Study Looks At Link Between Gum Disease And Mental Health Conditions


A new study from the University of Birmingham in the United Kingdom has found a link between periodontal disease and the development of numerous serious health conditions. Some of these health issues include autoimmune diseases, cardiovascular disease, mental health conditions, and cardiometabolic disease.

A number of adults are affected with gum health issues, which is why the associations with other conditions are even more concerning.

As explained by the Centers for Disease Control and Prevention (CDC), ‘Periodontal disease and tooth decay are the two biggest threats to dental health.’ Simply explained, periodontal disease refers to the gums.

This new study from the U.K. shows that periodontal disease actually impacts more than the mouth or oral health, with increases the risk of a number of other serious health conditions. The study found an association between poor gum health and a rise in mental health conditions, as well as the other types of diseases mentioned above.

According to the CDC, at least 47.2% of adults aged 30 years or more have some type of periodontal disease. Moreover, it increases with age, which means 70.1% of adults 65 years and above have periodontal disease.

According to co-first author of the study, Dr. Joht Singh Chandan, he shared in a press release, “When oral ill-health progresses, it can lead to a substantially reduced quality of life. However, until now, not much has been known about the association of poor oral health and many chronic diseases, particularly mental ill-health. Therefore, we conducted one of the largest epidemiological studies of its kind to date, using U.K. primary care data to explore the association between periodontal disease and several chronic conditions.”

In order to better understand the health effects of periodontal disease, along with its beginning phase, which is gingivitis, the research group took information from 64,379 adults in the country that had records with a general practitioner (GP) of gum health issues.

In their study, they shared that the average age of the participants was 45 years old, with 43% of the group male and 30% smokers. Every participant’s health was tracked throughout an average of 3.4 years as well.

The team also assessed the risk of participants gaining other health problems, which they did by comparing their medical histories with those of a demographically matched control group that consisted of 251,161 people that do not have periodontal disease.

The study results can be seen in BMJ Open.


The Surprising Widespread Influence of Gum Disease

In a surprising and most noticeable link found in the study analysis was periodontal disease and mental health conditions like depression and anxiety, which developing in 37% of those that had gum disease.

Periodontal specialist and study co-author, Dr. Devan Raindi, he told Medical News Today (MNT) that “it could be postulated that the consequences of periodontitis, which included halitosis (bad breath), drifting of teeth, mobility of teeth, and ultimately tooth loss, would have a psychosocial impact on an individual.”

“This can lead to loss of confidence, ability to socialize, as well as functional issues [relating to eating and pain]. However, it is important to remember that there is a multifactorial element to the development of mental health issues, and we are, of course, focusing on just one, albeit potentially modifiable, aspect,” he added.

33% of the participants developed autoimmune diseases, such as type 1 diabetes, psoriasis, rheumatoid arthritis, and arthritis.

To better explain the link between the autoimmune conditions and gum disease, Dr. Raindi decided to give an example. He shared,

“One mechanism that links rheumatoid arthritis and periodontitis looks at the post-translation changes in proteins caused by enzymes produced by P. gingivalis, a periodontal pathogen. This change is known as citrullination, which can, in turn, lead to production of antibodies against these proteins (known as anti-citrullinated protein antibodies). It is postulated that these autoantibodies may sustain synovial inflammation.”

Additionally, the study also identified that there was an ‘18% of increased risk of developing cardiovascular disease, a 26% greater risk of developing type 2 diabetes, and a 7% higher risk of developing other cardiometabolic disorders in the cohort with gum disease.’


Determining the Associations

Study authors wanted to understand whether common factors can also cause periodontal disease and other conditions.

Dr. Raindi explained, “The first thing I would say here is that we are not suggesting causal relationship for any of the outcomes, rather an association which, I think, is important to separate.”

“My understanding in relation to common factors here is that the study accounted for potential confounders, such as age, sex, smoking status, deprivation index, and ethnicity,” he added.

Since the study put together participants that had gingivitis and other advanced periodontal disease, MNTspoke with Dr. Chandan if the results also indicate ‘that the development of any level of gum disease could lead to increased health risks.’

His reply was, “It is difficult to know this for sure, as in some cases periodontal disease can be chronic, but you are right: In numerous cases, gingivitis may improve. However, in this study, we could not be sure of the length of timeframe of the initial periodontal disease.”

Dr. Chandan concluded, “So yes, it does appear that even simply developing a periodontal disease which then gets recorded by the GP is a risk factor.”