Infected Gums Leak Endotoxins Into the Bloodstream

Individuals with severe periodontal disease may be prone to releasing endotoxins into their bloodstream, which may help explain the link between gum infections and cardiovascular disease, Belgian researchers report.

“The mouth can be a major source of chronic or permanent release of toxic bacterial components in the bloodstream during normal oral functions,” lead author Dr. Eric H. Rompen, of the department of periodontology and dental surgery at the University of Liege, Belgium, said in a statement.

“This could be the missing link explaining the abnormally high blood levels of some inflammatory markers…observed in patients with periodontal disease,” he added.

Previous research has found periodontal disease to be associated with an increased risk of stroke and coronary artery disease. While researchers have shown that oral bacteria can be released into the bloodstream, they have not shown that endotoxins can also enter the bloodstream via the mouth.

In their study, Dr. Rompen and colleagues sought to determine whether endotoxins could in fact be released into the bloodstream by a “usual and frequent oral habit,” such as chewing gum, and if people with more severe gum disease might release more endotoxin into their blood.

To investigate, the researchers had 42 people with moderate to severe periodontal disease and 25 people with healthy gums chew gum 50 times on each side of their mouth. The level of endotoxins circulating in each individual’s bloodstream was measured before chewing and 5 to 10 minutes afterwards.

According to the report published in the January issue of the Journal of Periodontology, the average amount of endotoxins present in the blood was significantly higher in all the patients after the gum chewing. Those with severe periodontal disease were nearly four times as likely to have significant levels of endotoxins after chewing than those with healthy gums.

These findings provide additional evidence for a link between the bacteria present in the mouth of those with periodontal disease and inflammatory reactions linked to heart disease, the authors conclude.

J Periodontol 2002;73:73-78.