Oral Health’s Role in Gut Inflammation

Poor dental health can cause chronic inflammatory bowel disease or at least make it worse. If you take care of your teeth and oral flora, you can prevent these diseases or avoid flare-ups. A healthy oral flora is therefore an important prerequisite for a healthy gut.

Sick gums: contributing cause of intestinal inflammation

Those who regularly miss their dental check-ups risk much more than just tooth decay. Poor tooth and gum health (e.g. periodontitis, gingivitis) can cause chronic diseases such as diabetes, cardiovascular disease or even cancer and Alzheimer’s .

Chronic inflammatory bowel diseases (IBD), such as ulcerative colitis and Crohn’s disease, are also associated with poor dental health, researchers announced in June 2020.

Increasingly common: chronic inflammatory bowel diseases

Eighty-five thousand adults in Australia are affected by chronic inflammatory bowel diseases, although it is assumed that there are a high number of unreported cases and that these diseases will continue to increase in the coming years.

The symptoms of diarrhea and pain reduce the quality of life enormously. Since there is no curative therapy, only medication with many side effects, people are feverishly looking for solutions.

Bacteria from the oral flora migrate into the intestine

Nobuhiko Kamada, Professor of Internal Medicine at the University of Michigan , has been researching the intestinal flora—the totality of all microorganisms in the digestive system—for many years and has found that foreign bacterial strains are prevalent in the intestines of patients with chronic inflammatory bowel disease. In this case, he refers to “foreign bacterial strains” as bacteria that do not normally live in the intestines but in the oral cavity (1).

In his study, which was published in the journal Cell in June 2020, Kamada was able to demonstrate two mechanisms by which bacteria in the oral flora can worsen intestinal inflammation.

Gingivitis worsens intestinal inflammation

If periodontitis is present (inflammation of the gums and periodontal ligament), there is an imbalance in the distribution of bacteria in the oral flora, which means that inflammation-promoting bacteria take over. Unfortunately, these do not stay in the oral cavity, but migrate further into the intestines, where they can contribute to the development of inflammation.

If the intestinal flora is healthy, the mere migration of the oral flora bacteria into the intestine would not cause any noticeable inflammation in the intestine. This is because a healthy intestinal flora does not allow other microorganisms to settle in its territory. However, if the intestinal flora is already disturbed, e.g. in the case of a chronic inflammatory bowel disease, then the bacteria in the oral flora can spread almost unhindered and worsen the inflammation.

In mice, a more severe course of the disease was observed in those animals that had both inflammatory gum disease and inflammatory bowel disease.

Sick gums promote autoimmune processes in the intestine

The second mechanism by which a disturbed oral flora can worsen intestinal inflammation is the following: When gum inflammation is present, certain immune cells are activated in the oral mucosa, so-called TH17 cells, which can trigger inflammatory autoimmune processes.

These TH17 cells can migrate into the intestine and cause problems there. The healthy intestinal flora would of course be able to keep the TH17 cells in check, since in a healthy environment there are always sufficient regulatory cells that prevent autoimmune processes and excessive inflammatory reactions.

However, in the case of chronic inflammatory bowel disease, an autoimmune process is already taking place in the intestine. If a large number of TH17 cells from the oral cavity arrive on top of this, they can trigger the existing inflammation even further and make the disease worse.

If you treat gingivitis, the intestines will improve

For people with intestinal inflammation, these findings mean that they should definitely take care of their dental and gum health—especially if they also suffer from an oral disease—in order to ultimately improve their intestinal health in this way.

Dr. Shrinivas Bishu, Professor of Gastroenterology, is really excited about the prospect of being able to alleviate chronic inflammatory bowel disease in this way. “For many patients, standard medications for intestinal inflammation are completely ineffective, significantly reducing their quality of life and often leading to the need for surgery.”

Of course, you should discuss the specific procedure with your dentist. But you can also do a lot at home to ensure good tooth and gum health, even if you already have periodontitis . In particular, the right diet and nutritional supplements (e.g., vitamin D, vitamin C, omega 3 and antioxidants) can have a big impact and alleviate, if not cure, gum inflammation, as a study from 2017 found.

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