Peridontal disease, chronic (occult) inflammation and neuroinflammation

Marco

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Chronic infection has long been proposed as underlying ME/CFS but evidence is lacking leading some to propose various models of 'occult' infection from latent viruses to gut translocation to vagal nerve infection etc. As an apparent non-viral onset PWME infection has never been top of my list of possibilities.

Found out yesterday though that I have well established peridontal (gum) disease. I usually don't have significant problems with my teeth to the extent that I can go a decade without visiting a dentist. Just over a month ago however I had quite severe pain in my jaw and then a lump appeared just before Xmas. Turns out it's an abcess (a first for me) and I have a deep infection of the gums and possibly bone that erupted as an abcess and has undermined the supporting tissues around three teeth (they move). Apparently this is a long term process which begins with gingivitis. How long term? he reckoned 15 years off the top of his head and I've had bleeding gums all my adult life (so did my mother - there's a genetic component it seems).

So it turns out I've been harboring a chronic pretty much asymptomatic (as far as the teeth are concerned) infection for many years.

Scientists however propose that periodontal disease (PDD) may contribute to vascular disease and possibly Alzheimer's disease by way of chronic low grade systemic inflammation's impact on primed microglia.

"We propose that bacterial and viral infections commonly found in PDD may impact the brain, either directly or via systemic signals to the brain, and contribute to the development of AD. Periodontal infections may result in harmful pathogenic products leading to systemic inflammatory responses. Elevated systemic inflammatory response may contribute to the exacerbation of existing brain pathologies. Infections may also contribute to vascular pathology with the potential to impact brain function. PDD and AD may also share common risk factors such as genetic polymorphisms related to production of inflammatory mediators."

Inflammation as a potential mediator for the association between periodontal disease and Alzheimer’s disease

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2626915/

PS - I'm not necessarily proposing that peridontal disease caused my ME/CFS but it may not be helping it.


 

Marco

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So what's the treatment? Surgery? Drugs? Both?
For the time being a strict regime of antibacterial toothpaste, mouthwash, a little brush to clean between the teeth and a 6 day course of antibiotics plus I had a full 360° scan to pinpoint the infection. Follow up in a few weeks time.
 

Sherlock

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Since you probably can't wipe out the infection, it seems reasonable to try to dampen the resulting systemic inflammation.

Btw, that gum-disease heart-disease study from India was refuted by a followup study tehn confirmed by another followup, etc.
 
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Very strange that the infection could have been smouldering underneath for so long without you knowing.

I hope that treating it brings some good change in your health.

I had a tooth infection the week I got my viral onset. Extreme pain in the top jaw.
Always wondered about the connection to me/cfs, but there are were many other factors for me as well.
 

Marco

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Since you probably can't wipe out the infection, it seems reasonable to try to dampen the resulting systemic inflammation.

Btw, that gum-disease heart-disease study from India was refuted by a followup study tehn confirmed by another followup, etc.
Prior to seeing the dentist I seemed to be able to control the swelling by applying a little tumeric powder. Thanks for the into about the heart disease study - good to hear.
 

Marco

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Very strange that the infection could have been smouldering underneath for so long without you knowing.

I hope that treating it brings some good change in your health.

I had a tooth infection the week I got my viral onset. Extreme pain in the top jaw.
Always wondered about the connection to me/cfs, but there are were many other factors for me as well.
Thanks.

From what I've read the infection (which seems to comprise bacteria and viruses) in the early stages is contained within a biofilm around the gums and once it gets deep into the gums its pretty compartmentalised so apart from bleeding gums you wouldn't necessarily notice anything until you get loose teeth or an abcess as happened in this case.

Interesting to me is that most of the damage done to the gums and bone is due to the host immune response to the bacteria which is exaggerated in peridontal disease and apparently involves IL 1 (implicated in fatigue in Sjogren's!).

Here's hoping:thumbsup:.
 
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Hi @Marco

How's your teeth problems going ?

Just wondering if you have ever checked out @Ian 's cavitation thread ? http://forums.phoenixrising.me/index.php?threads/my-recovery-story.7912/

I pulled up this as well on neurospirochetosis , which mentions periodontal pathogen spirochetes http://www.jneuroinflammation.com/content/8/1/90

Not trying to alarm you. I think I'm partly trying to put together some sort of half assed Sherlock Holmes case for my own jaw problem/Lyme positive/ME/CFS deranged mystery illness.

I suppose it's too far fetched to wonder if treponoma denticola could give a positive ELISA for borrelia.
(Some would say that sneezing could give a positive on an ELISA for borrelia.)
 

