The Cochrane review by Simpson et al. in 2015 showed that the treatment of periodontal disease does improve glycemic control in individuals with diabetes, with a mean reduction of 0.3% in blood sugar (HbA1c) level at 3-4 months after periodontal therapy, which may be as good as the effect of adding a second drug to their pharmacological regime.
Where cardiovascular disease is concerned, robust evidence from observational and epidemiological studies suggests a positive association between periodontal disease and cardiovascular disease, especially severe periodontitis. “Periodontal disease may increase risk of future atherosclerotic cardiovascular disease. As both periodontal disease and cardiovascular disease are complex chronic inflammatory diseases that share similar risk factors like stress, diabetes and diet; inflammation in the gums may contribute to the systemic inflammatory burden of the body which may increase the risk of cardiovascular disease,” says Dr Lew.
Emerging evidence from epidemiological and clinical studies have also revealed that periodontal disease is more common and severe in patients with rheumatoid arthritis as both diseases share similar mediated pathogenesis, pro-inflammatory cytokines and environmental and genetic risk factors.
As one in five Malaysians has been identified by the National Health and Morbidity Survey 2019 as being obese and over-weight, individuals who fall into this category may need to note that studies have shown a significant association between obesity and periodontal disease, in that there is a higher risk for obese or over-weight individuals to develop periodontitis.
In listing other health conditions or factors that may pre-dispose individuals to certain oral health issues, Dr Lew cites poor immunity or individuals who are immunocompromised due to illnesses like HIV/AIDS, and patients who are under cancer therapy which results in lower immunity may have increased risk of getting gum disease, while reduced saliva flow may predispose them to root caries.
“Lifestyle factors like smoking also increases the risk and severity of gum disease and impaired treatment response. Stress, which lowers one’s immunity and a non-healthy sugary diet of carbonated drinks and excessive alcohol consumption, may also contribute to caries or periodontal disease
“Finally, hormonal fluctuations in puberty and pregnancy may exacerbate gum inflammation and hypertension drugs may also contribute to gingival enlargement.”
In reemphasising good oral health practices that are key to keeping your pearly whites and gum disease at bay, Dr Lew advises brushing your teeth with fluoridated toothpaste twice a day and use dental floss or an interdental brush to clean the gaps between your teeth.
“Do schedule a dental check-up once every 6 months, refrain from smoking and drinking alcohol excessively, eat a balanced diet, and maintain physical activity and regular exercise,” she adds.
Gum disease may be detrimental to pregnant women as there is moderate evidence that pregnant women with gum disease may have a higher chance of delivering a premature baby or a baby with a lower birth weight. “Genetics also play a role so individuals with family members that have periodontitis should keep a lookout for the condition and ensure strict oral hygiene,” says Dr Lew.
