According to new research, increasingly severe gum disease could cause lung function to decline.
Severe gum disease occurs due to a serious bacterial infection that attacks the gums and surrounding tissues. It is typically caused by plaque build-up; however, genetics, lifestyle choices and smoking can be contributing factors. Existing side effects of severe gum disease can include heart disease and rheumatoid arthritis, but new research indicates that lung function could be also affected.
“Our study indicates a link between periodontal disease and lung function meaning that good dental hygiene may benefit both oral and respiratory health,” said the study author Dr Anders Røsland of the University of Bergen, Norway. “More research is needed to evaluate causality and whether lung function can be improved with periodontal therapy.”
The findings were presented at EuroPerio10, the world’s leading congress in periodontology and implant dentistry.
Studying severe gum disease in adults
Previous research has indicated that dental cleaning is associated with a reduction in symptom flare-ups in patients with chronic obstructive pulmonary disease. To solidify this prior discovery, the research team from the University of Bergen investigated whether there was a further association between lung function and severe gum disease.
The researchers utilised data from the community-based Malmö Offspring Dental Study. The trial included 513 men and 508 women who were an average of 44.5 years old . The severity of the patients’ gum disease was measured depths around the teeth and loss of attachment from the surrounding tissues. The team measured the extent of gum inflammation by determining the percentage of sites showing bleeding from probing.
Moderate gum disease (also known as periodontitis) was found in 289 (28%) of the participants, plus 71 (7%) had severe gum disease. The remaining participants were classified with healthy or mild gum disease and acted as a comparison group. The researchers found that individuals with severe gum disease were on average 55 years old, and 59% were men. It was also discovered that smoking was prominent in the group with moderate or severe gum disease compared to the healthy/mild group.
Measuring lung function
The researchers investigated lung function using a spirometer, a commonly used tool that measures the volume of air exhaled from the lungs and the flow rate of air. They measured the following:
- Forced expiratory volume (FEV1) is the volume of air in litres expelled during a one second after maximal inspiration; and
- Forced vital capacity (FVC) calculates the amount of air in litres forcibly exhaled after taking the deepest breath possible.
Both these measurements were expressed as a percentage of the predicted value for healthy people and calculated as a ratio of FEV1/FVC (%).
The researchers discovered that FEV1 and FVC (both expressed as a percentage of the predicted value) and FEV1/FVC declined with increasing severity of gum disease. They accounted and adjusted for age, sex, smoking, body mass index, diabetes and education level and found significant inverse associations between lung function and severe gum disease. When compared to the healthy/mild group, those with severe gum disease had 3.6% lower FEV1 and 2.2% lower FEV1/FVC.
Dr Røsland concluded: “All measures of lung function deteriorated as gum disease worsened. In addition, as gum inflammation became more widespread throughout the mouth, some of the respiratory values tended to worsen. A decline in lung function may indicate airway inflammation, possibly originating from inflamed gums and the inhalation of dental plaque, which contains bacteria. If this link between gum disease and lung function is confirmed, this could provide the rationale for periodontal treatment and oral hygiene programmes to improve oral and respiratory health.”