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Factors that Contribute to our Oral Health
Genetics
Bacteria/Colonization
Bacteria/Colonization
Genetics are shown to contribute 30% to 50% of a person's susceptibility to periodontal disease. Congenital syndromes can lead to aggressive periodontitis. A table of genes has been sequenced that are thought to play a role in our systemic health. The key role of these genes are related to inflammation, immune response, blood factors, tissue repair and Vitamin D.
Bacteria/Colonization
Bacteria/Colonization
Bacteria/Colonization
Periodontal disease is caused by bacteria. The bacteria found in our mouth does not just stay there. It travels through out our bodies including our brain, heart, lungs and contribute to our overall systemic health. There are specific known pathogens that are more virulent than others (Porphyromonas gingivalis, Aggregatibacter (Actinobacillus) actinomycetemcomitans, Tannerella forsthia, and Treponema denticola).
Inflammation
Bacteria/Colonization
Environmental Factors
Inflammation occurs as a response to pathogens (bacteria) that are found in our mouth and through out our bodies. As pathogenic bacteria gain control of our mouth, they trigger the production of inflammatory mediators. This process leads to a loss of your periodontal structures and increases your susceptibility to other conditions including: cardiovascular disease, diabetes, dementia, cancers, respiratory disease, kidney disease, liver disease and auto-immune disorders.
Environmental Factors
Environmental Factors
Environmental Factors
The biggest environmental factor, and one that we can control, is smoking. The risk of any chronic disease is more than double for smokers, including periodontal disease. If you would like to quit smoking, contact your physician. You can also visit the CDC for information/resources. Another factor, stress. When our bodies are stressed it makes our immune system weaker. Stress may be hard to manage, but it is important to find healthy ways to relieve our stress.
Host Response
Environmental Factors
Social Factors
Our bodies would prefer to live in a homeostatic (balanced) state. As our body is overwhelmed with pathogens, it will trigger our immune response to eliminate them. However, some people may have compromised immune systems that cannot control and/or balance bacterial attack. Examples would include: Rheumatoid arthritis, Diabetes Type 1, Multiple Sclerosis, Inflammatory Disease's (gout, Chron's) and Parkison's.
Social Factors
Environmental Factors
Social Factors
Social factors include age, gender, socioeconomics and lack of oral hygiene. Let's take a look at the leading factor in this category: age. As we age our risk for periodontal disease and chronic diseases increase. Approximately 47.7% adults aged 30 and older have had some form of periodontal disease. That percentage increases to 70.1% in adults aged 65 years and older. While we can't help but get older, we can visit our dentist regularly for dental screenings and cleanings.
Systemic Diseases that Link to our Oral Health
Cardiovascular Disease (CVD)
Cardiovascular Disease (CVD)
Periodontal disease increases a persons risk for heart attack or stroke up to three times. A specific bacteria, Porphyromonas gingivalis (Pg), accelerates aortic and coronary atherosclerosis (hardening of the arteries). This bacteria has also been found in the heart valves of deceased patients.
Type 2 Diabetes
Cardiovascular Disease (CVD)
Type 2 Diabetes is a chronic disease where the body cannot produce sufficient insulin to neutralize sugar levels, causing glucose levels to rise, in some patients can be difficult to manage. As sugar levels rise, bacterial colonies grow causing inflammation and infections. In severe cases, can cause sepsis (blood infection), which can be fatal.
Alzheimer's Disease/Dementia
A recent 2023 study, found a direct correlation between periodontal disease and Alzheimer's. Again, we can thank our bacteria friend Pg for this. As blood travels through our bloodstream, to our brain, these bacteria go too. Guidelines and even medications are being tested to try and eliminate this bacteria. By controlling periodontal disease in our early years it will help reduce our risk for Alzheimer's.
Respiratory Disease
Respiratory Disease
The most common respiratory disorders linked with periodontal disease are bronchitis, chronic obstructive pulmonary disease (COPD) and pneumonia. Bacteria that grow in our mouth can travel to our lungs causing disease. If you already have a weakened respiratory system, i.e., asthma, periodontal issues can exacerbate these symptoms.
Immune Disorders
Respiratory Disease
Immune Disorders
Periodontal disease and immune disorders seem to work both ways. Bacteria in our mouth travel systemically causing inflammation and infection. When our bodies are immune compromised it makes it harder to fight infection, likewise, when our immune system is weakened bacteria can overgrow faster/easier. Most commonly linked immune disorder is rheumatoid arthritis.
Cancers
Respiratory Disease
Immune Disorders
John Hopkin's has found a 24% increase in developing cancer is patients with severe periodontitis (compared to those with mild or no periodontitis). The highest risk was associated with lung cancer, followed by colon cancer, and lastly oral cancer.