Experts say we should view regular dental visits as less about cleaning our teeth and more about frontline prevention for systemic health issues. Photo: Michelle Kroll.
The sink basin runs faint pink as you spit into the drain. It doesn’t hurt, so you rinse, wipe your mouth and move on with your day.
Many of us view bleeding gums as nothing more than the result of brushing too hard or skipping floss, and our biannual dental appointments as little more than “getting our teeth cleaned”.
However, one expert warns that bleeding gums are almost always a sign of a chronic bacterial infection, and a growing body of evidence links this to serious systemic health issues.
Canberra dentist Dr Mohamed Elfar, of Elfar Dental, says it’s time to shift our mindset.
“We need to change our perception of our dental hygiene appointments from ‘having my teeth cleaned’ to diagnosis, monitoring and management of chronic periodontal inflammation and infection,” he says.
Elfar Dental treats every checkup as an opportunity to screen for gum disease. Among the most severe forms is periodontitis — a serious bacterial infection that damages soft gum tissue and destroys the supporting bone.
Contributing factors range from poor oral hygiene to genetics and age. However, contrary to common perception, gum disease isn’t exclusively an “old person’s” condition; it can affect children, too.
“One of the reasons we recommend bringing children in for regular dentist visits from no older than six years old is so that when we start screening, they’re already familiar and comfortable in the dental chair,” Dr Elfar says.
Periodontitis generally begins with a buildup of tartar, a hardened, mineralised plaque that clings to tooth surfaces and the gumline, creating a haven for bacteria.
This leads to early gum inflammation (gingivitis) which, if left unchecked, worsens and pulls the gums away from the teeth, forming deep pockets that trap even more bacteria. Because early stages are often painless, expert evaluation is critical.
“One of the biggest problems about periodontitis is that it doesn’t cause pain. Pain is often our signal that something is wrong. Without it, you might not feel motivated to seek advice or treatment,” Dr Elfar says.
“Often the only sign is bleeding of the gums. Unless you’ve caused trauma to the gum, bleeding is not normal. It means inflammation. Sometimes the inflammation causes the gums to swell, and that might look like healthy, dense gum tissue—but it’s masking bone and gum recession.
“This is why we recommend going to the dentist for regular cleans, regardless of how you perceive your oral health.
“Periodontitis is a progressive disease. If left untreated, it’s only a matter of time before the infection causes the bone and gum to dissolve around your teeth. If your teeth don’t have anything to hold them in place, they become loose and may fall out or need to be removed. But with proper monitoring, assessment, cleaning and maintenance, the success rate of managing it is very high.”
Dr Elfar says a growing body of research supports an oral–systemic health relationship. Photo: Michelle Kroll.
While periodontitis poses a clear threat to your smile, its wider health impact is even more concerning, because the damage doesn’t stop in the mouth.
“We tend to look at teeth and gums as a secondary thing, not as part of our systemic health,” Dr Elfar says.
“Increasing research demonstrates important relationships between periodontal health and systemic conditions including diabetes, cardiovascular disease, cognitive decline and some cancers.”
Although many people know diabetes can lead to gum disease, the two conditions actually share a bidirectional relationship. In this continuous feedback loop, each condition increases the risk of, and severity of, the other.
One analysis revealed that people with periodontitis faced a 26 per cent higher relative risk of developing diabetes, while those with diabetes had a 24 per cent higher relative risk of developing periodontitis.
Research also highlights strong evidence of an independent link between gum disease and cardiovascular health.
It may seem surprising that an oral issue could impact the heart, but Dr Elfar points to the bleeding caused by gum disease, which contributes to overall vascular and inflammatory risks.
“When we brush our teeth and the gums bleed, that opens a window for the bacteria to enter the bloodstream,” he says. “Over time, frequent exposure can cause an accumulation around heart valves and cause problems.”
Emerging evidence also connects periodontal disease with a heightened risk of cancer. Large-scale studies show that a history of periodontal disease correlates with an increased overall cancer risk, as well as specific increases in breast cancer risk.
Dementia research reveals similar concerns. In one prominent study, brain tissue autopsies of deceased Alzheimer’s patients revealed an unexpected intruder in the central nervous system: Porphyromonas gingivalis, a bacterium native to the human mouth.
“It is important not to interpret this as proving that oral bacteria cause Alzheimer’s disease or cancer,” Dr Elfar points out.
“But it remains that everything is linked. We cannot separate the teeth and gums from the rest of the body.”
For more information, visit Elfar Dental.
