Recent research suggests poor oral health may worsen gut inflammation.
You probably already know that your oral health can affect your overall health, and can often lead to systemic diseases such as heart disease and diabetes. Now a collaborative study from the University of Michigan Medical and Dental Schools suggests that inflammatory bowel disease – IBD – may also be made worse by poor oral health. IBD, which affects an estimated 3 million adults in the US, includes Crohn’s disease and ulcerative colitis.
Nobuhiko Kamada, Ph.D., an assistant professor of internal medicine in the division of gastroenterology, has been studying bacteria normally present in the gut – the gut microbiome – for years. When he found emerging research linking foreign bacteria that are normally found in the mouth to bacteria in the guts of people with IBD, he approached the dental school. “I decided to approach the dental school to ask the question, does oral disease affect the severity of gastrointestinal diseases?” says Kamada.
The collaborative study on mice that proceeded, published in Cell, reveals two ways that oral bacteria contribute to gut inflammation:
The first way is through gum disease – periodontitis – which leads to an increase in the oral bacteria that causes inflammation. These bacteria then travel to the stomach. The researchers found that healthy guts in mice resisted colonization of this foreign bacteria, but the mice with IBD were less able to resist the disease-causing bacteria from the mouth, since their healthy gut bacteria were disrupted. The mice with both gut inflammation and gum disease had much higher levels of weight loss and disease activity.
The second way involves the immune system’s T cells in the mouth, which are activated by periodontitis. (T cells are one of the important white blood cells of the immune system and play a central role in the adaptive immune response.*) The T cells from the mouth travel to the gut and cause further inflammation. Because of the gut biome’s delicate balance, the inflammatory T cells from the mouth trigger the gut’s immune response. This will worsen IBD symptoms further.
“This exacerbation of gut inflammation driven by oral organisms that migrate to the gut has important ramifications in emphasizing to patients the critical need to promote oral health as a part of total body health and wellbeing,” says co-author William Giannobile, DDS, the William K and Mary Anne Najjar professor of dentistry and chair of the department of periodontics and oral medicine at the U-M School of Dentistry.
The study could lead to possible new treatments for IBD, especially for patients who have failed medications. Study co-author Shrinivas Bishu, M.D., assistant professor of gastroenterology, adds: “This study importantly implies that clinical outcomes in IBD may be improved by monitoring oral inflammation — an intriguing concept.”
*https://en.wikipedia.org/wiki/T_cell
