Dental disease is linked to heart disease

Dentistry: When sick teeth hit the heart

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Whether we bite into a crunchy apple for breakfast or chew a fibrous steak at lunch, small remnants stick to our teeth at every meal. A coating is created on which bacteria settle and multiply over time - which can unbalance the oral flora. The immune system tries to fight the bacteria, which leads to inflammation. In the worst case, the tooth support system becomes ill and periodontitis develops.

Every second German today suffers from periodontitis. Many without knowing it. This problem with the teeth, in addition to their loss, can possibly lead to other serious diseases in the body. Doctors suspect that heart attacks or type 2 diabetes could be the result. Even Alzheimer's has been linked to periodontal disease. So can good dental health protect against certain diseases?

With periodontitis, the gums and the jawbone, among other things, become inflamed. Both recede in the course of the disease and the tooth necks are always exposed. Gum pockets develop into which bacteria can penetrate and multiply. "If periodontitis is particularly severe, the disease can spread to the entire oral cavity. Taken together, the inflamed area can then be about as large as that of your own hand," says Henrik Dommisch, head of the periodontics department at the Berlin Charité. "The immune response is enormous in such a case."

Periodontal disease and diabetes could be mutually reinforcing

This has consequences for the body. Cytokines, messenger substances released by immune cells, can increase blood sugar levels by preventing blood sugar from reaching the body's cells. So the body has to produce more insulin, which ensures that the sugar is transported out of the blood. This could deplete the insulin-producing cells in the pancreas and contribute to the development of diabetes.

Dental health

What causes periodontal disease?

A Inflammation of the gums (gingivitis) or the teeth supporting structures is caused by leftover food that sticks to the teeth. These Toppings are the Food for certain bacteria multiply in the mouth that multiply. If the initially soft deposits are not removed, they solidify due to the storage of minerals. Bacteria can then penetrate to the root of the tooth with the plaque. Over time they form Gingival pocketsin which the bacteria can settle. The body tries to fight this with the help of its immune system. How severe the subsequent inflammation is depends on how strong the body's defenses are. However, it is important: Periodontitis and gingivitis never develop without bacteria on the plaque. How quickly the inflammation develops and progresses, on the other hand, depends on various factors.

What increases the risk of getting sick?

stress and Conditions like diabetes or smoking can increase the risk of periodontal disease developing and progressing quickly. According to the German Society for Periodontology (DG Paro), smoking is particularly problematic.

What preventive measures are there?

According to the DG Paro, it is enough that Brush teeth twice a day and once a day with Use floss to clean the spaces in between. If plaque is overlooked and it solidifies over time, professional teeth cleaning can also help.

How is periodontal disease treated?

If periodontitis develops, there are various measures to treat it, depending on the severity of the inflammation. Is the Focus of inflammation still small, will the Root surfaces as Gingival pockets in a Dental office cleaned. If the bacteria in the area are particularly aggressive, antibiotics can also be used. If the bacteria are inaccessible to dentists because they are too deep in the gum pockets or if the jawbone has receded significantly in the course of the disease, this is a surgical intervention necessary.

Accordingly, it seems plausible that periodontitis promotes diabetes. Researchers at the University of Eastern Finland checked whether this can also be observed in real life. For a study, they divided almost 400 test persons into three different groups, depending on the depth of their gum pockets: four to five millimeters, more than six millimeters and toothless. The subjects were examined for the first time between 1990 and 1992. Further examinations followed 15 years later. It turned out that the risk of diabetes was increased by 32 percent in people with gum pockets up to five millimeters deep compared to healthy subjects. In the group with the deepest pockets it rose by more than 50 percent. (Journal of Clinical Periodontology: Myllymäki et al., 2018)

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Periodontitis and diabetes may be mutually dependent. Because diabetes is associated with wound healing disorders. In addition to reduced blood flow and a changed insulin metabolism, so-called advanced glycation end products, which accumulate when blood sugar is high, inhibit wound healing.