Gut Health and Periodontal Disease

We already know about the proven relationship between periodontal disease and diabetes, obesity, Alzheimer’s, and cardiovascular diseases, but the gut is less discussed. However, an unhealthy gut results in many diseases and disorders.

Inflammation is the key player in most disease processes, including periodontal diseases and diseases of the gut (e.g., Crohn’s, celiac, IBS, etc.). When the body is overridden with inflammation, each system functions less effectively.

When bacteria invade the sulcus, it travels through the epithelial lining of the pocket and is then circulated through the body.6 It triggers an immune response, which prompts the production of proinflammatory cytokines in the pocket, which then can also enter into systemic circulation, causing systemic inflammation.

The bacteria in the mouth (whether by traveling from the mouth through the digestive tract or by seeping into the systemic circulation) then arrive in the gut where it causes additional inflammation. The dysbiosis of the gut microbiota is one of the first reactions that can happen after periodontal disease. Once these pathogens become predominant, they wreak havoc in the gut microbiome, causing inflammation and organ dysfunction.

Oral pathogens such as P. gingivalis have been proven to show inflammatory changes in adipose tissue and liver, decrease gut barrier function, and significantly alter microbial communities in the gut, showing higher numbers of pathogenic bacteria and less diversity in the microbiome.

By affecting the gut, oral pathogens thus affect all the functions the gut carries out. When the gut is unhealthy, it’s unable to perform these operations efficiently. The immune system is compromised and is unable to defend the body against pathogenic microbes, including those in the mouth.

The oral environment is likewise affected by the dysbiosis of the gut microbiome. The overgrowth of harmful bacteria can cause local and systemic inflammation, contributing to oral health issues. The mouth will often be the first representation of disease, which can be true of poor gut health as well. For example, a swollen tongue can be a sign of vitamin deficiency or immune imbalance. Overgrowths of certain bacteria or fungi can present as lesions or candida infections. Red and inflamed gums that are not plaque-induced can be indicative of poor mineral absorption. All of these oral dysfunctions point back to gut health.

Though brushing and flossing are a big part of the picture, they’re not the whole picture, and periodontal diseases happen as a result of many things.

Many periodontal diseases can be easily remedied by increases in diligent home care and enacting strict protocols, but for the disease that is not reduced or eliminated, other factors must be considered and discussed.

When determining where disease stems from, systemic health needs to be addressed, but specifically, gut health. This includes how the gut contributes to disease, how the oral pathogens can affect the gut, and how you can improve your gut microbiome, and therefore, your oral health.