gum disease where the gum begins to pull away from the teeth. This tends to leave small pockets where bacteria thrives and forms more infections.
While some part of our oral health is hereditary, regular oral hygiene (brushing, flossing, professional teeth cleanings, etc.) can help mitigate the prevalence and progression of oral disease.
The statistics are alarming. In the United States, more than 40% of adults aged 30 and older have some form of gum disease. As we get older, the progression of the disease gets worse.
Men have a higher likelihood of developing periodontal disease. Habits like smoking or conditions like diabetes can also increase the risk of developing the disease.
Periodontal disease is a global issue. While the numbers are not clear, between 20-50% of all individuals have some form of periodontal disease, making it a global public health issue.
Fortunately, there are a number of saliva tests that can be used to understand the risk of developing the disease, the different strains of bacteria that are triggering the disease, and its severity.
One accessible early detection test is used to measure collagen breakdown, which detects the level of a particular enzyme (aMMP-8). This enzyme can detect the rate of collagen breakdown in our mouths.
Collagen is the main component of the tissue that supports our teeth. Too much harmful bacteria, or other factors that can lead to collagen breakdown, can lead the body to activate the MMP-8 enzyme.
The activation of this enzyme can lead to collagenolysis. Essentially, to protect itself from disease, the body activates the enzyme, which leads to a breakdown in collagen.
A healthy range of this enzyme is below 10 ng/ml, considered Grade A. Any number below 10 ng/ml is viewed as low risk for the development or progression of periodontal disease.
For comparison, any level above 20 ng/ml is viewed as Grade C, which means there is a highly elevated rate of collagen breakdown, and, therefore, a risk of a rapid rate of advancement of the disease.
Beyond preventative care, which includes dietary choices, when diagnosed with periodontal disease patients may require supplements, medication, or the removal of hardened material from teeth’s surface.
Studies show that when periodontal disease goes untreated, it can increase the risk of many other diseases, including cardiovascular, metabolic, and respiratory.
The percentages speak for themselves. A 2017 study shows a 19% increased risk of cardiovascular disease. For those over the age of 65, the risk increases to 44%.
Individuals with type 2 diabetes and periodontal disease have a 3.2 greater risk of mortality compared to those who don't. Those with diabetes have a higher rate of periodontal ligament damage, which can result in tooth loss.
Studies show that diabetics with periodontal disease who receive treatments and regular interventions to mitigate the prevalence and progression of periodontal disease see as much results in controlling diabetes as they would with medication to control its advancement.
Infection, preterm labor, preeclampsia, and low birth weight are just some of the complications that can occur during pregnancy when suffering from periodontal disease.
In addition to poor oral hygiene and habits like smoking, one of the great risk factors for women is hormonal changes. High levels of the hormone progesterone, which augment before menstruation and during ovulation, cause the dilation of blood vessels.
High levels of progesterone can cause an inflammatory condition that can damage the structures surrounding the teeth.
Similarly, particularly for menopausal and postmenopausal women, the deficiency of estrogen can lead to conditions like osteoporosis. The effects of bone loss can also mean that teeth have a risk of falling out.
Another risk factor for periodontal disease is stress. And with approximately 75% of respondents reporting to the American Psychological Association that they experienced stress in just the last month, this is a risk factor that everyone should consider.
Stress can cause significant immunological responses to different triggers. These responses can impact the production of saliva and the concentration of the hormone cortisol, which activates our ‘fight or flight’ responses, including the production of adrenaline.
Elevated cortisol levels are useful when we’re in dangerous situations, but chronic elevated levels of cortisol can negatively impact the immune system, reducing the body’s ability to fight off infections.
Stress also reduces the flow of saliva and can lead to a condition called dry mouth. The less saliva we have, the greater the formation of dental plaque and infection. Saliva helps keep harmful bacteria at bay.
The importance of saliva is what makes mouth swab diagnostic tests so effective and, so far, one of the best diagnostic tools available for early intervention and to measure the severity of periodontal disease.
The COVID-19 pandemic has highlighted the connection between oral health and infections. Those with periodontal disease are more likely to experience respiratory infections, and, therefore, more grave symptoms of COVID.
With the increased prevalence of communicable diseases and oral health, maintaining a healthy oral microbe can help us live longer, healthier lives by managing our risk of disease.
Sources: (National Library of Medicine) (International Journal of Health Sciences) (Journal of Clinical Periodontology) (BBC) (CDC) (CNN)
See also: Important health checks by age
The potential of mouth swabs in improving life expectancy
The alarming risks related to periodontal disease
HEALTH Oral health
Cardiovascular disease, diabetes, pregnancy complications, respiratory infections, osteoporosis... What do all these have in common? Well, they can all start in the mouth! Indeed, periodontal disease can pose serious risks to our oral health, but did you know this can also facilitate the progression to more serious health conditions? Yet there is good news: a saliva test could assess your risk.
Curious? Click on to find out more.