Where Do Those Microbes Go?

You’ll find different types of bacteria thriving on the tongue, palate, cheeks, teeth, and inside the periodontal pockets between teeth and gums that deepen as the periodontal disease advances. As this process unfolds, bacteria can enter the bloodstream, and untreated infection can lead to chronic inflammation throughout the body. This is a bad situation for systemic health. The mouth is filled with billions of microbes. Unlike other parts of the mouth and gut where the outer layer of tissue is constantly shedding and renewing, the microbes below the gum line don’t get regularly flushed out or disrupted. They organize into colonies, form biofilms that coat teeth, and live there for long periods of time. But it’s more complicated than that. Parents commonly transfer their oral microbes to their children, though kids also get their microbiomes from other caregivers, siblings, friends, and even pets! Depending on the quality of the microbiome, this can be a good thing or a bad thing. Where Do Those Microbes Go and What Are They Doing There? There are lots of places microbes can go. Once they gain access to the bloodstream, they can travel anywhere in the body. Having bacteria in the bloodstream is very bad. Generally, if enough bacteria build up in the blood, sepsis may occur.

The Center of Attention

This is a whole body infection and is very serious indeed. These are the direct ways oral bacteria can cause systemic disease. In the presence of bacteria, these plaques develop around bacterial cells, as a sort of defense mechanism. Scientists have also known that the presence of Porphyromonas gingivalis, a common bacteria involved in gum disease, is a risk factor for Alzheimer’s. This bacterium has been found in the brains of deceased Alzheimer’s patients in the presence of amyloid plaques, but it was unclear if the bacteria was a cause, or a result, of Alzheimer’s. In these mice, gum infection led to brain infection, amyloid production, tangles of tau protein, and neural damage in the regions and nerves normally affected by Alzheimer’s. If these results are replicated and we determine that gum disease can cause Alzheimer’s, I predict a lot more attention will be paid to gum disease prevention, and, hopefully, to oral health in general. This feels like a potential public health eureka moment! Bacterial infection in the mouth can also indirectly cause chronic whole body inflammation, and that can be very dangerous too. It’s that hot, red, swollen thing your body does in response to injury, and it’s a vital part of staying healthy. Your body is injured, it responds in force, dispatching white blood cells and fluid to repair cells or fight off hostile microbes. This is great news when the injury is acute and short term. As an infected wound heals, the inflammatory response subsides.

That'll Be the Day

The body has done its urgent triage, and you can go on your merry way. Those cells and chemicals meant to heal begin to circulate through the body. This is called chronic inflammation, and it can cause grave damage. A condition in which the immune system is perpetually on may not sound so bad. If the immune system is on all the time, you’re extra safe, right? Unfortunately, the immune system doesn’t work that way. A lingering immune response can begin to attack healthy tissues or organs. Chronic inflammation is connected to many chronic diseases like Alzheimer’s, diabetes, rheumatoid arthritis, heart disease, and more. Chronic inflammation can happen for many reasons, but one common cause is untreated gum disease. The oral microbiome isn’t just composed of bacteria. Viruses are also common in the mouth, and they can also cause many different types of systemic problems. Type 1 is the most common and is usually acquired in childhood. It can cause sores around the mouth and lips, called fever blisters or cold sores.

Stick To Your Guns

Genital herpes can be passed on to the baby during childbirth, if the mother has an active infection. It’s time we all took that to heart. Evidence of the links between periodontal disease and many systemic diseases and conditions is growing stronger by the day. In addition to the study mentioned earlier, another recent study determined that people who have had periodontitis for more than 10 years are 70 percent more likely to develop Alzheimer’s disease than people without periodontitis, even after accounting for other factors such as the environment, diabetes, and heart disease. Additionally, gum disease can speed up mental decline by six times in Alzheimer’s patients. Atherosclerosis makes it more difficult for blood to flow through the arteries, raising blood pressure. If a blood clot forms in the arteries, it can stop the blood flow entirely, leading to a heart attack or stroke. Diabetes and periodontal disease have a bidirectional relationship. Remember that bidirectional in this context means the periodontal disease contributes to the systemic disease, and the systemic disease contributes to the periodontal disease. Diabetes increases the risk of periodontal disease because people with diabetes are more susceptible to contracting infections. In turn, periodontal disease makes it harder to control blood sugar in diabetics. As you may imagine, overall outcomes are worse when these two conditions are combined. People with diabetes who also have periodontal disease are about three times more likely to experience complications such as kidney disease. They are also more likely to get hospitalized for diabetes. What is perhaps scariest of all is that nearly half of adults suffering from Type 2 diabetes are not even aware they have it. As I mentioned earlier, infective endocarditis is a devastating disease in which the inner layer of the heart, the endocardium, becomes inflamed. Endocarditis has a high mortality rate of 20 percent. Periodontal disease is a potential risk factor in the development of erectile dysfunction. It turns out periodontal disease is associated with elevated plasma triglycerides and total cholesterol. No surprise here, high blood pressure is associated with periodontal disease. A thorough review of the current research, published in 2020 in Cardiovascular Research, showed that the more severe the periodontal disease, the higher the risk of hypertension.