Anyone who thinks periodontitis, when poor dental hygiene leads to compromised gum status and consequently tooth loss takes hold, is simply a disease of ageing might need to rearrange their mindset. One in five Australians has periodontitis and, with the incidence increasing minimally with ageing, it’s as much a disease of the young as it is of older folk.
On the plus side, we are faring much better than our American compatriots: a staggering 50 per cent of the US adult population has to deal with the consequences of this disorder, ramifications which extend way beyond mere gum decay and the forfeiting of one of our most prized natural assets.
Technically, periodontitis is a consortium of inflammatory diseases affecting the periodontium, the tissue that houses your teeth. Inflammation is usually a useful operation harnessed by our immune systems to ward off threatening microbes, but when this process becomes ongoing, often as a result of bacteria overcoming our defences and establishing a successful insurgency, we are forced to maintain some form of inflammatory cordon in the hope of one day defeating the enemy. The problem with inflammatory cells is they are highly rambunctious and in their need to vent their rage and indignation are compelled to attack our own tissue, inevitably seeding a pathway of decimation.
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What spawns the development of inflammation is the accumulation of fungi and bacteria at the base of the tooth, in the form of an amorphous lethal mass called dental plaque. Although this deadly explosive material can often generate a number of symptoms, including bleeding while brushing, flossing or biting into hard food, as well as redness of gums and bad breath, pain may not be a presenting feature, allowing the damage to proceed unnoticed until a probe is applied to your receding gums, which defines the extent of bone loss around the tissue cradling the teeth.
As many of us are not fastidiously devoted to flossing, especially when we are younger, poor dental hygiene is one of the primary reasons for the pre-eminence of this disease. Smoking, diabetes and elevated blood sugar are other documented causes of periodontitis. Dry mouth and the excessive consumption of carbohydrates and fructose found in fruit juices also encourage harmful bugs to replicate.
Aside from the devastating consequence of possibly losing teeth, the inflammatory wildfire unleashed by periodontitis has the potential to extend way beyond the mouth. There virtually isn’t a medical condition that isn’t linked in some documented fashion to this insidious disorder. Blocked arteries and heart disease, blood clots, stroke, lung infections, prostatitis, erectile dysfunction and even Alzheimer’s dementia are all connected.
Autoimmune diseases such as rheumatoid arthritis and Hashimoto’s thyroiditis are associated in a bidirectional fashion, with research suggesting periodontitis might be a trigger for these diseases as well as causing their symptoms to be more disabling, while also manifesting in a more severe fashion if these conditions are present. Periodontitis causes blood glucose levels to escalate, making diabetes increasingly unmanageable. Obesity is another end result of a situation that is raging out of control.
Treatment
What makes periodontitis so difficult to restrain once it has set in is the presence of a rather malicious and unscrupulous triumvirate of germs known as “the red-complex” bacteria, including Porphyromonas gingivalis, Tannerella forsythia and Treponema denticola, a group that are as foreboding as they sound. Not only do these bacteria overcome a local immune system that is well armed and usually highly competent, they also commandeer a flotilla of inflammatory cells, employing them to cut a swathe of destruction through vulnerable gum tissue, allowing the establishment of an impenetrable fortress that is hell-bent on eroding bone, which ultimately makes teeth unstable.
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Treatment needs to eradicate the safe haven that houses the inflammatory cells and bacteria that are not only locally active but are also conducting regular sorties all around your body. Once the periodontologist has removed the plaque that harbours the insurrection, daily use of an interdental brush — or twice daily if the disease is advanced — is mandatory to prevent any calculus or infective material from reaccumulating.
Aside from anti-bacterial mouthwashes such as chlorhexidine, and antibiotics in more severe cases, there’s a host of natural remedies that can play a preventive and treatment role. Various strains of Lactobacilli and Bifidobacteria have been shown to reduce inflammation and to neutralise the dangerous bacteria. Cranberry, green tea, xylitol lozenges, 4-methoxycarbonyl curcumin, aloe vera and soy isoflavones all have the power to eradicate plaque, inhibit bacteria and modulate inflammation, especially when delivered locally in the form of gels or rinses.
In the war against periodontitis, you need to enlist all of nature’s warriors.
