oral health

Inflammation and Your Oral Health

By Dr. Nammy Patel

When my patient, Derek, came into the office seven years ago, he explained that he’d been under a lot of stress, going through a divorce and dealing with custody issues. He was forty-two years old, and it had been two years since his previous dental visit. 

During my exam, I found he had bleeding gums, with a distinct keto odor. That set off alarm bells. I told him I was concerned that because of this stress, his age, and the telltale keto odor, he probably had periodontitis associated with diabetes. I asked him if he had had any lab work done recently, and when he admitted he hadn’t, I urged him to see his doctor.

Three weeks later, he came back to the office and told me he’d been diagnosed with type 2 diabetes. I sent him to a nutritionist, and after meeting with her, he decided to go raw and vegan. Now, seven years later, he’s doing much better—and he’s much more diligent about getting to the dentist! 

What I had seen in his exam was symptomatic of inflammation. Inflammation is your body’s response to injury, a way in which it tries to protect itself. This is a naturally occurring phenomenon, designed to work for you, but it does damage when it becomes a chronic condition. When you get a cut or a bruise, you’ve probably noticed that the area around that injury becomes reddened and warm. That’s because your immune system has sent out mediators (cytokines) to protect the area from infection. A very similar thing happens when you have an internal infection, such as pneumonia. 

When you’re injured or ill, this inflammatory response works to fight infection and to keep it from overwhelming your system, but when it goes into overdrive, it causes more problems than it solves. The example I like to use is when you’re in a traffic jam, even though you’re not getting anywhere, your car’s engine is still running, so the gas is being used up, and you might even run out of fuel before you get where you need to go. The same happens with inflammation: when the body is under attack and focused on fighting off the infection, its resources are used up and little energy is left for healing and proper function. 

Your mouth hosts a naturally existing population of bacteria, both useful and harmful. When the body suffers a trauma of some kind or a long-term illness, or if you suffer from an autoimmune disorder, these bacteria will overgrow. The body will send its foot soldiers, the cytokines and proteins, to fight off this infestation. At that point, you see the initial signs of inflammation, rubor (redness) expressed in bleeding gums, and gingivitis. If you’re on a six-month cleaning schedule with your dentist, that next cleaning may not come quickly enough to forestall the onset of periodontitis and the loss of bone it entails. 

Even if you’re otherwise healthy, when you miss a few visits, you will need a deep cleaning to address the chronic inflammation that’s produced by those inflammatory mediators in your gum tissue. 

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