Happy New Year – Highlights of 2023 – Part 4 – October

Then the next instalment Mind, Body, Mouth, it’s all connected. Dental Health Week 2023 – Diabetes

DIABETES

The impact of periodontal disease on insulin resistance and blood sugar control potentially exacerbates diabetic complications. As this year’s resources detail: “severe gum disease is now considered to be the sixth issue with diabetes. It makes controlling diabetes harder and diabetes will make gum disease worse”.

Severe gum disease has a strong association with diabetes and heart disease. Bacteria from gum disease can spread through the bloodstream, leading to arterial and blood vessel issues. Managing diabetes becomes more challenging when gum disease is present, and in turn, diabetes worsens gum disease.

Mind, Body, Mouth, it’s all connected. Dental Health Week 2023 – Lungs

Lungs

Periodontitis and respiratory diseases share common risk factors including smoking, obesity and diabetes. There is early evidence supporting the association between periodontitis and some common respiratory diseases – chronic obstructive pulmonary disease (COPD), obstructive sleep apnoea (OSA) and COVID-19.

There are several hypotheses for the association between periodontitis and respiratory diseases:

1. Micro aspiration of oral bacteria into the lower airways
2. Systemic elevation of inflammatory markers

Evidence is emerging for oral bacteria being a risk factor for aspiration pneumonia.

Mind, Body, Mouth, it’s all connected. Dental Health Week 2023 – Inflammatory Bowel Conditions

Early evidence indicates that there is a link between periodontitis and inflammatory bowel diseases in that they both share a common pathological make up and the disease outcomes are worse when both conditions are present in an individual.

Inflammatory bowel disease (IBD) is the broad term used to encompass conditions affecting the gastrointestinal tract including Crohn’s Disease and ulcerative colitis. It is estimated that one in 200 Australians suffer from inflammatory bowel conditions.

In inflammatory bowel conditions, genetically susceptible individuals have increased chronic inflammation due to an aberrant immune response to gut bacteria. Manifestations of the disease can be seen in the joints, eyes, skin, liver and mouth. Signs in the mouth are usually seen at the onset of gastrointestinal inflammation or follow it. The presentation of signs outside of the gut, vary between individuals.

Finally the month ends with Mind, Body, Mouth, it’s all connected. Dental Health Week 2023 – Pregnancy.

There is early evidence supporting the association between periodontitis and adverse pregnancy outcomes including preterm birth, low birth weight and preeclampsia.
There are several factors proposed to explain the association including:

1. Inflammatory mediators
2. Oral bacterial dissemination

The microbial imbalance in the mother’s oral cavity is thought to be linked to maternal immunity and infant health leading to some studies hypothesising this imbalance to be the link between the mouth and the adverse pregnancy outcomes.

Pregnancy related pathology in the oral cavity is most commonly found in gingival (gum) tissue. Gingival inflammation is plaque induced but modified by oestrogen and progesterone during pregnancy.

Studies have identified that these hormones can alter the micro-organism under the gums, compromise periodontal ligament cells (which hold the tooth to the bone) and change the maternal immune response. Gingivitis (gum inflammation) typically precedes periodontitis (inflammation of the ligament that holds the tooth to the bone).