Holes in our teeth are a consequence of prosperity – we are eating too much sugar. Humanity has been battling gum disease since antiquity, however. This disease is not only a danger for our teeth, but also for our general health. A risk taken too lightly, think Frank Abbas and Arie Jan van Winkelhoff, professors at the University of Groningen/UMCG. ‘Brushing your teeth is not enough.’
We all know that lots of sugar is bad for our teeth. But there’s a greater danger lurking in our mouths, which many of us know virtually nothing about – chronic gum disease. Nearly a third of the general population are sufferers, often unbeknownst to themselves. It can have serious consequences for about ten to fifteen percent of the population. More attention must be paid to the disease, is the opinion of Frank Abbas and Arie Jan van Winkelhoff. This is not only to protect the teeth – gum disease can contribute to numerous other medical problems, from rheumatism and heart problems to premature births.
Gum disease is caused by bacteria in dental plaque that cause the gums to swell, explains professor of periodontology Frank Abbas. This creates pockets around the teeth. If the bacteria are left to it, the bone will also be affected, which will eventually loosen the teeth. The problems are caused by poor oral hygiene. How quickly the bacteria will have an effect depends on heredity and the type of bacteria found in the mouth. Stress, smoking and a reduced natural resistance can also play a role. Abbas: ‘You don’t notice that you are starting to have gum disease because you can’t see the source of the infection and the fluids created by the infection are carried away quickly. This means that no abscesses are formed, so you don’t feel any pain. However, if you went to the doctor with such a serious infection in your arm or your leg, all the alarm bells would go off and you’d be sent straight to hospital for treatment.’
If you have gum disease, your immune system is in a constant state of alarm,’ explains professor of medical microbiology Arie Jan van Winkelhoff. ‘The bacteria in the pockets can get into the bloodstream and cause problems all over your body.’ This has been known for thousands of years, he adds – the Greek doctor and philosopher Hippocrates already realised that unhealthy gums were an indication of poor physical condition. But in recent years it has become steadily clearer what exactly the link is between gum disease and other ailments. For example, the infection causes the amount of C-reactive protein (CRP) in the blood to increase, explains Van Winkelhoff, which can contribute to cardiovascular diseases. The amount of prostaglandin (PGE) also increases, which can lead to premature births.
Recent research has revealed that the mothers of premature babies have significantly more gum disease problems. On the other hand, it appears that treating the infection can help reduce the chances of premature birth. Patients with rheumatism and diabetes can also benefit from their chronic gum disease being healed. The importance of more research has been proved beyond doubt, is the opinion of both professors. Van Winkelhoff: ‘The University of Groningen and the UMCG are both participating in the LifeLines project, a large scale investigation of the risk factors for disease. For decades to come, the health of 165,000 people in the north will be monitored from Groningen. The project does not yet pay attention to the condition of the gums, unfortunately, although this has a significant effect on our health. This important research opportunity should not be missed, we think. If we don’t do it now, we’ll regret it in ten years time.’
If you care about your health, make sure that not only your teeth but also your gums are in good condition. Abbas: ‘A good brush is definitely not enough. People should use dental floss more often, as well as toothpicks and interdental brushes. That’s the only way to really keep your teeth and gums clean and prevent the bacteria in dental plaque infecting your gums.’ Not all dentists pay enough attention to the condition of the gums, thinks the periodontologist. ‘My advice is to ask your dentist about the state of your gums. Make sure that he or she checks whether there is any sign of infection. If it’s discovered in time, good oral hygiene can prevent all sorts of problems. Patients should give their dentists a bit more lip.’
Prof. Arie Jan van Winkelhoff is professor of Medical Microbiology, in particular the microbiology of the oral cavity, at the University of Groningen/UMCG. He studied medical biology in Utrecht, gained his PhD from the VU University in Amsterdam and has been guest professor at the University of New York in Buffalo and the Royal College of London. Until his appointment in Groningen he was a professor at the Academic Centre for Dentistry in Amsterdam (ACTA).Prof. Frank Abbas is professor of Periodontology at the University of Groningen/UMCG. He studied dentistry in Groningen and periodontology in Amsterdam. He gained his PhD in Amsterdam, has held many managerial positions within the university world and the Dutch Society for Periodontology (NVVP), is joint founder of the Amsterdam Periodontology Clinic and chair of the Centre for Dentistry and Dental Hygiene at the UMCG.
Contact: UMCG, Communication office, tel. 050-361 2200, e-mail: voorlichting bvl.umcg.nl
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