Alvin H. Danenberg, DDS • Nutritional Periodontist
January 8, 2018
Many dentists and physicians, whom I know, have some degree of gum disease. How do I know? I can diagnose gum disease when I do a periodontal examination. Sometimes, I can see gum disease when a person smiles. Occasionally, I can smell gum disease on the breath.
There are primarily two stages of gum disease: gingivitis and periodontitis.
Gingivitis is inflammation and infection in the gum tissues, which do not involve the bone of the jaw. Sometimes, gingivitis can progress to the advanced stage of gum disease called periodontitis. Periodontitis involves infection in the gum tissues as well as the surrounding jawbone that supports the teeth.
Cause of Gum Disease
So, why do these healthcare professionals have gum disease?
Occasionally, it is because they don’t brush and clean between their teeth properly. Just because a person is trained to be a healthcare professional, he or she doesn’t necessarily take care of his or her mouth correctly. However, there is an underlying cause of gum disease that is independent of how well a person cleans his or her mouth.
A change in the bacteria in the gut can change the bacteria in the mouth. Then, a give-and-take can occur between unhealthy bacteria in the gut and unhealthy bacteria in the mouth. [1] The change from a healthy balance of bacteria to an unhealthy level of pathogenic bacteria is called dysbiosis.
There are many factors that can cause an increase in unhealthy bacteria (or dysbiosis) in the gut. Some of these factors include poor food choices, chemicals in food, stress, poor sleep, some prescription and over-the-counter medications, low-level electromagnetic fields, over-exercising, and sleep apnea.
As I mentioned, medical research shows that dysbiosis of the gut microbiome and dysbiosis of the oral microbiome affect one another. Therefore, both the gut and the mouth must be addressed if a healthy result is the goal. If only the gut or only the mouth were to be treated independently, the other location of dysbiosis could continue to spread back and forth.
Prevalence of Gum Disease
Gum disease is not a stranger in today’s modern world. The prevalence of gum disease in the US is staggering, in my opinion.
A study was published in 2010 in the American Journal of Dentistry. This peer-reviewed paper demonstrated that 93.9% of adults in the United States had some form of gum inflammation or gum bleeding. [2]
In 2012, the Centers for Disease Control and Prevention (CDC) published their results in the Journal of Dental Research. [3] It showed the prevalence of periodontitis was estimated to be 47.2% for American adults. For adults 65 years old and older, the prevalence jumped to 70.1%.
Be Proactive
I encourage everyone to evaluate their diet and lifestyle. The choices we make can improve our overall health and the health of the mouth. [4] From my point of view, dental diseases are frequently a sign that healthy bacteria in the mouth have gotten out of balance. Pathogenic bacteria have taken control, leading to dysbiosis.
Poor food choices certainly feed gum disease, tooth decay, and pathogenic bacteria. However, published science [5], [6], [7], [8], [9] suggests that the overgrowth of harmful bacteria in the mouth is a direct result of (1) the friendly bacteria in our gut becoming overwhelmed by pathogenic bacteria, (2) the gut lining becoming damaged, allowing toxic elements to seep into the blood system (called “leaky gut”), and (3) our immune system becoming compromised.
Once gum infection is allowed to progress, toxic substances in the infected gum spaces could enter the blood system. Chronic systemic inflammation could result from a “leaky gum space” just as chronic inflammation could result from a “leaky gut”.
No one is immune to gum disease. My medical and dental colleagues certainly are not immune to gum disease. Since there is an epidemic of gum disease in the US [10] based on the prevalence of dental disease, it is no surprise that many dentists and physicians have fallen victims to this disease. The goal should be to regain homeostasis of the gut and oral bacteria along with practicing efficient oral hygiene.