Bugs, Gums, and Blood Vessels
Research is filling in more details regarding the mechanisms by which periodontal bugs (bacteria) destroy the gums and bone and contribute to the development and progression of atherosclerosis (build-up of waxy plaque on the inside of blood vessels).
Periodontal bacteria have been shown to damage the arterial lining of blood vessels and lymphatic vessels by creating spaces between the cells in the arterial lining, allowing the bacteria and anything smaller, including HDL, LDL, etc., to migrate into the arterial walls and contribute to the formation of plaque.
Research published recently demonstrates the mechanism by which P. gingivalis (a type of bacteria found in the mouth) is involved in the onset of inflammation and tissue destruction in periodontal disease and the initiation and progression of atherosclerosis.
Dental plaque accumulation under the gums leads to the development of periodontal pockets. The gingival crevicular fluid, an inflammatory exudate, is the source of nutrients essential for the growth of P. gingivalis. These nutrients are present in low levels in healthy individuals but drastically increase during gum inflammation.
P. gingivalis has been seen in many sites other than the mouth. It has also been shown to survive in other type of cells including smooth muscle cells. Smooth muscle cells are integral components of arterial cell walls. In addition to surviving in these various cells, P. gingivalis spreads from one cell to another, potentially using these cells as a means of transportation, traveling to peripheral tissues.
These periodontal bugs have been found in atherosclerotic plaques. And, in animal models, P. gingivalis has been shown to accelerate arterial plaque formation.
Saliva DNA testing is now available to check for these bugs. There are two types of tests. One is My Perio Path, which finds out which type of bacteria are triggering a patient’s periodontal disease.
The second one is the Celsus One, which tests for eight gene markers associated with inflammation. This test tells if you are genetically wired to develop inflammation. Remember, if there is bleeding in the gums, there is inflammation. And, if there is inflammation in the gums, there is also inflammation in the arteries. If your gums bleed during a routine teeth cleaning, then your gums are not healthy.
With the advent of these tests, dentists are able to
Personalize therapy by establishing which patients are at risk before clinical signs and symptoms appear.
Determine which patients may require more aggressive treatment and optimize timing of re-care appointments instead of guessing if patients are supposed to get their teeth cleaned every three, four, or six months.
The photo below shows bacteria present in a patient’s mouth viewed on a microscope. As you can see, there are a lot of black spots (these are the high risk bacteria). If you were looking at this live, you would see a tremendous amount of movement on the screen. This is an unhealthy mouth.
The second photo (see below) shows a healthy mouth. You can see that the screen is relatively clear.
Prevention is always the best path. Get the tests done, so you can prevent these problems before they start. If your gums bleed when you have your teeth cleaned, talk to your dentist now.