by Chiara Daina

In Italy, 50% of people suffer from periodontal diseases. Beware of gum bleeding, strong bad breath and pain when chewing. The pathology worsens systemic diseases such as diabetes and vice versa

Protecting your mouth defends the health of the whole body. «Recent studies associate the state of bodily inflammation due to periodontal infection with the worsening of systemic diseases already present in the subject, such as cardiovascular, metabolic, especially diabetes, neurological, such as Alzheimer’s, and even oncological, such as colon cancer , and rheumatoid arthritis – explains Marco Baldoni, professor of odontostomatological diseases at the Bicocca University of Milan and director of the Dental Clinic of the Irccs San Gerardo dei Tintori of Monza -. Treating periodontal disease can help improve the evolution of the main disorder, but the opposite is also true: systemic disease can influence periodontal disease.

Gingivitis and periodontitis

Gingivitis, i.e. superficial inflammation of the gums, and periodontitis, the result of neglected gingivitis, determine the progressive destruction of the tooth support structures, with resorption of the bone surrounding the teeth and sometimes recession of the gum causing a gradual mobility of the teeth until they are lost.” In Italy approximately 50% of people suffer from periodontal diseases. Severe forms affect more than 10% of cases, starting from the age of 35. «Periodontitis can influence other organs and systems due to the passage of the responsible bacteria into the blood, or due to an increase in general inflammation of the body due to the release of pro-inflammatory substances released by the organism by the bacteria responsible for periodontitis» specifies Baldoni. “Diabetes comes first among the main pathologies aggravated by periodontitis: controlling it therefore helps to better manage the complications of diabetes.”

The signs and symptoms

The most common early signs of periodontitis are: bleeding gums, bad breath and pain when chewing. «The primary cause is the infiltration of pathogenic bacteria into the deep periodontal tissues which leads to their destruction. The progression of the disease is contributed to by the patient’s greater susceptibility to infection, genetic predisposition, inappropriate dental therapies (poorly made fillings, protruding prosthetic crown), which favor the accumulation of food and the consequent bacterial proliferation which is difficult to remove with a toothbrush and water flosser. Risk factors such as smoking, alcohol and drugs play a role, which reduce the defenses against the bacteria responsible for gingivitis” specifies the specialist. Bleeding is often overlooked. «If it persists for a few weeks when you brush your teeth or use dental floss, it means that an inflammatory process is underway – continues Baldoni -. In this case, an appointment must be made with the dentist, who can refer the patient to the dental hygienist.” To resolve simple gingivitis, it is enough to improve home oral hygiene and a professional hygiene session. If the bacteria have affected the deeper tissues, the help of a periodontist specialist is sought.

The cure

«First of all, it is necessary to analyze the severity of the disease by measuring the periodontal pockets, the space created between the internal surface of the tooth and the gum, where the plaque accumulates and which indicates that the bone has been partly reabsorbed, through the ‘insertion of a probe into the gum – explains Gianluigi Caccianiga, who teaches periodontology at Bicocca University -. Radiological tests and the evaluation of bacterial contamination with microbiological tests may also be useful. Demonstrating to the patient how many microbes live in his gums motivates him to adopt the most suitable oral hygiene measures at home.” The treatment of periodontitis involves «professional hygiene sessions to eliminate pathogenic bacteria from the gums and, in the most problematic areas, small surgical interventions that help recover the periodontal tissues lost due to the infection» reports Baldoni.

Blood tests

As we said at the beginning, it is important to consider systemic pathologies related to periodontal disease. «It is necessary to evaluate metabolic parameters, such as levels of cholesterol, vitamin D, glycated hemoglobin, used to control blood sugar levels. If the values ​​are altered, their correction helps to improve the response to treatment for periodontal disease also improves” continues Caccianiga.


Furthermore, it is important to rebalance lifestyles to increase the body’s resistance to the aggression of periodontal bacteria. «By controlling stress, which favors the formation of cortisol, a hormone that reduces the good immune response, and by avoiding the abuse of smoking, alcohol and drugs» warns Caccianiga. Which then adds the usefulness of taking probiotic supplements, «which contain “good” bacteria capable of rebalancing the intestinal and oral microflora».

September 23, 2023 (modified September 23, 2023 | 1.29 pm)

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