l Written by Dr. Ahn Kwang-sung at Yonsei Bolt Dental Clinic
l Edited by Sia, The Pylon Square
“My gums bleed a little when I brush, but it doesn’t hurt, so I’ve just left it.”
This is one of the hardest things to hear in my consulting room. Periodontitis, the advanced form of gum disease, usually causes little pain in its early stages, so it’s easy to miss.
By the time symptoms bring someone to the clinic, much of the alveolar bone, the jawbone that holds the teeth in place, has often already been lost.
The reason not to ignore periodontitis goes beyond the risk of losing teeth.
Medicine and dentistry are paying growing attention to how gum disease may affect overall health, particularly cognitive decline and dementia.
Periodontitis and Dementia: A Dentist’s Perspective
Large epidemiological and neurological studies in Korea and abroad have observed a significantly higher risk of dementia, including Alzheimer’s disease, among people with severe chronic periodontitis or extensive tooth loss.
We cannot say with certainty that periodontitis directly causes dementia. Even so, many studies report a link between periodontitis and the nervous system.
As a dentist, I take this link seriously, as a clinical warning that deserves close attention.
How Periodontitis May Affect the Brain
Periodontitis may not be a problem that stays in the mouth. Inflammatory substances and bacteria can spread through the bloodstream, allowing it to act as a kind of chronic “infection reservoir.”
Researchers are currently exploring three main hypotheses.
-
Periodontal bacteria reaching the brain
Porphyromonas gingivalis (P. gingivalis), a major bacterium behind periodontitis, and the toxins it releases can circulate through the bloodstream. They may cross the blood-brain barrier (BBB) and trigger inflammation in brain tissue. -
More inflammatory substances in the body
Inflamed gums continually produce inflammatory cytokines. These may stimulate the brain’s immune cells and speed up damage to nerve cells. -
Less chewing stimulation and blood flow to the brain
When periodontitis leads to tooth loss, chewing ability can decline. Chewing increases blood flow to the brain and sends sensory signals through pathways that include the trigeminal nerve, reaching areas such as the cerebral cortex and hippocampus. Losing this stimulation may contribute to cognitive decline.
While researchers continue to study these links, there’s a simpler reason not to wait: periodontitis can cost you your teeth.
How Can You Prevent and Manage Periodontitis?
Periodontitis destroys bone, and there are limits to how fully damaged alveolar bone can be restored.
That is why the most important thing is to catch it early and keep bone loss from progressing.
Bleeding and Bad Breath Are Warning Signs
If you notice blood when brushing, itchy or swollen gums, or worsening bad breath, you may have periodontitis. Please don’t ignore these signs, and visit a dentist.
Regular Scaling and Gum Checkups
If you have no history of gum disease, I recommend professional scaling once or twice a year to remove plaque and tartar. Brushing alone can’t remove hardened tartar, and if it has spread below the gumline, you may also need gum treatment.
Clean Between Your Teeth Daily
Periodontal bacteria thrive in the gaps between teeth and along the gumline, where toothbrush bristles can’t reach. Along with brushing, it’s essential to use interdental brushes and dental floss.
Why You Should Start Gum Treatment Before It’s Too Late
Many people put off the dentist out of fear, and I understand why. But the earlier gum treatment begins, the less you may need to worry about pain, and it can also take less time and cost less.
Wait until a tooth feels loose, and the question may change from how to treat it to whether it can be saved.
Keeping your natural teeth preserves the simple pleasure of a good meal and is a first step toward protecting your cognitive health and brain vitality.
If your gums are sending you warning signs, please don’t put it off any longer. I recommend visiting a dentist for a thorough gum examination.
>Book your visit to Yonsei Bolt Dental Clinic
[FAQ]
Q. What is periodontitis?
Periodontitis is a chronic disease in which inflammation caused by bacteria in plaque and tartar spreads below the gums and destroys the bone that supports the teeth.
Treatment usually happens in stages. Left untreated, periodontitis can lead to tooth loss, so early diagnosis matters.
Q. What gum symptoms mean I should see a dentist?
See a dentist if your gums bleed when you brush or eat, if they are swollen or discolored, or if your teeth feel sensitive or loose. The same applies if your bad breath has worsened.
Gum disease is often painless until an abscess forms, and by the time pain appears, it may already be quite advanced. If you notice any of these signs, it’s best not to delay a checkup, even if nothing hurts.
Q. Is periodontitis linked to dementia or other brain diseases?
Many studies have reported a link, but they have not proven that periodontitis directly causes dementia. Scientists are still investigating this link, partly because inflammatory substances and bacteria from the gums can spread through the body. For now, periodontitis is best understood as a possible risk factor.
Q. How is periodontitis treated?
Periodontitis is treated in stages according to how far it has progressed. Scaling comes first. If the disease has spread below the gums, gum treatment is also needed. Bone grafting or other regenerative procedures may be considered when bone loss is severe.
Q. How much does gum treatment cost in Seoul?
The exact scope and cost of treatment are determined after an examination. At Yonsei Bolt Dental Clinic in Yeongdeungpo, Seoul, scaling is KRW 100,000 and gum treatment is KRW 180,000 per quadrant (one-quarter of the mouth).
Q. Can lost gum bone grow back?
Even after treatment calms the inflammation, damage to the bone and periodontal tissues often remains. Bone grafting or other regenerative procedures may be possible in some cases. However, there are limits to how fully the original condition can be restored, so it’s important to treat periodontitis before it progresses further.
