Can gum disease actually kill you?

Originally published in the North Lake Tahoe Bonanza (link), February 21, 2011.

Gingivitis isn't something most of us spend much time thinking about. We dutifully sit through lectures to floss during our routine dental cleaning — it's not like we have much choice, given the sharp metal bits they have stuck in our mouths. But do we really care? It's not like gum disease is going to kill us, right?

Maybe it will. New studies are looking at ties between gum disease and life-threatening conditions including heart attack and stroke.

Mechanisms are still being investigated, but it is clear that those with the most gum disease double their risk of heart attack, and possibly stroke and other clotting conditions. Many researchers think that bacteria in our mouths can enter the bloodstream and travel to other body sites and cause damage directly.

Others feel that periodontal disease can trigger the body to mount an exaggerated immune response and attack healthy tissues, contributing to inflammatory conditions such as asthma, food allergies, eczema, and autoimmune diseases such as lupus and arthritis. Our mouth is the castle's moat and gate, the first place where threats to our immune system enter the body. Unfortunately, these threats can collect in the gaps between the teeth and gums. From here, bacteria enter the blood stream through the thin gum lining. As counts of bacteria in the blood rise, our body mounts a response, increasing numbers of white blood cells, inflammatory markers and clotting factors.

It's possible that the association is more simple and that gum disease may not be the cause, but rather that the same lifestyle factors that lead to heart disease promote gum disease as well. Refined carbohydrates, particularly sugars, clearly increase our risk of both gingivitis as well as raise cholesterol levels, promote obesity and metabolic syndrome, and with that, increase risks of diabetes and heart disease. Those who consume high amounts of these foods are clearly at risk for all these conditions.

Also, people who are more health-conscious tend to take care of their teeth as well as the rest of their bodies. Those who exercise, floss. Those who watch their diets, lipids and blood pressure and go in for regular physical exams with their primary care doctors are more likely to make regular dental appointments as well. Their teeth, and hearts, thank them for it.

So for now, the jury's out. It's not clear if gum disease contributes to heart disease or if the two processes simply coexist in some individuals, but the association is clear and will hopefully be better explained over the coming years. In the meantime, there are a few things you can do:

Brush and floss frequently, thoroughly, and consistently.

See your dentist regularly for cleanings and checkups.

Avoid sugary foods and refined carbohydrates.

— Dr. Rebecca Gelber is an Incline Village resident and graduate of The Johns Hopkins School of Medicine. She is an adjunct professor with the UNR School of Medicine and practices locally at Tahoe Aesthetic and Integrative Medicine, 775-298-1750,