Periodontitis: Why the hidden inflammation in the mouth is so dangerous

According to the current fifth German Oral Health Study (DMS V), every second middle-aged adult suffers from periodontitis. Among seniors, 75 percent are affected by the mostly chronic inflammation of the periodontium. Periodontitis is therefore one of the most common chronic inflammatory diseases worldwide. The insidious thing about periodontitis is that it usually goes completely unnoticed at the beginning and therefore remains untreated. Periodontitis is one of the risk factors for systemic diseases such as Alzheimer's, diabetes and cardiovascular diseases. Find out here how periodontitis develops, what consequences it can have and how you can protect yourself.

How does periodontitis develop?

Periodontitis is an inflammation of the periodontal ligament. This includes the gums, the tooth, the tooth socket and the periodontal membrane. Our mouth is populated by countless bacteria. Don't panic, these bacteria are part of our microbiome and are usually quite useful. They colonize the mucous membrane in the mouth and throat so densely that harmful bacteria hardly have a chance to spread. However, inadequate oral hygiene can also cause harmful bacteria to spread in the rough plaque. As a result, plaque hardens into tartar due to the deposit of minerals, and the gums are attacked by acidic metabolic products of the bacteria. Red gum edges are a sign of developing gingivitis. As the disease progresses, the bacteria get between the gums and the neck of the tooth and form pockets in which they can continue to multiply. The pockets on the teeth can no longer be cleaned without professional support. The ongoing inflammation leads to a recession of the gums, allowing the bacteria to penetrate even further and attack both the tooth root and the surrounding bone tissue. The tooth loses its hold and is at risk of being lost.

Further consequences of periodontitis

But the insidious thing about periodontitis is not just the threat of tooth loss. In its early stages, the disease is often not noticed or ignored. The redness of the inflamed gums is often rather inconspicuous and other typical signs of inflammation, such as swelling or pain, are usually not present. Bleeding gums, a typical symptom of gingivitis, is more likely to be attributed to vigorous brushing of the teeth or to foods that are too crunchy. In addition, teeth become more vulnerable as we get older. While only about one in seven people in their 30s is affected by periodontitis, more than half of those aged between 35 and 65 are affected. The number rises to over 75 percent among seniors. It can therefore be described as a real widespread disease, and one that should not be taken lightly. The hidden, inflamed areas quickly become the size of the palms of the hands. Such a large area of ​​inflammation can affect the entire body and influence systemic diseases. Inflammatory messengers such as CRP (C-reactive protein) spread throughout the body and are suspected of triggering further inflammation or unnecessarily exacerbating it. Since teeth naturally pierce the mucous membrane, inflammation in the area of ​​the tooth root also makes it easier for bacteria to enter the bloodstream.

Periodontitis and Diabetes

Numerous studies have shown an interaction between periodontitis and diabetes mellitus. Diabetics are 3.5 times more likely to suffer from periodontitis. The reason is believed to be that the increased blood sugar level increases the risk of inflammation. This can make periodontitis easier to develop and more severe. The inflammatory messengers of periodontitis can, in turn, affect the course of diabetes. They are able to block insulin receptors and thus promote insulin resistance. This makes it more difficult to regulate blood sugar levels by administering insulin.

effects on cardiovascular diseases

There is also evidence of a connection between periodontitis and the occurrence of coronary heart disease. In patients who have suffered a heart attack or stroke due to deposits in the coronary arteries, bacteria from the mouth were found in these deposits. These bacteria appear to at least promote the calcification of blood vessels. The involvement of bacteria from the mouth has also been shown to occur in inflammation of the inner lining of the heart and the heart valves. In addition, periodontitis appears to play a role in other systemic diseases such as Alzheimer's, Crohn's disease or rheumatoid arthritis. However, further studies will have to show how great the influence actually is, especially since systemic diseases are usually promoted by more than one triggering factor.

risk factors for periodontitis

The risk of developing periodontitis is influenced by various factors:

• Genetic predisposition: If the disease progresses more rapidly and severely in younger people, this is often due to genetic factors.
• Diabetes: As described above, diabetes also increases the risk of periodontitis
• Smoking: The risk of periodontitis is two to seven times higher for smokers. Smoking can lead to a narrowing of the blood vessels in the mouth and thus poorer blood circulation. This delays wound healing and allows the inflammation to spread more quickly. In addition, the typical warning signal of bleeding gums does not occur as often.
• Psychological stress: Stress can have a negative impact on the immune system and thus increase susceptibility to infections.
• Hormonal changes can also lead to an increased susceptibility to infection. This particularly affects women during pregnancy. They are at a significantly higher risk of periodontitis.

What can I do myself?

The treatment of periodontitis must always be carried out by a dentist and includes the removal of all plaque and tartar, as well as cleaning the periodontal pockets. In severe cases, surgery may even be necessary. Careful oral hygiene is also important. In addition to a toothbrush, an interdental brush or dental floss should be used, as a lot of plaque starts in the spaces between the teeth. The use of mouthwashes can also be useful. Dental health can also be supported through diet. Fruit, vegetables and whole grain products not only contain valuable vitamins, but also strengthen the gums because they have to be chewed more vigorously. An anti-inflammatory diet can also be useful. Anti-inflammatory diet is based on the principles of Mediterranean cuisine and is characterized above all by fresh, regional and seasonal products. Meat and animal fats are only used in small quantities or are replaced by fish and vegetable oils. This creates a more favorable ratio of omega-3 to omega-6 fatty acids . The additional intake of Omega-3 oil capsules can also be useful in this context.