FAQ About Systemic Involvement

My gums bled when I was pregnant, does this mean that I have gum disease?

The hormonal changes taking place during pregnancy often cause inflammation and bleeding gums. While this is a sign of periodontal disease, it can be only temporary with pregnancy. If your oral hygiene is good and you have had regular cleanings up to that point, you probably have nothing to worry about with a little bleeding. However, there are new studies that point out an incredible link to periodontal disease and premature, low birth weight newborns. If you have periodontal disease, your risk is 7.5 times greater that you will give birth to a premature or low birth weight baby. This statistic is far larger than smoking or alcohol consumption. Given the increased mortality rate, health problems, and possible learning disability risks with prematurely born babies, a check-up with your periodontist or dentist should be a part of your prenatal routine.

How does diabetes affect periodontal disease?

Diabetes changes a patient’s response to infection and inflammation. Given the same genetic tendency toward periodontal disease, a diabetic individual will have more frequent and more severe problems. Since periodontal disease is an infection, and since inflammation is one of the results, diabetics often have multiple abscesses, heavier bleeding and earlier tooth loss. The good news is that studies show that well-maintained and well-controlled diabetics can have the same risks as non-diabetics. With close monitoring from you and your physician, and guidance from your periodontist and dentist, diabetes may only have a minimal effect on your oral health.

What is the link between diabetes and periodontal disease?

Diabetic Control: Like other complications of diabetes, gum disease is linked to diabetic control. People with poor blood sugar management are more prone to gum disease and are more likely to loose teeth than are people with good control. In fact, people whose diabetes is well controlled have no more periodontal disease than persons without diabetes. Children with IDDM (insulin-dependent diabetes mellitus) are also at risk for gum problems. Good diabetic control is the best protection against periodontal disease.

Studies show that controlling blood sugar levels lowers the risk of some complications of diabetes, such as eye and heart disease and nerve damage. Scientists believe many complications, including gum disease, can be prevented with good diabetic control.

Blood Vessel Changes: Thickening of blood vessels is a complication of diabetes that may increase the risk for gum disease. Blood vessels deliver oxygen and nourishment to body tissues, including the mouth, and carry away the tissues’ waste products. Diabetes causes blood vessels to thicken, which slows the flow of nutrients and the removal of harmful waste. This process can weaken the resistance of gum and bone tissue to infection.

Bacteria:Many kinds of bacteria (germs) thrive on sugars, including glucose — the sugar linked to diabetes. When diabetes is poorly controlled, high glucose levels in mouth fluids may help germs grow and set the stage for gum disease.

Smoking:The harmful effects of smoking, particularly heart disease and cancer, are well known. Studies show that smoking also increases the chances of developing gum disease. In fact, smokers are five times more likely than nonsmokers to have gum disease. For smokers with diabetes, the risk is even greater. If you are a smoker with diabetes and are age 45 or older, you are 20 times more likely than a person without these risk factors to get severe gum disease.

Why do I have bad breath?

There are several causes of bad breath. Mouth breathing from sinus problems, infection in the throat or tonsils, bacteria on the tongue or diseases of the lung or stomach can affect your breath. But by far the most prevalent cause of bad breath is periodontal disease. Bacteria living in the pockets around the teeth produce by-products that give off a strong odor. Often people mask these effects with mouthwashes or mints. It is much more effective, however, to treat the periodontal infection and see your periodontist and/or dentist for regular maintenance (re-care) therapy.

How bad is snuff or chewing tobacco to my gums?

The effects of tobacco exist no matter how it is ingested. Using tobacco not only increases your risk of coronary artery disease and stroke, it also reduces your immune response to viruses and bacteria. The use of tobacco products, therefore, opens the door to overgrowth of bad bacteria involved in periodontal disease. The type of periodontal infection seen with cigarette smoking is very specific to certain teeth and more difficult to address than others simply because one source of inflammation is so constant. Similarly, with oral tobacco use, you have the direct application of an irritant to the tissues. Precancerous changes become evident within several weeks of tobacco use. It is in the best interest of your oral and overall physical health to discontinue any type of tobacco use.

Is gum disease a strong risk factor for having a heart attack?

Periodontal (gum and bone) disease is a chronic, painless condition that gives off few warning signals, but one sign that you may notice is bleeding gums when you brush or floss vigorously. The bacteria that develop in the pockets around the teeth by the billions can cause serious health problems. Recent research has shown an increase in clotting of the blood when one of the most common of these bacterial species enters the bloodstream. Blood clots can obstruct normal blood flow, restricting the amount of nutrients and oxygen required for the heart to function properly. Also, the inflammation caused by periodontal (gum and bone) disease increases plaque build-up, which may contribute to swelling of the arteries. This may lead to heart attacks. Large studies indicate that those with gum disease have twice the usual risk of dying prematurely from heart disease.