Is Gum Disease a Matter of Life and Death?

Probiotics can certainly be one of the key components to help deal with rheumatoid arthritis (RA). A quality oral probiotic such as “Evora Pro aka Probiora Pro” can help restore and maintain the balance of healthy bacteria in the oral cavity. Periodontal disease (gum disease) occurs when pathogenic bacteria become established in the oral cavity.

Studies have found that individuals with RA are eight times more likely to have periodontal disease compared to those without RA. (Arthritis Res Ther 2016;18(1):161) (J Periodontal 2008 Jun;79(6):979–86)

One of the main forms of bacteria responsible for periodontal disease is Porphyromonas gingivalis (P. gingivalis). Studies have shown that just before someone starts to experience the onset of RA symptoms, the concentration of antibodies against P. gingivalis begin to increase. Additionally, P. gingivalis leads to earlier onset, faster progression, and greater severity of RA, including increased destruction of bone and cartilage tissue. (Connect Tissue Res 2012;53(4):327–33)

One of the latest studies in this area, published in October 2018, found a connection between RA and tooth loss. The more teeth you lose, the greater your risk of developing RA and experiencing increased joint inflammation. (Korean J Intern Med 2018; kjim.2018.093)

A full set of adult teeth, including wisdom teeth, numbers 32. A study involving 540 patients with very early-onset RA found that 24 percent had 10 or fewer teeth, 15 percent had 11 to 20 teeth, 36 percent had 21 to 27 teeth, and 22 percent had 28 or more teeth. The RA of those with the fewest teeth (10 or less) progressed the fastest. These people experienced higher rates of inflammation and more swollen and tender joints as the disease progressed. They also had the least positive response to any type of therapy.

Patients with fewer than 20 teeth have also been found to have eight times the risk of having at least one swollen joint compared to those with all 32 teeth.

Hippocrates suggested pulling teeth could cure arthritis. The procedure wasn’t that uncommon a century ago. Fortunately, periodontal disease can be treated and controlled, and removing teeth isn’t required to treat RA.

It stands to reason that if periodontal disease and its accompanying inflammation either causes or exacerbates RA, then getting it under control is a good way to treat RA. And research shows that’s exactly the case. If you get rid of infections and inflammation in the mouth, it will subdue it in the joints.

Researchers at Case Western University tested this theory on 40 patients with severe RA. Half the people were given deep, nonsurgical dental cleanings, while the other half were given instructions from a dentist on how to keep their teeth clean at home.

Within six weeks, those who had the professional cleanings had significantly less pain and morning stiffness and fewer swollen and painful joints than the group that cleaned their teeth at home. Not surprisingly, the researchers also found that those receiving the professional deep cleanings had far less of the inflammatory proteins that trigger joint inflammation in their blood. (J Periodontol 2009 Apr;80(4):535–40)

If you have RA, eliminating periodontal disease is a no-brainer. If your doctor hasn’t mentioned this, then maybe it’s time to look for a new one. Regular dental cleanings and care should be part of every RA treatment program.

Beyond RA

Arthritis wasn’t the only condition found to be associated with pathogenic bacteria in the oral cavity. Various forms of bacteria are known to attack and damage not just the joints, but also the heart, nervous system, kidney, liver, and brain. While I’ve primarily discussed joints, more and more “new” discoveries are linking many of our most prevalent diseases to oral pathogens as well.

Periodontal disease increases the risk of cardiovascular disease by 19 percent (and that number jumps to 44 percent for those 65 and older) and heart attack by 78 percent. Type 2 diabetes patients with severe periodontal disease have 3.2 times greater mortality risk compared to diabetics who do not.

Pathogenic bacteria from the oral cavity also appear to be linked to many forms of autoimmune disease. If you suffer from any chronic inflammatory condition, don’t overlook periodontal issues as a contributing cause or factor.

Finally, in what may be one of the most important studies to be released so far this year, researchers have identified P. gingivalis in Alzheimer’s patients and discovered that this bacterium appears to drive the brain destruction associated with the disease. The ramifications of these findings could be a gamechanger in both the prevention and treatment of this horrible disease. (Science Advances 23 Jan 2019. DOI: 10.1126/sciadv.aau3333)

While there have been other infectious agents implicated in the progression of Alzheimer’s, prior to this study there hasn’t been any convincing research to pinpoint exactly what causes the disease.

This latest research was performed at the University of Louisville. The researchers discovered that in animal models, an oral P. gingivalis infection led to brain colonization of the bacterium, along with increased production of the telltale amyloid plaques commonly associated with Alzheimer’s disease.

The research also went a step further and revealed that the toxic enzymes specifically produced by P. gingivalis were present in the nerve cells of patients with Alzheimer’s. These are the neurotoxins that lead to the destruction of nerve cells in the brain and the formation of amyloid plaques.

The researchers were testing synthetic drug compounds that could block the action of these toxic enzymes. Although their focus wasn’t on methods of preventing Alzheimer’s, their work has spotlighted periodontal disease as a cause of the brain condition.

Alzheimer’s is a horrendous disease. More than 5.7 million Americans have it, and over the next 30 years that number is expected to rise to 14 million. Between 2000 and 2015, deaths from Alzheimer’s have increased 123 percent. It is currently the sixth leading cause of death in the United States, killing more people than prostate and breast cancer combined. None of this is that surprising when you look at the corresponding prevalence of periodontal disease in this country.

The National Health and Nutrition Examination Survey assessment in 2009–2010 determined that the rate of periodontal disease in the general US population over age 30 is 47.2 percent, with 30 percent being moderate and 8.5 percent being severe. In adults 65 and older, prevalence rates increase to 70.1 percent. (J Dent Res 2012 Oct;91(10):914–20)

Living with chronic periodontal disease is a recipe for longterm disaster. Periodontal disease is the equivalent of having a constant intravenous drip of toxins entering your body on a 24/7 basis. If you don’t have a health goal this year, resolving or preventing gum disease would be a very worthwhile one.

Legal CMA Disclaimer:

Although this article may contain factual information, the information contained in this article has probably not been evaluated by the FDA nor is it in any way intended to be medical advice.

Unfortunately I must recommend that for any change in medical or health behavior or for any change in the way you use prescribed drugs by your healthcare providers or before acting upon any of the advice given in this or any other article, that you consult with your licensed healthcare provider or physician.

Dr. Locker and his friendly, knowledgeable staff invite you to call Gentle Family Dentistry in Duncansville, PA for the greatest, most advanced, painless dental experience you have ever had.

You can call us at: 814-693-6777 or just click the link to
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And remember, You only have to floss daily the ones you want to keep.