Treating gum disease may lessen the burden of heart disease, diabetes, other conditions

In the folk song “Dem Bones,” every bone is connected to the next one in line. Here’s an interesting wrinkle on that idea: The gum bone, or at least problems with it, are connected to all sorts of health problems.

Gum disease—which begins when the sticky, bacteria-laden film known as plaque builds up around your teeth—is closely linked to premature birth, heart disease, diabetes, and other chronic health problems. Now, a report in the August issue of the American Journal of Preventive Medicine finds that treating gum disease (also called periodontal disease) can lead to better health — as evidenced by lower health care costs and fewer hospitalizations — among people with common health conditions.

The study looked at health and dental insurance records from nearly 339,000 people, all of whom had periodontal disease and one of five conditions: type 2 diabetes, cardiovascular disease, cerebrovascular disease (usually a stroke), rheumatoid arthritis, or pregnancy. Researchers found that people with four of the five conditions (all except rheumatoid arthritis) who had at least one periodontal disease treatment had lower medical costs and fewer hospitalizations within four years of the treatment compared with people who weren’t treated.

The savings were especially striking — 74% lower — among pregnant women. The savings came from avoiding the costs associated with premature births, which has been linked to periodontal disease, and other complications. People with cardiovascular disease and diabetes who had their periodontitis treated had health-care costs that were between 20% and 40% lower.

“This is a really solid finding and a testimony to what we’ve been preaching,” says periodontist Dr. Alpdogan Kantarci of the Harvard-affiliated Forsyth Institute, a not-for-profit research organization focused on oral health. Daily tooth brushing and flossing can prevent and even reverse the earliest form of gum disease, called gingivitis, says Dr. Kantarci.

Left untreated, gingivitis can turn into periodontal disease. The gums pull back from the root of the tooth, creating a tiny pocket that gradually widens. Eventually, the infection and inflammation attack the tissue that holds the tooth to the jawbone, which can cause the tooth to loosen and possibly fall out.

A dentist or hygienist can treat periodontal disease by cleaning the teeth above and below the gum line, a procedure known as scaling and root planning (SRP). They use manual scalers or ultrasound devices to scrape away hardened plaque (tartar). Most people only need local anesthesia, such as a shot of Novocain.

The common thread between gum disease and chronic health conditions is inflammation — the body’s natural response to an infection or injury. The build-up of inflammatory substances in the blood seems to worsen heart disease, diabetes, and other chronic conditions. Eliminating the gum infection may dampen that harmful response throughout the body.

Bottom line: As your dentist always tells you, brush and floss every day to keep your gums healthy. Be on the lookout for these signs of gum disease—especially if you’re pregnant or have a history of heart disease, stroke, or type 2 diabetes—and seek treatment.

Gum disease develops when inflammation spreads to the tissues that support the teeth. Healthy gums (A) are firm and tightly hug the teeth. Without proper cleaning, plaque can build up where the gum tissue meets the tooth. As plaque accumulates, the gum tissue pulls away from the tooth, creating a tiny pocket. The gums become inflamed, a condition called gingivitis (B). Gingivitis can get worse, causing a more severe gum disease known as periodontitis (C). Here, the pocket widens as the gum pulls back from the root of the tooth. The disease also destroys the periodontal ligament and bone, reaching the tooth socket. Depending on the level of severity, the ligament and bone damage can cause the tooth to become loose, and it may fall out.