September 27, 2020
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Gum disease can kill more than your smile

By: George Malkemus
September 4, 2020

Watch out for the silent killer, Gum Disease! Called periodontal disease, it is a bacterial infection of the gums that affects the entire body.  Gum disease is correlated with heart disease, diabetes, strokes, arthritis, dementias, ulcers and pre-term births.  Bacteria that builds up between the tooth and gum can enter into the bloodstream whenever the gums bleed. These bacteria can travel throughout the body and cause serious health problems. 

Also, the bacterial gum infection causes an immune response making periodontal disease a combined disease of infection and the body’s immune response.  This immune response exacerbates other inflammatory diseases throughout the body, such as diabetes, heart disease, arthritis, prostate inflammation and dementia including Alzheimer’s disease.

Preventing periodontal disease with good oral health habits such as, brushing and flossing, and regular professional cleanings, improves the health of the entire body.

Heart disease

People with periodontal disease are almost twice as likely to suffer from coronary artery disease as those without gum disease.  Bacteria from the gums can affect the heart when they enter the blood stream, attaching to fatty plaques in the coronary arteries (heart blood vessels) and contributing to clot formation. Coronary artery disease is characterized by a thickening of the walls of the coronary arteries due to the buildup of fatty plaques.  The bacterial plaque in the mouth is found to be similar to the plaque found in the hardening of the arteries. Narrowing of the arteries and blood clots can obstruct normal blood flow, restricting the amount of nutrients and oxygen required for the heart to function properly. This can lead to a heart attack!

Periodontal disease can also exacerbate existing heart conditions.  Bacteria in the blood stream from bleeding gums can attach and grow on the heart valves causing a dangerous disease called infective endocarditis. 


Studies have pointed to a relationship between periodontal disease and a stroke. People diagnosed with acute cerebrovascular ischemia, a sever decrease in blood flow to the brain that can lead to a stroke, were found much more likely to have gum disease.  One study found that 50 percent of the fatty deposits lodged in the carotid arteries of stroke sufferers were the same type as the deposits found in their infected gums.


Diabetics are three to four times more likely to have periodontal disease, due to their reduced immune and healing response.  It is extremely important for diabetics to have excellent oral hygiene and regular professional cleanings.  Recent studies have shown that the elimination of gum disease can directly improve a person’s control over diabetes.  The presence of any gum infection can make it much more difficult for a diabetic to control his or her blood sugar.  A study of Pima Native Americans in Arizona shows that reducing periodontal infection helps control diabetic sugar levels.   The Pimas were known for their high number of diabetics and an increased proportion of periodontal disease.   After intense treatment to reduce their gum disease, the study found vast improvement in their diabetes, with a general reduction of insulin needed, and in some cases, complete removal from medications.

Prostrate Inflammation

Treatment and improvement in periodontal disease has been shown to reduce prostrate inflammation called prostatitis.  Twenty-one out of 27 men showed significant improvement of reduced prostatitis after treatment and improvement in their moderate to severe gum disease.  Prostate specific antigen (PSA) levels were lowered after four to eight weeks of gum therapy.  Healthy gums lead to reduced prostatitis, an improved quality of life and a reduced chance of prostate cancer for these men. 


Periodontal disease increases the risk and symptoms of arthritis.  The chronic inflammatory association of periodontal disease and arthritis has been long known.  Recently studies have shown that periodontal disease leads to an earlier onset, faster progression and greater severity of rheumatoid arthritis, including increased bone and cartilage destruction.

Alzheimer’s disease

New York University dental researchers found evidence that periodontal disease increases the risk of cognitive dysfunction associated with Alzheimer’s disease in healthy individuals as well as those already impaired.  Gum inflammation correlates to brain inflammation, neurodegeneration and Alzheimer’s.

Stomach ulcers

Periodontal disease has been correlated with an increase in stomach ulcers.  The bacteria that are found in the periodontal mouth are the same bacteria that cause gastric ulcers. An increased periodontal infection in the mouth will increase the number of bacteria traveling to the stomach, which can cause the ulcers.

Pre-term births 

For a long time, we've known that risk factors such as smoking, alcohol use and drug use contributed to mothers having babies that are born prematurely and underweight. Now evidence shows that pregnant women who have periodontal disease are seven to eight times more likely to give birth prematurely to low birth weight babies. More research is needed to confirm how periodontal disease may affect pregnancy outcomes. It appears that periodontal disease triggers increased levels of biological fluids that induce labor. All infections are cause for concern among pregnant women because they pose a risk to the health of the baby. Women considering pregnancy should have a dental and gum evaluation from their dentist and hygienist.

Contagious disease

Periodontal disease is contagious.  It spreads through saliva contact, particularly through kissing.  Newborns pick up their bacterial flora through their first suckling interactions with their mothers, so periodontal disease can be passed from mother to child.  I had a female patient who had good brushing and flossing habits and made regular, three-month periodontal maintenance appointments.  Even so, her gums continued to swell and bleed.  Her husband had advanced periodontal disease, with much plaque, bleeding, swelling, bone loss, bad breath and even pus.  He refused to have regular cleanings and did a poor job of brushing and flossing, if he made any attempt at all.   Later they separated and eventually divorced.  Her gums improved in health dramatically, with little or no bleeding or swelling.  Her ex-husband had been continually infecting her with periodontal disease over all their years together.

An epidemic 

Gum disease is rampant in our society.  More than half of all people over 18 have at least the early stage of periodontal disease.  After age 35, three out of four adults are infected.  However, gum disease can occur at any age, even children as young as five or six can have signs of gum infection. 

Periodontal disease is often painless, and usually develops slowly over many years, but may progress in rapid destructive stages.  Since the early stages of periodontal disease are painless, many people are unconcerned even when their gums bleed. Bleeding gums is a major sign of infection.  If any other part of their body spontaneously bled, they would be seeking immediate treatment.  By the time they notice a problem, usually with pain, heavy bleeding, pus or a loose tooth, it is often too late. A severe bacterial infection has attacked the gums and bone that support the teeth.  The major cause of tooth loss is from gum disease. 

The good news is the silent killer can be stopped.   So, please don’t wait until it hurts!  Have regular dental exams and cleanings.




George Malkemus has a Family and Cosmetic Dental Practice in Rohnert Park at 2 Padre Parkway, Suite 200. Call 585-8595, or email  Visit Dr. Malkemus’ Web site at