Gum Sleuths Find Sick Mouths a Factor in Deadly Diseases

Gum Sleuths Find Sick Mouths a Factor in Deadly Diseases

Bacteria-laden mouths and bleeding gums are giving medical researchers plenty to think about. Turns out gum disease is associated with a greater risk of developing diabetes, heart disease and even pregnancy complications. And a study released last week found evidence that bacteria linked to gingivitis traveled to brains afflicted by Alzheimer’s disease, hinting at a role in dementia. As the latest research deepens scientists’ understanding of the link between dental health and disease, the potential implications are coming into focus. Something as simple as treating gum disease, a neglected, often painless condition, could limit damage from some of the world’s most widespread and costly illnesses. About half of all adults have some form of gum disease, says Iain Chapple, a professor of periodontology at the University of Birmingham in England. That shows the potential impact of healthier mouths, he said.“Even if it’s just going to delay onset of arthritis or cardiovascular disease, if you add it up in fiscal terms, the savings would be huge,” said Chapple, who co-led a recent review of research on gum disease’s links with diabetes.

Heart disease and diabetes are costly illnesses and are becoming more prevalent around the world. Heart disease, the world’s biggest killer, costs the U.S. alone $108.9 billion each year, according to the American Heart Association. Diabetes, which most frequently occurs in older people who are overweight and sedentary, cost $245 billion last year, according to the American Diabetes Association.

The link to an increased risk of diabetes, heart disease and pregnancy complications was highlighted in the research review organized by Chapple and other scientists from the U.S. and Europe. Colgate-Palmolive Co. funded the review.

Bugs Travel

Colgate (CL), a New York-based maker of toothpaste and toothbrushes, and other makers of dental-hygiene products such as Johnson & Johnson (JNJ), Procter & Gamble Co. and Royal Philips NV stand to benefit if more connections between oral health and disease are established.

What gum disease has in common with other illnesses is inflammation, a response by the immune system to invaders that features swelling, redness, heat and pain as fluids and white blood cells rush to the affected area.

Bugs can travel from the mouth by being swallowed, inhaled or by entering the bloodstream through the gums, according to Frank Scannapieco, chairman of the department of oral biology at the University of Buffalo’s School of Dentistry. If harmful bacteria and viruses spread from the mouth, that could explain inflammation that leads to disease elsewhere in the body.

Seeking Funds

“The real question, the so-what question, is does it act as a risk factor with other medical conditions,” said Ian Needleman, a professor at University College London Eastman Dental Institute. “There’s a substantial body of research that connects them, but we are a long way from demonstrating causation. Can there be smoke without fire?”

To answer that question, larger and more expensive studies are needed, and funding is scarce, according to Needleman. The budget of the U.S. National Institute of Dental and Craniofacial Research is about $400 million, compared with the $30.9 billion its parent organization, the National Institutes of Health, invests in medical research each year.

“The field is wide open and the gaps in knowledge are large,” Chapple’s group wrote in the Journal of Clinical Periodontology in April.

Scientists are trying to fill that void. At least four trials are exploring whether dental treatment improves diabetics’ control of their condition, according to clinicaltrials.gov, a U.S. government website. Colgate-Palmolive is collaborating on one of the trials.

Brush and Floss

To prevent gum disease, the American Academy of Periodontology recommends brushing both teeth and tongue after meals, flossing and rinsing with a mouthwash once daily and seeing a periodontist. Eating a healthy diet rich in vitamin C and stopping smoking also help.

“Prevention is better than intervention,” Steve Engebretson, the chairman of the department of periodontology and implant dentistry at New York University’s College of Dentistry, said in an interview.

If the diabetes research shows a benefit, patients would have another way to improve their health in addition to diet, exercise and medication. One of the studies, a U.S. trial of about 600 people, has been completed, said Engebretson, the lead researcher. It builds on previous findings that show treating gum disease improves a measure of blood sugar.

‘Biggest Cynic’

“Our trial will be the largest to date to address the question,” Engebretson said. “One large trial is often not enough to convince clinicians about usefulness of one intervention or another.”

He declined to comment further on the study, which was funded by Stony Brook University, because it was submitted to a medical journal and hasn’t yet been published.

Heart disease is another promising area for research. The link between it and gum disease is “robust and significant” though it isn’t clear whether gum disease can cause heart disease, Chapple said. Only long-term trials can establish a connection, he said.

“I was the biggest cynic” about the link between the two illnesses, Chapple said. “But I’ve changed my view. The evidence is very strong now and I’ll be surprised if there isn’t a causal role.”

The U.K. research team behind the Alzheimer’s study is seeking more funding for a larger trial that would track recently diagnosed patients, said StJohn Crean, the dean of the School of Medicine and Dentistry at the University of Central Lancashire in England. The goal of the trial would be to show whether taking action against gum disease can slow the progression of the dementia, according to Crean.

People should take care of their teeth regardless of gum disease’s links to other illnesses, Needleman said.

“There are over 1,000 different kinds of bacteria in your mouth,” Chapple said.

To contact the reporter on this story: Kristen Hallam in London at khallam@bloomberg.net

About bambooinnovator
Kee Koon Boon (“KB”) is the co-founder and director of HERO Investment Management which provides specialized fund management and investment advisory services to the ARCHEA Asia HERO Innovators Fund (www.heroinnovator.com), the only Asian SMID-cap tech-focused fund in the industry. KB is an internationally featured investor rooted in the principles of value investing for over a decade as a fund manager and analyst in the Asian capital markets who started his career at a boutique hedge fund in Singapore where he was with the firm since 2002 and was also part of the core investment committee in significantly outperforming the index in the 10-year-plus-old flagship Asian fund. He was also the portfolio manager for Asia-Pacific equities at Korea’s largest mutual fund company. Prior to setting up the H.E.R.O. Innovators Fund, KB was the Chief Investment Officer & CEO of a Singapore Registered Fund Management Company (RFMC) where he is responsible for listed Asian equity investments. KB had taught accounting at the Singapore Management University (SMU) as a faculty member and also pioneered the 15-week course on Accounting Fraud in Asia as an official module at SMU. KB remains grateful and honored to be invited by Singapore’s financial regulator Monetary Authority of Singapore (MAS) to present to their top management team about implementing a world’s first fact-based forward-looking fraud detection framework to bring about benefits for the capital markets in Singapore and for the public and investment community. KB also served the community in sharing his insights in writing articles about value investing and corporate governance in the media that include Business Times, Straits Times, Jakarta Post, Manual of Ideas, Investopedia, TedXWallStreet. He had also presented in top investment, banking and finance conferences in America, Italy, Sydney, Cape Town, HK, China. He has trained CEOs, entrepreneurs, CFOs, management executives in business strategy & business model innovation in Singapore, HK and China.

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