It’s no secret that periodontal inflammation has been connected to a host of medical conditions, from cardiac disease to arthritis and diabetes. The presence of the mouth bacteria S. mutans in arterial plaque makes it easy to imagine out-of-control bacteria hitching a ride through the vascular system to take up residence in multiple parts of the body—bleeding gums become the gateway and who knows where those bacteria will wreak havoc!
But the fact is that the connection between oral and overall health is more profound than just the spread of bacteria. Understanding the cellular immune response triggered by periodontal infection can enlighten our awareness of the cascade of inflammatory actions that results in untold numbers of auto-immune and other disorders. The key to this is cytokines.
Cytokines are signaling proteins produced by immune cells in response to infection or trauma (from the Latin ctyo = cell + kines = movers). They send signals to other cells to release antibodies, activate T cells, and act as either anti-inflammatory agents or as proinflammatory agents when inflammation becomes chronic, as often happens with periodontal disease. The problem with these proteins is that they have been connected to several harmful conditions beyond what happens in the mouth. When cells begin producing greater levels of cytokines, it’s not always the result of oral inflammation–but preventing gum disease is certainly one way we can work to stop this process before cytokines spread their harmful effects to other parts of the body.
For example, the production of certain cytokines can harm your mouth by reducing blood flow to oral tissues. The same cytokines that do this are found in extremely high levels in patients who suffer from obesity. Add that to the list of medical conditions connected to oral infection!
One particular cytokine known as interleukin 6 (IL-6) has been found in much higher levels in patients with gingivitis and periodontitis. The problem with this cytokine is that there are more than 30 auto-immune diseases that have been connected to higher levels of IL-6, and it may also be a growth factor in the development of oral cancers. It is found in much higher concentrations in patients with these harmful conditions, so if the event that triggers its production it periodontal infection, just imagine how beneficial it can be if we can stop it in its tracks!
There is evidence that genetic factors may affect how your immune cells respond to infection, vis-a-vis IL-6 specifically, but this has not yet been validated by large independent studies of specific populations. Scientists are also pioneering the therapeutic reduction of IL-6 by pharmacological means. This is currently limited to the treatment of illnesses such as Crohn’s disease and rheumatoid arthritis, and uses antibodies to neutralize IL-6 activity on immune cells. Unfortunately, harmful side effects like increased cholesterol levels limit how well these methods can be tested at present. But the research has begun!
The bottom line is that preventing and controlling oral inflammation can help prevent the production of harmful cytokines by our immune cells. We’re still discovering the full extent of the damage these baddies can do to any part of the body where inflammation can set in—but the connection between oral and overall health is on the way to being better understood. That has to count for something!
About the Author: Dr. Mickiewicz owns a private practice in Sacramento and lectures across the nation on TMD treatments. He is a diplomate of the American Academy of Pain Management and holds membership in many professional associations for dentistry, sleep medicine, and TMD. In addition, Dr. Mick, as his patients call him, founded Pacific Orofacial Pain Consultants, a team of experts in various disciplines, who tackle the issue of TMD pain and treatment, to help sufferers find relief from chronic pain. To talk with Dr. Mick, call his Sacramento dental office at 916-457-7710.