The periodontitis epidemic

Periodontitis is a gum disease that, according to the Centers for Disease Control and Prevention, affects one out of every two American adults aged 30 and over. The problem with this disease is: Although it can lead to bone resorption and tooth loss, it goes unnoticed for a long time.

Many people report occasional bleeding gums. Some even assume that it’s something normal. But it isn’t! As with any other type of bleeding, bleeding gums are a sign that something isn’t right. In this case, it is a symptom of gingivitis. This means that bacteria have penetrated into the space between teeth and gums and are in the process of causing damage.

Bacteria imbalance

There are over 600 different species of bacteria in the mouth. Many of these are useful and contribute to oral health, but some are also harmful. As long as this bacterial community is balanced, their numbers are self-regulated. If certain circumstances conspire to shift this balance in favor of the harmful bacteria, however, these bacteria are able to spread increasingly easily.

In the course of periodontitis gingival pockets are getting deeper and the jawbone is broken down.

Vicious circle culminating in tooth loss

Many periodontitis-associated bacteria do not like oxygen and therefore prefer to colonize areas of the mouth in which the oxygen concentration is not so high – e.g. in the space between teeth and gums. Here, the bacteria then emit certain substances that attack both the gums and the jaw. Together with the immune system response to the bacteria, this leads to the spaces becoming deeper, resulting in the formation of “periodontal pockets”. These provide ideal living conditions for the periodontitis-associated bacteria. These bacteria proliferate and cause the periodontal pockets to become ever deeper. A vicious circle ensues. If this process is not stopped, this can lead to gum recession and bone resorption in the jaw in the long term.

Important to know: Beyond a certain stage, the damage caused by the bacteria can no longer be reversed. If you do not act promptly, the end result may be tooth loss.

Immune response influences the disease

Although bacteria are the main cause of the disease, its course is also influenced by other factors. The immune response to the invaders in particular is what leads to tissue damage and, in the long term, to bone resorption. The speed and intensity with which the immune system responds to the infection depends partly on 3 aspects:

  • On the type of bacteria:
    The various bacterial species have their own individual characteristics and are capable of provoking the immune system to varying degrees.
  • On the quantity of bacteria:
    The fewer periodontitis-associated bacteria are present, the more effectively the immune system is able to respond to the situation.
  • On the patient’s genetic background:
    Some patients have a disproportionately intense response to bacterial infection. This is genetically determined. This is why some patients suffer from severe periodontitis despite having low levels of periodontitis-associated bacteria.

From the mouth into the body

The bacteria are not restricted to the mouth, however. They can also enter the bloodstream via the inflamed gums. They therefore represent a risk to the whole body. Some periodontitis-associated bacteria accumulate on vessel walls, for example, and increase the risk of certain cardiovascular diseases. Other possible consequences include: Complications of pregnancy, rheumatoid arthritis, chronic respiratory tract infections and pneumonia. Diabetes and periodontitis even influence each other. This is why diabetes patients should be particularly conscientious about getting their gums checked.