Gum Disease, Autoimmune Disorders, and Leaky Gut Syndrome:

ARE THERE FORBIDDEN RELATIONSHIPS WE’RE MISSING?

Periodontitis is the medical term for gum disease. It’s a serious gum inflammation that destroys the soft tissue and even extends to the bone supporting your teeth if left untreated. This can result in loose teeth or loss of teeth. It’s a common condition and is usually secondary to poor oral hygiene. A less severe type of gum disease is often referred to as gingivitis. Both gingivitis and periodontitis can typically be prevented by brushing your teeth at least twice a day, daily flossing, and visiting your dentist regularly.

IS GUM DISEASE AN AUTOIMMUNE DISORDER?

Gum disease is a chronic inflammatory disease like autoimmune disorders that has a complex development. As of now, that development (etiopathogenesis) is still incompletely understood. With continued advances in diagnostics and research, maybe someday we’ll be able to classify it as an autoimmune disorder.

The main goal of your immune system is to defend your body from harmful microorganisms like viruses and bacteria, which cause various diseases. Under normal conditions, that’s what an immune system is supposed to do. Sometimes, the immune system turns its attention to and attacks healthy cells and tissues in the body. This can result in autoimmune disorders. Some of these autoimmune disorders can negatively affect your gums and lead to gum disease. Other parts of your oral cavity may also be involved.

COULD THERE BE A CONNECTION BETWEEN GUM DISEASE AND AUTOIMMUNE DISORDERS?

Yes, there’s a link between gum disease and autoimmune disorders. Both produce chronic inflammation that causes tissue damage over time. Unfortunately, no reliable research studies have shown a direct cause-and-effect relationship between the two. We have selected some autoimmune disorders and briefly discussed their complicated relationship with gum disease.

1. Rheumatoid arthritis and gum disease. A research study conducted at Johns Hopkins University provided recent evidence that a particular bacterium notorious for contributing to the development of gum disease also triggered the inflammatory response found in the affected joints of people with rheumatoid arthritis. This study demonstrated a newer understanding of the long standing relationship between gum disease and rheumatoid arthritis. In this particular relationship, both gum disease and rheumatoid arthritis may be caused and initiated by a single bacterium (named Aggregatibacter actinomycetemcomitans, what a name, huh?).


2. Inflammatory bowel diseases and gum disease. A 2020 study published in the Cell journal demonstrated that inflammatory bowel diseases(IBD) like Crohn’s Disease and Ulcerative Colitis could be worsened by ongoing gum disease. Gum disease creates an imbalance of the bacteria in your mouth and can mirror this imbalance in your gut. Gum disease also activates harmful inflammatory cells found in your mouth that attack your gut, further worsening IBD symptoms. In this relationship, gum disease worsens an autoimmune disorder (IBD).


3. Diabetes mellitus and gum disease. In this relationship, the feeling is mutual. We mean bidirectional. It goes both ways. Diabetes reduces your body’s ability to fight infection by messing with your immune system. This can put your oral health, especially your gums, at risk. On the flip side, a 2019 study published in the British Dental Journal demonstrated that people with severe periodontitis have difficulty controlling their blood sugar levels. This translates to an increased risk of developing type 2 diabetes mellitus.


4. Sjogren’s syndrome and gum disease. Sjogren’s syndrome is another autoimmune disorder that can include different parts of your body. Its primary target is glands that make moisture like your salivary glands. Your body has a hard time producing saliva leading to a dry mouth and difficulty swallowing. Saliva is essential as it lubricates every action in your mouth, neutralises acids, prevents bad breath, kills harmful microorganisms, hastens wound healing, and of course, prevents gum disease. Its absence results in dental caries, oral thrush, and gum disease. In other words, Sjogren’s syndrome can cause gum disease. To make matters worse, a 2019 research study published in the International Journal of Environmental Research and Public Health found that the relationship can be bidirectional at the same time by as much as 50%!


5. Psoriasis and gum disease. Psoriasis is primarily a skin disease that can have joint involvement in approximately 30% of cases. In rare and unlucky cases, it can include the oral cavity and the structures within. Symptoms include bleeding gums, redness and burning sensation in the mouth, and difficulty chewing and swallowing. In this relationship, psoriasis can cause gum disease.

The connection between gum disease and autoimmune disorders is definitely present and complicated. Each has its unique relationship with gum disease. Some associations have been established, but there’s still a lot to be unravelled.

GUM DISEASE AND LEAKY GUT SYNDROME

When someone tells you that you may have leaky gut syndrome, it means that the lining of your digestive tract is damaged and can’t optimally function as a barrier. The gaps or holes become bigger and permit the passage of uninvited substances like harmful bacteria, gluten, and undigested food particles. These substances enter and circulate in your system, causing a lot of damage.

Several healthcare professionals and scientists don’t recognise leaky gut syndrome as a specific medical condition or diagnosis. It’s not found in the WHO ICD-10 list of diseases, unlike gum disease. ICD-10 stands for International Statistical Classification of Diseases version 10. It’s the latest version in use when this article was being written, and it’s the global standard for clinical documentation, health data, and statistical aggregation.

