Dentists are concerned people care more about having pearly whites than their overall oral health, despite gum health being a major risk factor for a slew of diseases.
Second only to the gut, the mouth is home to a diverse community of bacteria – known as the oral microbiome – with more than 700 species found on our tongues, gums and teeth.
This means poor oral hygiene – when brushing along the gum line, interdental brushing and tongue scraping are overlooked – can lead to wider inflammatory changes, driving the risk of diabetes, heart disease and even dementia.
As such, hygienist Laura Hempleman says daily interdental brushing – when you use a small pipe cleaner style toothbrush to clean between each tooth – is more important than a two-minute brush which only removes up to 80 per cent of plaque in the mouth.
‘Brushing alone is not enough,’ she said.
‘It’s all about interdental cleaning, spitting not rinsing to keep the toothpaste in for as long as possible and brushing the gums for longer, with just the weight of the toothbrush.’
And Dr Sebastian Lomas, a biochemist and dentist at Wonder of Wellness Clinic agrees that what starts off as inconvenient bleeding – a tell-tale sign of gum disease – can result in a chronic inflammatory response in the body.
He said: ‘In biological dentistry, we view the mouth as a mirror to the body.
Gum disease is thought to affect about four in ten people and this could lead to diabetes
‘Because the oral microbiome connects directly with the gut, sinuses and airway, shifts in bacterial balance or tissue tone often correlate with broader inflammatory or metabolic changes and vice versa.’
‘The mouth is not separate from the body,’ he continued.
‘Chronic gum disease is a persistent inflammatory condition which releases bacterial by-products and toxins into the bloodstream which can not only worsen insulin resistance, resulting in diabetes, but also changes in brain cells which defend against dementia.
‘In other words, poorly controlled oral inflammation can contribute to the metabolic dysfunction that underpins a range of systemic diseases, not just result from them.’
Yet, it is estimated that more than half of British adults either have gum disease or are at risk of developing it. And experts say these patients could be in danger of developing a host of life-threatening conditions.
Age increases the risk of developing gum disease, with around 90 per cent of people over 50 susceptible to the early stages of the disease, characterised by inflammation and bleeding.
It can also lead to bad breath, shrinking gums and loose teeth. it’s typically caused by poor oral hygiene – with people failing to floss and properly remove bacteria from the mouth – which allows plaque to build-up.
Left untreated, what started off as painless bleeding can progress into periodontal disease, which occurs when bacteria in the mouth erode the bone and tissue that hold teeth in place.
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Experts add that this is concerning because, once identified, gum disease is easily treated – a move which could also slash the risk of diabetes, heart disease and dementia.
A number of studies support the strong association between poor gum health and a plethora of diseases including a 26 per cent raised risk of type 2 diabetes.
As Dr Lomas explains, the presence of bacteria in the mouth and along the gum line can cause blood sugar levels to spike, providing the immune system with energy to fight fight off infection.
But over time, high levels of blood glucose can trigger diabetes – which raises the risk of serious complications including blindness, loss of limbs and even heart attacks.
‘But the good news is that if you treat gum disease in people with diabetes well, blood sugar control improves significantly, complication of diabetes reduce and overall health outcomes improve,’ Professor Iain Chapple, an expert in periodontology at Birmingham University said.
Research spearheaded by the institution found that tackling gum disease could prevent more than 300,000 cases of type 2 diabetes over the next decade.
Poor gum health has also been linked with key markers of cognitive decline and brain aging.
Experts argued the findings highlight the importance of good oral hygiene – often considered twice daily brushing, flossing and regularly visiting the dentist.
Brushing alone is not enough to ward off disease experts say. It’s better to focus on cleaning in between the teeth and ridding the mouth of potentially harmful bacteria
How do you scrape your tongue?
1. Stick out your tongue.
2. You should start the scraper at the back of the tongue.
3. Run the scraper all the way to the front 3 or 4 times.
4. Be sure to use light pressure
5. Rinse the scraper under warm water between scrapes.
6. Swish your mouth out with water afterwards or use mouthwash if you wish.
Tongue scraping can help boost oral hygiene dentists say
Surveys have shown however that as few as just three in ten Britons floss daily.
Assessing over 1,100 older adults, US researchers found that people with gum disease had more damage to the brain’s white matter.
After adjusting for factors that could skew the results, people with gum disease had a 56 per cent higher risk than those with healthy mouths.
That study followed findings from researchers at Boston University that bacteria associated with gum disease can produce changes in brain cells that defends against the build-up of amyloid plaque in the brain – which is thought to be behind the symptoms of Alzheimer’s.
Last year, US researchers also found that people with gum disease were 86 per cent more likely to suffer an ischemic stroke, which occurs when an artery in the brain is blocked by a blood clot.
Poor oral health generally also raised the risk of heart attacks and other cardiovascular conditions by more than a third.
Now dentists are urging people not to ignore bleeding gums, and focus on their overall oral health rather than just their teeth alone.
‘Bleeding is inflammation, not a brushing issue,’ Dr Lomas warned.
‘And when inflammation is disproportionate to lifestyle factors and brushing effort, it should raise a red flag as this could be a tell-tale warning sign before symptoms appear elsewhere.’
But there are a number of things you can do to ward off gum disease and minimise the risk of other more serious health problems.
Firstly, the dentists recommend focusing on what you can control daily, including cleaning interdentally every day, tongue scraping to remove bacteria that has built up over night, brushing gently at the gum line twice a day and supporting saliva by staying hydrated, reducing sugar and prioritising sleep.
‘But if you have ongoing bleeding, swelling, or recession, seek assessment,’ Dr Lomas advises.
‘Even if its private, early intervention is far less costly than advanced disease.
‘The earlier these issues are addressed, the better the outcome, both orally and systemically.’
