Take care of your gums and you'll take care of your lungs

There are a number of things that provoke one's first thought to something like 'of course, logical, it couldn't be otherwise'. But it is often not easy to get to that point; and that, surely, should be the second thought that comes to one's senses. There is something of that in the result of a Chinese study reported in the latest issue of the journal published by the American Society for Microbiology. Gum infections, a very common disease known to dentists as periodontitis, promote the onset and, above all, aggravate chronic obstructive pulmonary disease. That is, COPD, which is what pulmonologists now call what was traditionally known as chronic bronchitis. If you smoke, therefore, you will destroy your lungs, but also if you do not take care of your mouth.

"It makes perfect sense," says Eduardo Anitua, a dentist from Vitoria and winner of the National Prize for Innovation in Medicine. "A large number of infections are contracted through the mouth, which is directly connected to the lungs. Think of covid or the flu, which this winter are causing a great deal of illness. If you breathe through your mouth and you have an altered oral microbiota, there is a very high chance that this altered microbiota will pass to your lungs. Consequently, all people who are mouth breathers and not nasal breathers have a higher risk of COPD.

The relationship between periodontitis and chronic bronchitis has long been known. What was not known, and this work by the University of Sichuan has put some clues on the table, are the mechanisms that connect the two pathologies. The answer, it seems, lies in two cells that are part of the human defence system, T cells and M2 macrophages. It seems that both are activated when they detect periodontitis bacteria and promote the development of COPD.

The conclusion of the study, as confirmed by its leader, microbiologist Yan Li, is clear: "If we improve periodontal therapy, we will inhibit both cells and help control chronic lung infection.

Both diseases are two of the great workhorses of human health. COPD, which was renamed COPD years ago to include a number of conditions beyond chronic bronchitis, is the sixth leading cause of death in the world. Palliative therapies exist to contain it or improve the quality of life of patients, but there is currently no way to cure it. In advanced countries, the main cause is tobacco use, but in poorer or middle-income countries, environmental pollution has also been found to be a determining factor.

Periodontitis, on the other hand, is one of the complications that dentists have to deal with the most. Poor oral hygiene favours the appearance of dental plaque, a sticky film that gradually builds up on the teeth and is mainly made up of bacteria. Over time, this plaque hardens into tartar and causes gum tissue to become irritated and inflamed. This is periodontitis, a silent disease that causes deep spaces to develop between the teeth and gums where bacteria proliferate and work to destroy both the teeth and the bone that supports them.

COPD thus joins the long list of diseases whose onset is directly linked to gum inflammation. These include diabetes, hypertension, cardiovascular diseases and even some cancers. Especially of the head and neck, but also of the lung, digestive tract and breast.

"Once all these bacteria pass into the blood, the bloodstream can carry the infection to any part of the body," says Eduardo Anitua, "We are even seeing this relationship in neurodegenerative diseases such as Alzheimer's. Small sepsis that start in the mouth end up colonising other parts of the body. Small sepsis that start in the mouth end up colonising other parts of the body.

There is something of that notion in the result of a Chinese study published in the latest issue of the journal for the American Society for Microbiology (ASM). Gum infections, a very common disease known to dentists as periodontitis, promote the onset of and, above all, worsen chronic obstructive pulmonary disease (COPD).

Preventing periodontitis requires proper oral hygiene, but above all, the specialist stresses, getting used to breathing through the nose. Most people are used to breathing through the mouth, which becomes a gateway for viruses and bacteria to enter the body. The nose, on the other hand, acts as a natural, physiological and biological filter against them. "Breathing is an unconscious act. If we have always done it through our mouth, at first it may be difficult to use our nose, especially if we are ex-smokers. But if we get used to it, and it is very easy, it will become automatic," advises the expert.