Oral/Systemic Connection

There are two books that have made significant impact in my thinking process about the connection between gum disease and other systemic diseases. In Plague Time, the author, Paul Ewald postulates that the majority of chronic diseases that plague mankind are really chronic transmissible infections. We all know acute transmissible infections, the cold and flu being the most common. They attack us shortly after we have been exposed, and generally run their courses in a matter of a week or so. But chronic transmissible infections are different. These infections can wait for years or even decades to attack us, and all the while we can be spreading them without knowing we are infected. Dr. Ewald gives multiple examples in his book, but the one that jumped out at me was a cancer pathogen in Japan that is spread from mother to daughter in breast milk that does not manifest until the fifth or sixth decade of life, by which time the daughter has already passed the pathogen to the grand-daughter.

What is difficult for us to imagine, is that there are chronic diseases such as cancers that have a pathogen as the cause because we don’t know or can’t find what the actual pathogen is. The invention of the microscope allowed mankind to look at one celled animals first the first time, but their existence had already been postulated if not yet well understood by the infectious disease specialists at the time.

Wouldn’t a transmissible pathogen explain the breast cancer cluster in Marin County of California? Researchers have looked at the air, the water, the high power lines and who knows what else in Marin without an explanation of the breast cancer cluster there.

Wouldn’t a sexually transmitted pathogen explain the fact that a man’s risk for prostate cancer is exactly in line with the number of sex partners? The fact that we don’t know what that pathogen is does not diminish the likelihood of its existence.

What does all of this discussion have to do with our oral health? Well, I asked Dr. Ewald if he thought that the route of entry to the body of some of these pathogens might be through the bleeding gums. He told me that he thought it was not only possible but likely.

Which brings me to the other book that has had a major effect on my thinking. Stealth Killer, by WIlliam Nordquist. Dr. Nordquist is also a dentist, who had noticed the presence of spirochetal bacteria in the biofilms of the plaques of gum disease. These spirochetes worry me, because they are related to the bacteria that cause Syphilis and Lyme disease, which are truly dread diseases with no known cure if they aren’t defeated soon after infection. They worried Dr. Nordquist even more (and sooner), so he began studying them.

When a mature spirochete is attacked by antibiotics, it rolls its body up into a little ball that resembles a spore. The spores are impervious to any known attack that we can mount against them, and they can live for decades in the tissue of the body waiting for a signal to attack the host. Dr. Nordquist identified that presence of these spores in the bacterial plaques that had occluded the coronary arteries of recent heart attack victims. How did those spores get there? Since the exact same spores can be found in the plaques around the teeth under the gums, it would certainly follow that these are getting access to the bloodstream via the bleeding gums. The bacteria can be as small as 1 micron, and the red blood cells that we are seeing are between 70-100 microns in size. Isn’t it likely that these bacteria are getting access back through the damaged blood vessel wall in the gums and attacking the blood vessel walls around the heart? And when we use an antibiotic, these spores defend themselves from the attack by rolling up into the defensive spores that we see in the coronary arteries of recent heart attack victims and the gums of periodontal patients.

I am tired of the hedging of all the doctors that are saying that gum disease MAY be related to other diseases such as coronary artery disease. Isn’t it time that we stop the hedging and say that the bacteria from bleeding gums create the bacterial plaques that CAUSE heart attacks? The evidence here is nearly as strong as the evidence that HIV causes AIDS, and we can’t prove that either. Why can’t we prove HIV causes AIDS? Do you want to volunteer for the study to be inoculated with HIV and wait to see if you develop AIDS? Me neither.

And what about pancreatic cancer? What is the cause? We will admit that it MAY be related to gum disease again. What about Alzheimer’s disease? Renal (kidney) Insufficiency? Preterm births? Ischemic stroke? What else?

Gregory L Sawyer DDS