Macular Degeneration Linked to Gum Disease

Good news if you have excellent oral hygiene habits. However, if you don’t really floss much and only brush your teeth once per day, you may want to re-think not only your dental routine but the health of your future sight as well. Researchers continue to connect very specific, detailed bio-markers found in people with periodontal (gum) disease and the development of age-related macular degeneration (AMD). 

Each year the population of those suffering with an AMD diagnosis rises. Yet, many beneficial results from the research community have increased hope for slowing this disease and seem to be getting very close to curing it. 

Some new studies look at the bio-marker comparison of periodontal disease and AMD and something called C-Reactive proteins. Find out ways you might be able to avoid this rising risk of macular degeneration linked to gum disease. 

Chronic Systemic Inflammation

Periodontal Disease (PD) aka Chronic Periodontitis (CP) is an inflammatory response to various factors including: 

• Substandard oral hygiene
• Poor diet
• Trauma
• Infection
• Disease or gene anomalies 
• Environmental toxins

Constant inflammation of the gums is continuous and therefore requires your immune system to constantly fight it. This can be taxing on the immune system creating a constant struggle to remain healthy on all fronts. 

Retinal Physician reported that, 

“Periodontal disease is highly prevalent (47.2% in adults 30 years old or older), and its prevalence increases with age. Ranging from inflammation of the gingiva in gingivitis (the lesser and reversible form of periodontal disease) to loss of supporting connective tissue and alveolar bone in periodontitis (the more advanced form), the accumulation of bacterial biofilm (dental plaque) adjacent to the gums in periodontal disease results in damage to the periodontal tissue from bacterially induced inflammation.”

As the gums become compromised in this way, over time, periodontal pockets can form and store bacterial biofilm. These pockets are close to your circulatory system and, eventually, leach this bacteria into your body which could lead to chronic systemic inflammation and possibly contribute to macular degeneration, particularly AMD. 

AMD Biomarker Search 

This whole body inflammation brings with it the development of C-reactive proteins (CRP), a clinical biomarker for inflammation which has been associated with an increased risk of developing AMD. 

Some infections/chronic systemic inflammation biomarkers are identified as: 

• Cytomegalovirus
• Helicobacter pylori
• Chlamydia pneumoniae
• Porphyromonas gingivalis 

One example of how macular degeneration may be linked to one of these as well as many other inflammatory biomarkers is discussed in an investigative study on porphyromonas gingivalis. 

Science News reported on a study by researchers at the Department of Periodontics, Dental College of Georgia, Augusta University, titled, ‘Investigating the enigmatic link between periodontal inflammation and retinal degeneration.’ Lead investigator of the study, Dr. Pachiappan Arjunan, commented on the inflammatory biomarker porphyromonas gingivalis and how this common bacteria can afflict the retina.

“This is the first study to demonstrate the link between oral pathobiont [disease-causing organism usually non-harming] infection and AMD pathogenesis [disease development] and that Pg [porphyromonas gingivalis] can invade human retinal-pigment epithelial cells & elevate AMD-related genes which might be the target molecules for both diseases.”

As inflammatory biomarkers like porphyromonas gingivalis have shown good indication of a PD/AMD link, dental bone loss is also a significant factor. 

Dental Bone Loss and AMD

An earlier study of PD and AMD simply measured gum and bone loss in 8,208 adults aged 40 years and older. Combined research by various university labs including Harvard Medical School, Michigan State University, and Beth Israel Deaconess Medical Center found that,

“Association between PD and AMD was assessed while controlling for sex, race, education, poverty income ratio, smoking, hypertension, body mass index, cardiovascular disease, and C-reactive protein [CRP]…In this population-based study, PD is independently associated with AMD in those aged 60 years or younger…In the whole study population, the participants with AMD had fewer teeth and more alveolar bone loss compared with non-AMD participants. In a logistic regression model adjusted for age, smoking, and diabetes, alveolar bone loss was associated with AMD in males ”

It is theorized that other inflammatory processes throughout your body could create CRPs that contribute to AMD however those developed during PD may be more compromising. This is mainly due to CRPs leaching into your system closest and in abundance to your retina. Although research continues to link PD with AMD, the writing is on the wall as it is imperative to continue, enhance, or improve your oral hygiene routine.

Re-Evaluate Your Dental Hygiene

When you are young your teeth and gums are thriving. Bacteria and oral flora are usually strong prompting most to be lax in proper maintenance. Flossing eventually falls to the wayside and brushing may become a lazy attempt. You might rely on an occasional dental checkup that is not scheduled in the allotted time and even when warned by your dentist you may still compromise your oral hygiene. 

Healthline offers a good reminder list of the best way to take care of your mouth, teeth, and gums which may hopefully be a good set of steps in avoiding the development of AMD.

• Don’t go to bed without brushing your teeth – Brushing before bed gets rid of the germs and plaque that accumulate throughout the day.
• Brush properly – Doing a poor job of brushing your teeth is almost as bad as not brushing at all. Take your time, moving the toothbrush in gentle, circular motions to remove plaque.
• Don’t neglect your tongue – Plaque can also build up on your tongue. Brush or scrape your tongue twice per day.
• Use a fluoride toothpaste – Fluoride is essential for healthy teeth so don’t fall for natural anti-fluoride toothpaste products.
• Treat flossing as important as brushing – Flossing stimulates the gums, reduces plaque, and helps lower inflammation.
• Don’t let flossing difficulties stop you – If flossing is difficult ready-to-use dental flossers from the drugstore can make a difference.
• Consider mouthwash – Reduces the amount of acid in the mouth, cleans hard-to-brush areas in and around the gums, and re-mineralizes the teeth
• Drink more water – This can help wash out some of the negative effects of sticky and acidic foods and beverages in between brushes.
• Eat crunchy fruits and vegetables – Eating fresh, crunchy produce not only contains more healthy fiber, but it’s also the best choice for your teeth.
• Limit sugary and acidic foods – Sugar converts into acid in the mouth, which can then erode the enamel of your teeth. These acids are what lead to cavities. Acidic fruits, teas, and coffee can also wear down tooth enamel.
• See your dentist at least twice a year – A dentist removes tartar and looks for cavities but will also be able to spot potential issues and offer treatment solutions.

In addition to these oral health tips avoiding alcohol, tobacco and coffee can also help reduce teeth and gum compromises as well as lessen staining. Keep your oral hygiene at its optimal health and avoid potential AMD as well as other possible systemic compromises.