Diabetes Health Talk

Gums, teeth are indicators about what’s going on inside your body

Gum disease may also be implicated in a “small, but significant” increase in overall cancer risk for men, according to a recent study in The Lancet Oncology. The authors linked gum disease to a higher chance of lung, kidney, pancreatic and blood cancers. A similar pattern is emerging for kidney disease and Alzheimer’s. But as with heart disease and preterm labor, the question of what causes what has not been definitely answered.

In diabetes, however, the body-mouth connection is clear-cut. Diabetics who have uncontrolled gum disease, Cram said, “have a much harder time (than other diabetics) controlling their blood sugar levels.” The reverse, she noted, is also true: People with uncontrolled diabetes are about “three to four times at greater risk of developing periodontal disease.” The cycle is very hard to break.

Regular visits to a dentist can make the mouth an early warning system for a variety of problems. Sores or fungus in the mouth, for example, are often the very first indications of infection by HIV, the virus that causes AIDS, or of cancer. Osteoporosis, a disease of the bones, could show up in a routine dental X-ray before you notice its impact on your hips or spine.

Patients tend to minimize oral health, treating mouth issues as merely “dental.” Professionals echo this artificial dichotomy: Dentists and doctors don’t really talk to each other; they don’t attend the same conferences; they don’t read the same journals.

But recent research indicating a link between their disciplines is attracting attention from both doctors and dentists. Several studies show a startling correlation between gum health and atherosclerosis, a condition underlying much heart disease: The worse a person’s gum disease, the narrower that person’s arteries due to a buildup of plaque. This holds even for young, healthy adults who have no other symptoms of heart disease.

Many questions remain about the nature of the body-mouth connection.

In gum disease (called gingivitis in the early stages, before it develops into full-blown periodontal disease), the tissue that surrounds the bones supporting the teeth become inflamed or infected. Often this results from the accumulation of bacteria in the plaque under the tissue holding the teeth. The bacteria release toxins and other chemicals that begin to destroy the bone. Scientists believe they circulate and cause damage elsewhere in the body; exactly how remains unclear.

“It is like setting up a garbage dump on the edge of a river. You wouldn’t be surprised if the lake downstream ended up polluted with the garbage from the dump,” Vincent J. Iacono said in 2005, when he was president of the American Academy of Periodontology.

When Maurizio Tonetti, chair of the University of Connecticut’s Division of Periodontology, conducted a study looking into whether reversing the production of bacteria and toxins in the mouth would benefit patients who had atherosclerosis, the results were encouraging. He reported in the New England Journal of Medicine last year that patients who underwent an intensive, six-month program of treatment for gum disease emerged not only with healthier gums but also with improved endothelial function - that is, better function of the lining of the blood vessels. No, this does not necessarily mean better vascular function overall, but the experts say that these findings merit further study.

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