Gum Disease and the Menopause – why you should be concerned

How many of you expect to be asked by your doctor about the health of your teeth and gums?

Almost everyone nowadays expects to be asked by their doctor about their smoking, diet and exercise habits and almost everyone is aware that they are risk factors for their overall health. But how many of you are aware that the state of your teeth is also a risk factor for your health with gum disease linked to lots of health problems in other parts of your body?

Most of you when you think about gum disease, you might link it to bad breath, bleeding, swollen or tender gums, loose or sensitive teeth. No doubt these are common effects of what gum disease can do to your mouth.

However, there is more and more evidence that gum disease could also be related to other serious health problems that you may not expect, including certain cancers and dementia.

Health conditions where there is evidence that gum disease could be a risk factor include:

• heart disease
• stroke
• diabetes
• lung conditions
• arthritis
• complications in pregnancy

This is rather alarming considering that gum disease can be preventable. But this should also be good news for the same reason.

How to prevent gum disease – keep your dentist and doctor involved!

This of course is the area for my expert dental colleagues to advise, however the general consensus on how to care for your gums involve the following:

• Brushing your teeth at least twice a day
• Flossing regularly
• Attend your dentist for regular check-ups and cleanings

As a GP I would also like to reiterate some of the behaviours that are good for your overall health and help protect your gums. These include eating a healthy diet that is low in sugar and high on whole grains and also by not smoking.

It is also important that you let both your GP and dentist know about your medical history, any family history of heart disease, stroke or diabetes, and if you have noticed any bleeding or swelling in your gums or problems with your teeth.

Your gums protect your teeth and the structures that hold them in place. If you don’t brush and clean between your teeth well and often enough, bacteria, mucous and food particles can build up to form a layer known as dental plaque.

Dental plaque invades the small space between your gums and teeth and leads to inflammation of the gums surrounding your teeth, causing them to become swollen and sore, and sometimes to bleed. This is known as gum disease. If left, your gums can become infected, putting them and your teeth at risk.

What happens once gum disease has developed?

There are a number of theories as to how the health of your gums and the rest of your body could be related. Research suggests that it is chronic inflammation that may be responsible for the link of gum disease to serious diseases. The body responds to the increase in the bacteria in the mouth by producing inflammatory markers. Prolonged chronic inflammation can then damage your blood vessels which can increase the risk of developing diabetes, rheumatoid arthritis, chronic kidney disease and even some forms of cancer.

The current thinking is that treating inflammation may not only help manage gum disease but may also help with other chronic inflammatory conditions.

Heart disease:

Studies indicate that gum disease increases the risk of coronary artery disease almost twice compared with people without gum disease. It can also exacerbate existing heart conditions.

Stroke:

Studies have indicated a relationship between gum disease and stroke. In one study people diagnosed with an ischaemic stroke were found more likely to have an oral infection when compared to those in the control group.

Diabetes:

It has been well known that if you have diabetes you are at a higher risk of developing gum disease and the higher the blood sugar levels the more severe the gum disease. Research now suggests that the relationship between gum disease and diabetes is more of a two-way process than we first thought. Not only having diabetes increases your risk of gum disease, but having gum disease also increases your risk of developing diabetes.

In addition, if you have diabetes and gum disease you are six times more likely to have your blood sugar worsen over time than if you did not have gum disease. This can also increase your risk of diabetic complications and kidney disease compared to people with diabetes but no gum disease.

Lung conditions:

Your airways lead from your mouth to your lungs and if your mouth contains a lot of bacterial plaque, the theory is that you could then breathe this into your lungs. Once inhaled, bacteria could then go on to cause an infection in your lungs such as pneumomia or could aggravate an existing condition.

Gum disease – should women be concerned?

The menopause may affect many parts of a woman’s body and the mouth is no exception. If you are perimenopausal or menopausal then you may notice discomfort in your mouth, including dry mouth, pain and burning sensations in your gums. Some women notice an alteration in their taste, especially for salty, peppery or sour foods. In addition, gums may look dry or shiny, bleed easily and range from abnormally pale to deep red. Replacing hormones with the right type and dose of HRT can be really beneficial for many women.

Dr Theodora Kalentzi MBBS (equiv) DRCOG MRCGP MSc GP,

Menopause Specialist and founder of Medical Prime

www.medicalprime.co.uk

Medical Prime is a private GP and Menopause service located in the City of London.