Mother’s Gum Disease Linked to Infant’s Death
Scientists from Case Western University worked with a 35 year-old mother to investigate the loss of her baby. Earlier studies by these researchers showed that an oral bacteria called Fusobacterium nucleatum could spread from the bloodstream to the placenta in mice. The woman wanted to know if it was possible in humans. Bacteria from the mouth can easily get into the bloodstream once a woman’s gums are bleeding, explains the study’s lead author Yiping Han, an associate professor of periodontics and pathology at Case Western University. Generally, this type of bacteria can be easily combated by the immune system of the mom-to-be, whether mouse or human. But because of special conditions that exist in the womb, the fetus can be more susceptible, Han suspects.
The California woman told researchers that she had experienced heavy bleeding from her gums — a sign of gum disease — during her pregnancy. Bleeding gums aren’t unusual in pregnant women, with about 75 percent developing the condition due to normal hormonal changes. According to the conventional wisdom, mild gum disease can be treated simply by brushing and flossing more often. Pregnant women with more serious cases may need dental surgery. Usually, women’s uterine infections, which can harm a fetus, are thought to be caused by bacteria that work their way up from the vaginal canal, says Han. But the researchers detected a bacteria in the baby not typically found in the vaginal region. Plaque samples from the woman’s teeth were found to be positive for the exact same strain of the oral bacteria found in the dead baby’s stomach and lungs.
Dr. Phillippe P. Hujoel reviewed the relationships between diet, dental disease, and chronic systemic illness in a report published July 1 in the Journal of Dental Research. He weighed two contradictory viewpoints on the role of dietary carbohydrates in health and disease. The debate surrounds fermentable carbohydates: foods that turn into simple sugars in the mouth. Fermentable carbohydrates are not just sweets like cookies, doughnuts, cake and candy. They also include bananas and several tropical fruits, sticky fruits like raisins and other dried fruits, and starchy foods like potatoes, refined wheat flour, yams, rice, pasta, pretzels, bread, and corn.
One viewpoint is that certain fermentable carbohydrates are beneficial to general health and that the harmful dental consequences of such a diet should be managed by the tools found in the oral hygiene section of drugstores. A contrasting viewpoint suggests that fermentable carbohydrates are bad for both dental and general health, and that both dental and general health need to be maintained by restricting fermentable carbohydrates.
Sharp readers of this blog will quickly conclude that I tend to lean towards the latter view, of course. The first viewpoint is questionable because they’ve been providing this advice for years but it doesn’t seem to stem the tide of bad teeth in Western nations.
Over the past twenty years or so, Hujoel says, people have been advised to make fermentable dietary carbohydrates the foundation of their diet. Fats were considered the evil food. A high-carbohydrate diet was assumed to prevent a number of systemic chronic diseases. Unfortunately, such a diet – allegedly good for systemic health – was bad for dental health. As a result, cavities or gingival bleeding from fermentable carbohydrates could be avoided only – and not always successfully, as Hujoel points out — by conscientious brushing, fluorides, and other types of dental preventive measures. When these measures are not successful, people end up with cavities and gum disease.
Hujoel observed that the dental harms of fermentable carbohydrates have been recognized by what looks like every major health organization. Even those fermentable carbohydrates assumed to be good for systemic health break down into simple sugars in the mouth and promote tooth decay. All fermentable carbohydrates have the potential to induce dental decay, Hujoel notes.
So there seems to be no debate when it comes to the dentists, that restricting carbohydrates is a very good thing for the teeth. But what if fermentable carbohydrates are also bad for systemic health? Hujoel asks. What if dietary guidelines would start incorporating the slew of clinical trial results suggesting that a diet low in fermentable carbohydrates improves cardiovascular markers of disease and decreases body fat? Such a change in perspective on fermentable carbohydrates, and by extension, on people’s diets, could have a significant impact on the dental profession, as a diet higher in fat and protein does not cause dental diseases, he notes. Dentists would no longer be pressed to recommend to patients diets that are bad for teeth or remain mum when it comes to dietary advice. Dentists often have been reluctant, Hujoel says, to challenge the prevailing thinking on nutrition. Advising patients to reduce the amount or frequency of fermentable carbohydrate consumption is difficult when official guidelines suggested the opposite.
The close correlation between the biological mechanisms that cause dental decay and the factors responsible for high average levels of glucose in the blood is intriguing. Hujoel explains that eating sugar or fermentable carbohydrates drops the acidity levels of dental plaque and is considered an initiating cause of dental decay.
“Eating these same foods, he says, is also associated with spikes in blood sugar levels. There is fascinating evidence that suggests that the higher the glycemic level of a food, the more it will drop the acidity of dental plaque, and the higher it will raise blood sugar. So, possibly, dental decay may really be a marker for the chronic high-glycemic diets that lead to both dental decay and chronic systemic diseases. This puts a whole new light on studies that have linked dental diseases to such diverse illnesses as Alzheimer’s disease and pancreatic cancer.”
The correlations between dental diseases and systemic disease, he adds, provide indirect support for those researchers who have suggested that Alzheimer’s disease and pancreatic cancer are due to an abnormal blood glucose metabolism.
The headline under discussion today stems from a study reported in the Journal for Obstetrics and Gynecology. Dr. Hujoels work is published in the Journal of Dental Research. Given today’s climate of specialization, it’s entirely likely that the researchers and the mother who lost the child have no knowledge of the work of Dr. Hujoels team. The woman is unlikely to understand that her diet likely played the biggest cause in the infant’s death. Brushing and flossing is not at all a “preventive measure.” A preventive measure would be to tell people to stop eating foods that are bad for the body rather than sheepishly suggesting that they brush to counter the effects of poor nutrition. Many pregnant women have strong enough immune systems to ward off such a bacterial infection but I’ve written before how carbohydrates weaken the immune system.
This is the state of medicine in our country. We’re very good at treating manifestations of diseases but we are very poor when it comes to preventing these diseases because we are too afraid to face the obvious. Carbohydrates case disease of all kinds. They are cheap and tasty but they are also very deadly.
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on January 23, 2010 at 11:54 am
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on January 23, 2010 at 1:26 pm
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on January 23, 2010 at 3:47 pm
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on January 24, 2010 at 9:58 pm
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Just a note that if you eat no carbs, the acidity level of your plaque is moot; you will not form plaque to begin with. Bacteria can only attach to a tooth when a pellicle of glycoprotein coats it. Without carbs, plaque cannot form. I brush my teeth every night, but it’s only out of habit. It really accomplishes very little.
on January 25, 2010 at 1:11 am
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on March 3, 2010 at 8:39 am
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Pregnant women with untreated gum disease may have more at stake than just their teeth. They may also be risking the lives of their babies. Mothers have long been warned that gum disease can cause a baby to be born prematurely or too small. But for the first time Scientists from Case Western University have linked bacteria from a mother’s gums to an infection in a baby.