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Periodontal disease, the advanced form of gingivitis, is nasty, nasty stuff. I try and impress this on my patients here in Los Angeles, and we’ve given it some space on the blog, as well. But it’s worth repeating. Over and over. You don’t want periodontal disease.

Los Angeles Porcelain VeneersWhy don’t you want periodontal disease? Well, for starters it’s bad for your mouth, for a whole litany of reasons, not the least of which is that it’s painful. And furthermore, it could be bad for everything else. There is currently a wide and growing body of research linking periodontal disease to any number of more severe health problems, such as diabetes, cancer, heart disease and even dementia. Studies that show that heart surgery patients, for example, are twice as likely to have gum disease than the regular population. Or others that tie diabetes to people who brush less than twice a day.

How do you know if you have it?

If your gums are regularly red, swollen, and sensitive, for no particular reason, you may have periodontal disease or may be developing it, and you should see a dentist to find out. If your gums regularly bleed when you brush or floss, you may have periodontal disease or may be developing it, and you should see a dentist to find out. If your breath stinks constantly or your teeth are coming loose for no apparent reason, you may have periodontal disease or may be developing it, and you should see a dentist to find out. If you have pus in your mouth, well, you might want to go to the doctor immediately, but I would hope you would go to a dentist, after.

This has all been common knowledge in the dental community for quite some time, what’s new is that we now understand the mechanism by which it happens. A new study performed by researchers at the University of Pennsylvania paints a much better, and geekier, picture of just how pernicious the disease can be.

The bacteria that cause periodontal disease are not very numerous in the mouth, and never grow to become such, even in advanced cases. Instead, they wreak havoc by creating generally favorable conditions for other bacteria.

Porphyromonas gingivalis (PG) feeds off of substances your body secrets as part of its natural immune response, which creates a conundrum, in that the body’s natural immune response is fairly effective at killing bacteria.

PG has an ingenious, almost nefarious solution to the apparent dilemma. It acts simultaneously to suppress the body’s actual immune system, while leaving intact its inflammatory response, a central component thereof. With the body left largely defenseless, other bacteria in the mouth thrive, settling in tight spaces, where they cause cavities and attack the gums. This triggers an inflammatory response that, deprived of its ability to actually kill bacteria, serves essentially to feed the PG bacteria, and to further its efforts to create colonizable conditions in the mouth.

PG, in other words, turns the body against itself, which sounds about as evil as it is.

Understanding how this works may inform medical strategies to mitigate the effects, such as treating gum disease with anti-inflammatories, rather than drugs that target the bacteria themselves. But for now, let it serve simply to scare you enough to lay off the cigarettes — a major cause of periodontal disease — and the sugar — another — and to see your dentist regularly, which is always the best way to catch and prevent dental disease in the first place.

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