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Periodontal Disease

The Link Between Periodontal Disease and Depression

We are hearing more and more of the correlation between poor oral health and cardiovascular disease that is well documented in the literature of medicine and dentistry.What has recently come to light is the correlation between periodontal health (gum disease and infection) and mental health.

It becomes a question much like which came first, ‘the chicken or the egg?’ Depression can lead to periodontal health problems. And periodontal health problems can lead to depression.

Can depression lead to periodontal health problems?

Yes! Mental health is also negatively affected by periodontal disease and the associated inflammation and its cellular byproducts. From a dental standpoint, we can easily see how those persons suffering with depression are less inclined to take appropriate care of their physical needs, especially dental health and hygiene needs. The ensuing periodontal disease from oversight or neglect of dental hygiene makes perfect sense.

But a recent report links the effects of inflammation (always present with periodontal and gingival disease) in the body as a cause and contributor of depression.

Periodontal health problems can lead to depression

From a scientific, albeit technical viewpoint, the inflammatory response resulting from periodontal disease appears to be mediated by macrophages, which produce various cytokines, although periodontal tissues may also directly produce cytokines, such as IL-6 and IL-8. As such, periodontal disease may be a marker of a failure of the immune system to resolve inflammation a state that may also result in vulnerability to depression.

Of course, we can also trace it from a psychosocial standpoint. Those with gum disease problems usually have trouble eating and lack aesthetics because of misaligned, decaying or missing teeth. They may feel ashamed of their appearance and would prefer to be alone (isolation) that can lead to loneliness, a predisposition that might lead to depression.

Healthy Mouth, Healthy Mindset

Avoid depression tendencies by reducing periodontal disease and inflammation. In a holistic point of view, good oral health generally leads to better overall health for a person. The bottom line: inflammation is a sign of developing disease or a full-blown infection. Reduction of inflammation, regardless of system in the body: arthritis, cellulitis, or the more easily treated periodontitis and gingivitis; is linked to lessening of depression and mood swings.

The Difference Between Gingivitis and Periodontal Disease

There is a difference between gingivitis and periodontal disease even if the two are classified under gum diseases. Gingivitis that is left untreated eventually worsens and progresses to periodontal disease. Gingivitis (gum inflammation) usually precedes periodontal. However, it is important to know that not all gingivitis progresses to periodontal disease.

What is the Difference Between Gingivitis and Periodontal Disease?

The main differences between gingivitis and periodontal disease are the severity of inflammation and pain level. Gingivitis is basically just an inflammation or swelling of the gums and is easily treated. In fact, it often goes unnoticed save for slight bleeding of the gums when brushing your teeth. Periodontal disease is a full-blow infection and one will be in pain all the time.  

How Does It Develop?

Normally, gums should appear coral pink, firm and form a sharp point where they meet the tooth. When too much bacteria and food debris build up in the spaces between the teeth and gums, plaque forms.

This sticky plaque can harden into calculus (tartar) and irritates the gums. Toxins from tartar cause gums to become inflamed or infected making it red and tender – this is gingivitis. Gingivitis is the beginning stage of periodontal disease.

If you do not receive treatment like professional dental cleaning to stop the spread of gingivitis, the infection will spread into the ligaments and bone supporting the teeth.  Infection will reach a level where the body’s immune system can no longer contain or reverse infection. This is serious periodontal disease - teeth may become loose and the gums may recede, creating increased spaces between teeth. Tooth loss may happen.

One of the ways dentists confirm periodontal disease is measuring how well the gums are attached to the teeth or how deep the pockets around the teeth are by using a little ruler called a periodontal probe.  In general, as long as the pockets are 3mm or less, that is considered to be healthy. Gingivitis is diagnosed if the pockets are 3mm or less with bleeding. Once the pockets are 4mm deep or greater with bleeding and even pus, then periodontal might be present. Assessing the amount of tartar and bones loss on x-rays further confirm this.

Gum Diseases is a Silent Teeth Killer

Don’t take gum disease lightly. Dentists say that it’s a silent teeth killer because you can have it without knowing. In fact, according to a report in the September/October 2003 issue of General Dentistry, a journal publication of the Academy of General Dentistry (AGD), 88% of American adults have some form of gum disease, but the beginning symptoms are usually painless, so many who are at risk do not recognize the signs and stages. Periodontal disease is still one of the most under-diagnosed and under-treated diseases in the United States.

See your dentist if you experience any of the following:

  • Bleeding gums when brushing or flossing
  • Mouth sores
  • Bright red, red-purple or shiny gums
  • Gums that are tender to the touch
  • Constant bad breath that does not go away

Because your mouth is connected to the rest of your body, the bacteria that cause chronic gum disease do get into your blood stream and spread throughout your body.  The infections that result have been shown to increase the risk of heart attack, stroke, worsen diabetes, increase the risk of pre-term births and even low birth-weight infants.  A healthy mouth means a healthy body.

Is there any treatment available?

The best solution for gingivitis and periodontal disease is prevention. You can prevent periodontal disease by regular flossing, brushing and dental checkups. In addition, maintaining a healthy diet, avoiding foods that are bad for your teeth and keeping low levels of stress boost the body's natural immune system which in turn fights bacteria in the mouth.

Dentists treat gingivitis by cleaning teeth to remove plaque and tartar and prescribing special mouthwashes or topical treatments. Treatment for periodontal disease involves more serious action such as antibiotics, antimicrobials and surgery.

Have Your Gums Checked

Since many people don’t know that they have periodontal disease, it’s a good idea to make an appointment with our office so Dr. Reese can check your teeth and gums. If you have one of the conditions listed above, or it runs in your family, this is especially important. For advanced cases of periodontis, we have periodontic services and are able to provide periodontal surgery all in one office. Please call 317-882-0228 to give us the pleasure of providing you with outstanding preventive dental care!