Gum disease associated with diabetes and other serious inflammatory conditions

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In a robust study led by researchers from the Faculty of Dentistry at the University of Toronto, severe periodontitis, or gum disease, is found to exacerbate conditions like diabetes, cardiovascular disease and even Alzheimer’s disease. According to the researchers, heightened production of a type of immune cell in people with periodontitis can initiate a much larger immune response that spreads hyperactive inflammatory cells throughout the entire body, leading to negative outcomes.

The frontline immune cells, or white blood cells known as neutrophils, are produced when the body senses infection or trauma. First using a mouse model of periodontitis, the researchers found that an acute oral infection rapidly leads to heightened neutrophil production in the mouth as well as the bloodstream and colon. Elevated neutrophil counts were also seen in the animals’ bone marrow, suggesting the oral infection may be triggering broader systemic production of these immune cells.

The neutrophils then circulate throughout the body, primed to attack any secondary infection – however, this could be triggering, or at least exacerbating, other inflammatory conditions.

Second, the researchers recruited a small cohort of volunteers who were directed to stop brushing their teeth for three weeks. This was to stimulate gingivitis, or inflammation of the gums. Enhanced systemic neutrophil activity was confirmed after three weeks, through a variety of tests.

Interestingly, these immune markers disappeared two weeks after the subjects resumed their regular oral hygiene behaviours.

“We believe this is the mechanism by which oral hygiene can impact vulnerability to unrelated secondary health challenges,” said postdoctoral fellow Noah Fine. “Neutrophil (immune) priming throughout the body can connect these seemingly distinct conditions.”

The researchers additionally suggest an explanation to cited connections between COVID-19 complications and poor oral health:hyperactive immune system activity, referred to as cytokine storms, has been implicated in severe or fatal COVID-19 cases.

Professor Michael Glogauer hypothesises gum disease amplifying neutrophil activity may play a role increasing a person’s risk for severe COVID-19, “Neutrophils are the cells that are at prime risk of causing cytokine storms – that’s the exact cell we show is primed with people with periodontal disease.”

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