Gum disease may exacerbate mental health and heart conditions

Novel UK research has revealed that the risk of developing mental health and heart conditions may be increased by gum disease.

The study, led by researchers at the University of Birmingham, indicates that gum disease – otherwise known as periodontal disease, causes an increased risk of patients developing illnesses that include mental-ill health and a range of heart conditions.

The investigation, which is published in BMJ Open, was a collaborative endeavour with the University of Oxford, Birmingham Dental Hospital, the University of Warwick, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle University, and Sandwell and West Birmingham NHS Trust.

Exploring the impacts of gum disease

To conduct their research, the team employed GP records of 64,379 patients who had GP-inputted recorded history of gum disease, including gingivitis and periodontitis, which can occur if gum disease is left untreated and can result in tooth loss. Of these patients, 60,995 had gingivitis, and 3,384 had periodontitis.

The researchers compared these records with 251,161 patients who did not have gum disease, with the average age across the cohorts being 44 and 43% were male, while 30% were smokers. Furthermore, the Body Mass Index (BMI) was similar across the groups.

Additionally, the team examined the data to see how many patients with and without gum disease go on to develop cardiovascular disease (high blood pressure, Type 2 diabetes), autoimmune conditions (arthritis, Type 1 diabetes, psoriasis), and mental ill-health (depression, anxiety, and serious mental illness) over an average follow-up of around three years.

Mental health and heart conditions

The team ascertained that patients with a recorded history of gum disease at the study’s inception were more likely to develop one of these additional conditions over a period of three years, compared to those without periodontal disease at the beginning of the research.

In patients who had gum disease at the start of the study, the results showed an increased risk of developing mental-ill health of 37%, autoimmune disease of 33%, and cardiovascular disease by 18%. Furthermore, the risk of a cardiometabolic disorder was increased by 7%, with the increased risk being 26% for Type 2 diabetes patients.

Co-first author, Dr Joht Singh Chandan of the University of Birmingham’s Institute of Applied Health Research, said: Poor oral health is extremely common, both here in the UK and globally.  When oral ill-health progresses, it can lead to a substantially reduced quality of life.  However, until now, not much has been known about the association of poor oral health and many chronic diseases, particularly mental ill-health.

“Therefore, we conducted one of the largest epidemiological studies of its kind to date, using UK primary care data to explore the association between periodontal disease and several chronic conditions.  We found evidence that periodontal disease appears to be associated with an increased risk of developing these associated chronic diseases. As periodontal diseases are very common, an increased risk of other chronic diseases may represent a substantial public health burden.”

Co-first author, Dr Dawit Zemedikun, of the University of Birmingham’s Institute of Applied Health Research, commented: “Our study was the most comprehensive study of its kind and the results provided vital confirmation of evidence which has previously either been lacking in strength or has had gaps – particularly the association between oral ill-health and mental ill-health.”

Co-senior author, Professor Krish Nirantharakumar, also of the University of Birmingham’s Institute of Applied Health Research, said: An important implication of our findings is the need for effective communication between dental and other healthcare professionals to ensure patients obtain an effective treatment plan targeting both oral and wider health to improve their existing overall health and reduce the risk of future illness.”

Periodontal specialist, Dr Devan Raindi of the University of Birmingham’s School of Dentistry, said: “This study strengthens the continually evolving research associating periodontal disease, in particular periodontitis, and various general health conditions. It reinforces the importance of prevention, early identification and treatment of periodontitis and the need for members of the public to attend regular oral health checks with a dentist or dental care professional.”

Caroline Aylott, Head of Research Delivery at Versus Arthritis, commented: “Some of the biggest challenges of arthritis, especially autoimmune conditions like rheumatoid arthritis (RA) which affects 400,000 people in the UK, is being able to know who is more at risk of developing it, and finding ways to prevent it. Previous studies have shown that people with RA were four times more likely to have gum disease than their RA-free counterparts, and it tended to be more severe. This research provides further clear evidence why healthcare professionals need to be vigilant for early signs of gum disease and how it can have wide-reaching implications for a person’s health, reinforcing the importance of taking a holistic approach when treating people.”

The research was partly funded by Versus Arthritis’s Centre for Musculoskeletal Ageing Research based at the University of Birmingham and supported by the National Institute for Health Research (NIHR) Birmingham Biomedical Research Centre.

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