Gum disease is listed under several entries like periodontal disease and gingival disease. If push comes to shove, leaky gut syndrome can be arguably lumped under functional gastrointestinal disorders. Your doctor might not acknowledge leaky gut syndrome or refer to it as a condition that increases intestinal permeability, which can be found in various functional digestive disorders.

But current scientific data indicates that leaky gut syndrome can negatively impact many medical conditions, including gum disease recognised by healthcare professionals. It’s clear that a specific link or connection is present, but the exact association as to how they’re connected has not been established.

1. A 2019 study published in the Journal of Oral Microbiology found that a certain bacterium, Porphyromonas gingivalis, can translocate itself to the digestive tract from the oral cavity and harm the local gut immune system, and ultimately cause gut dybiosis and leaky gut syndrome.
2. A 2018 research study also published in the Journal of Oral Microbiology discovered that people with gum disease have a less diverse gut microbiome (different populations of microorganisms in the gut). This is in line with other systemic inflammatory diseases like obesity, diabetes mellitus, metabolic syndrome, cancer, etc. Harmful bacteria from your oral cavity travel systemically throughout your body with their toxic immune complexes and substances that cause inflammation and damage to other tissues and organs like your heart.
3. The two research studies previously mentioned above indicate that your oral cavity, including your gums has its own oral microflora, just like your gut microflora. Dybiosis (imbalance in populations of microorganisms) in one leads to dysbiosis in the other, causing a variety of chronic inflammatory diseases.
4. The presence of harmful bacteria or an imbalance of gut flora may lead to a leaky gut. A leaky gut eventually weakens the immune system resulting in poor oral health and contributes to the development of chronic diseases like gum disease. Leaky gut syndrome, like autoimmune disorders, definitely shares a connection with gum disease. Now, how does LEAKY GUM SYNDROME sound? Somebody, get me the number of the medical patent office.

So now what? What do we do with all these complex forbidden relationships? What’s our takeaway? Autoimmune disorders and leaky gut syndrome require a holistic approach when it comes to prevention and treatment because they affect several body systems. Considering the complex relationships of gum disease with both of them, we also need to take a holistic approach (whole-body) when treating gum disease. Below are some tips on how to do that:

1. Don’t just fixate on your gums and oral cavity. We have enough information to help you with that.
2. If you have gum disease, you may have gut dysbiosis and leaky gut syndrome. Consider treatment options used for the latter conditions. They will benefit your oral health and help your overall health, especially if you have an autoimmune disorder.
3. Avoid taking too much NSAIDs (non-steroidal anti-inflammatory drugs) for pain. Look for natural remedies. Take antibiotics only when they’re prescribed to you by your doctor. Antibiotics and medications used in cancer therapy wipe out the population of beneficial bacteria in your gut, allowing the growth of harmful bacteria.
4. Handle your stress levels well. Stress can cause increased permeability in your digestive system and alter gut bacteria and even influence mood.
5. A high sugar diet, especially with lots of refined carbohydrates, will increase inflammation throughout your body and increase intestinal permeability.
6. Overgrowth of yeast infections in your gut, primarily due to Candida species, may affect the lining of your intestines by increasing your sensitivity to food antigens. This further aggravates increased intestinal permeability.
7. Zinc, an often ignored mineral, has shown tremendous positive impact on the integrity of your gut lining. On the opposite side, people with zinc deficiency suffer from a host of gastrointestinal disease because of increased gut leakiness.
8. Vitamin D deficiency negatively affects your body’s immune response to foreign substances and the population of gut microflora which will certainly favour an imbalance in your gut.
9. Consider probiotics and prebiotics. They’re widely available in food and supplement forms.
10. One of the widely accepted causes of leaky gut syndrome, aka increased intestinal permeability (ahem) among people suffering from IBD and celiac disease, is gluten sensitivity. If you have IBD or similar conditions, you may want to check with your doctor if you also suffer from gluten sensitivity. If you do have it, then it’s time to remove gluten from your diet. Gluten-sensitive people also have increased levels of a pro-inflammatory protein called zonulin, which regulates leakiness in your gut. More research is being done on this subject matter.
11. Avoid abrupt changes in your diet. Do it gradually and allow your mind and body to adapt to the new diet.
12. A holistic approach includes prevention of disease progression, so watch out for these signs and symptoms of periodontitis (from mild to severe):

A holistic approach in treating gum disease incorporates a triad of watching out for its signs and symptoms, maintaining a healthy gut and eating right, and strengthening your immune system .

It’s estimated that 3 out of 10 Australian adults suffer from moderate to severe gum disease. In New Zealand, it’s extrapolated that cases of periodontitis in all its forms can be as high as 15% across the population. Sprinkled among these cases are people who also have autoimmune diseases and leaky gut syndrome. Both conditions have complicated relationships with gum disease. One thing is sure, there’s a connection. The best lesson from this is that to treat gum disease, you have to take a holistic approach. Don’t forget to look outside the box (your oral cavity) and consider other conditions that may be causing or contributing to the development of your gum disease.

Note: DO NOT diagnose yourself as having gum disease, an autoimmune disorder, leaky gut syndrome, etc. Visit your dentist or primary healthcare provider and get the proper diagnosis and treatment.