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By , assistant professor clinical, UT San Antonio School of Dentistry

For many years, oral health was considered unrelated to overall systemic health. However, research now shows they are closely linked. An association has been found between periodontal disease (gum disease) and the onset and progression of several chronic conditions, including type 2 diabetes, cardiovascular disease, rheumatoid arthritis and possibly Alzheimer’s disease. The underlying factor between these conditions and gum disease is chronic inflammation. 

Understanding inflammation and gum disease

Inflammation, triggered by the immune system, is the body’s natural response to infection or injury. Normally, it subsides once the infection or injury is resolved. However, when the immune system is overactive or compromised, inflammation can become chronic, damaging healthy tissues and contributing to disease.

Gum disease is a chronic inflammatory condition that results in the loss of gum and bone that support teeth.  of periodontitis trends in 2020 found that gum disease affects 42.2% of the U.S. population, with 7.8% of people having a severe form of the disease. It is caused by the accumulation of harmful oral bacteria that trigger an immune response. Multiple factors can influence this response, such as smoking, diabetes, stress and genetics. The chronic inflammation triggered by the response is responsible for the bone loss associated with gum disease. Left untreated, it can lead to tooth loss and significantly reduce quality of life. 

The link between gum disease and systemic diseases

Type 2 Diabetes Mellitus
A well-established bidirectional relationship between gum disease and type 2 diabetes has been shown through numerous published studies, including earlier ones from  and  to more recent findings in  and . Uncontrolled diabetes compromises the immune system and makes it more difficult to fight infections like gum disease. At the same time, inflammation from gum disease can increase insulin resistance, making diabetes more difficult to manage.  that treating gum disease can lower HbA1c levels (a marker of long-term blood sugar control) by 0.4–0.9%, similar to adding another diabetes medication. This is significant because uncontrolled diabetes can lead to complications such as poor wound healing, heart disease, nerve damage, kidney disease and eye damage.

Cardiovascular Disease
that chronic inflammation from gum disease travels through the bloodstream, damaging blood vessels, and leading to the buildup of fatty deposits. The deposits narrow blood vessels and increase the risk of a heart attack or stroke. Researchers have found oral bacteria inside these deposits, indicating that the bacteria can enter the bloodstream and play a direct role in the progression of heart disease.

Rheumatoid Arthritis
an association between gum disease and rheumatoid arthritis, an autoimmune disease characterized by joint inflammation. Certain bacteria linked to gum disease can prompt the immune system to produce antibodies that lead to joint inflammation and damage. These bacteria are believed to enter the bloodstream and travel to the joints, contributing to inflammation and immune disruption, further reinforcing the link between oral and systemic inflammation. 

Alzheimer’s Disease
suggest a possible link between gum disease and Alzheimer’s disease. Oral bacteria may reach the brain through the bloodstream and contribute to the formation of beta-amyloid plaques, a hallmark of Alzheimer’s disease. Inflammatory markers from gum disease may also directly affect brain health. While more research is needed, these early findings highlight oral health's potential role in neurodegenerative conditions.

Why personalized dental care matters

Treating gum disease requires a personalized approach. The severity and progression of the disease vary from person to person, depending on individual risk factors and underlying health conditions. The dental specialty of periodontics addresses these unique needs by developing tailored treatment plans that support both oral and systemic well-being.

Maintaining gum health is a powerful step toward preventing chronic diseases. Here are some  to prevent gum disease.

Dental visit:

• Have a dental exam with x-rays at least every six months for early detection of disease.
• Get professional dental cleanings at least twice a year. Some patients may need cleanings every three to four months. 

At home care:

• Brush twice daily for two minutes with a fluoride toothpaste (ideally using an electric toothbrush).
• Clean between teeth daily with floss or interdental tools (e.g., Proxabrushes).
• Use a mouthwash to help reduce bacterial load (as a supplement to toothbrushing and flossing).

Treatment for gum disease

Gum disease goes beyond being a dental concern; it is a significant inflammatory condition that can impact your entire body. Its connection to chronic illnesses such as type 2 diabetes, cardiovascular disease, rheumatoid arthritis and potentially Alzheimer’s emphasizes the need for prevention, early diagnosis and effective treatment. 

The Periodontics Clinic at UT Dentistry offers care from expert, board-certified periodontic specialists and residents dedicated to ensuring patients receive comprehensive, leading-edge treatment and care for their gum health and smiles. For more information or to find a specialist, visit UTDentistry.org/Periodontics or call 210-450-3715. 

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About the author

"As a periodontist, I believe in treating the whole patient—not just their mouth."

, assistant professor clinical in the Department of Periodontics at the UT San Antonio School of Dentistry, is a dedicated dental professional specializing in Periodontics and advanced general dentistry. She earned her Doctor of Dental Surgery (DDS) degree in 2015, followed by an Advanced General Dentistry Certificate in 2017 after completing a two-year residency. In 2022, she obtained a Master of Science (MS) and Certificate in Periodontics. With extensive experience in both private practice and clinical settings, Dr. Casarez-Quintana specializes in a wide range of periodontal and surgical procedures. She is dedicated to a collaborative, interdisciplinary approach to patient care, ensuring comprehensive and optimal treatment outcomes.