Marco

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Hi @beaverfury

Thanks for asking. My teeth/gums are getting a lot of TLC and one more day to go with the antibiotics. The gum swelling has gone but I'm afraid I can't as yet report any beneficial effects on the old microglia.

I actually had that thread in the back of my mind when I posted and while I don't really track the Lyme stuff I did notice the mentions of spirochetes (in that paper you linked to actually).
 

Ian

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Found out yesterday though that I have well established peridontal (gum) disease
Buy a water pick, and put a warm solution of salt water in it. Probably the single most effective way to reduce periodontal disease, other than flossing, which dentists love to rave on about. But really the studies say flossing makes virtually no difference.
 

duncan

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Marco, if you haven't already, you may wish to take a look at some of Judith Miklossy's research. Seems those pesky spirochetes have lots of kissing cousins that may cause more harm than is commonly acknowledged.
 

Hip

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The enterovirus that triggered my ME/CFS also caused me to develop receding gums (periodontitis) within months of catching this virus. The same sudden onset of receding gums also appeared in some of my friends and family who caught the same virus as I did (although nobody else developed full ME/CFS from the virus).

On my website which details this nasty enterovirus (most likely coxsackievirus B or an echovirus) I caught, I talk about this vitally-induced rapid-onset periodontitis. Here are some excerpts from my website:

Receding gums — a sudden onset of periodontitis, with brown plaque suddenly appearing on teeth, manifested within a few months of catching this enterovirus:

My gums, previously extremely healthy and pink, began receding quite noticeably. Lots of brown plaque was suddenly deposited on my previously perfectly white teeth. No matter how much I brushed it away, the plaque still came back. Along with this increased plaque formation, and in spite of frequent tooth brushing, new dental caries (tooth decay/cavities) suddenly appeared.
receding-gums-periodontitis.jpg
The sudden onset of receding gums and brown plaque deposits
on my teeth,
beginning within a few months of catching my virus
Previous to this, my oral health was excellent. Therefore, it seems I developed periodontitis (receding gums) from this virus within a matter of months.

This gum disease may be a manifestation of the immune-weakening effect this virus creates in the body, allowing bacteria to thrive and colonize the oral region. In addition, gum tissue can be directly attacked by connective tissue-dissolving enzymes created in viral infections (enzymes such as MMP-9).

Source: here.

Cardiovascular Disease and Gum Disease: One does not Cause the Other

Research has shown that gum disease is statistically associated with cardiovascular disease. In order to explain this association, some have hypothesized that gum disease may cause cardiovascular disease because bacteria from the gums migrate to the heart and therein cause cardiovascular damage.

However, having observed how the virus described on this website very rapidly precipitated both periodontal and cardiovascular problems (specifically: heart attacks, myocarditis and pericarditis) in several people, I would suggest a more viable hypothesis: namely that a chronic viral infection such as this causes periodontal and heart disease simultaneously.

That is to say: I suggest that gum disease does not directly cause cardiovascular disease; rather a chronic viral infection is the singular etiological underpinning of both, and this explains why gum disease is statistically associated with cardiovascular disease.

Source: here.


Have you looked into MMP-9 inhibitors to ameliorate your periodontitis, @Marco?

The enzyme matrix metalloproteinase 9 (MMP-9) is a connective tissue destroying enzyme (the gums and periodontal ligaments are composed of connective tissues).

The drug Periostat, which is an MMP-9 inhibitor, is prescribed to treat periodontitis. Periostat is in fact low dose doxycycline, so it would be easier and cheaper to use regular doxycycline, and split the tablets into lower doses. The herb triphala is also a potent inhibitor of MMP-9.

MMP-9 has multiple roles in the body, and is made by the immune system to fight infections. So it may be elevated in those with chronic viral infections.

Although MMP-9 is not the only matrix metalloproteinase that has been shown to be involved in periodontitis.

Folic acid, Q10, calcium, lactoferrin and pomegranate have been shown to help periodontitis.
 
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Marco

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@Hip

That photo's a bit tame - wait until you get .......'THE DREADED BLACK TRIANGLES' :aghhh:

From what I've read once these oral pockets have formed they can harbour all sorts of bacteria and viruses so its perhaps not surprising if you had a slight tendency to peridontal disease prior to infection that the inflammation might be worse.

Thanks for the tip on Periostat. I'll look into it.
 

adreno

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Interesting, @Hip

I have receding gums, and also EDS-like hyperelasticity/mobility. I never knew this could actually be connected. Now I wonder if an MMP-9 inhibitor would help improve both. Perhaps it might even improve POTS, as this is also tied to hyperelastic veins.
 

adreno

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@Marco

My gum inflammation/bleeding is controlled with 4-6 grams of vitamin C daily. If I lower my dose, symptoms come back within days.

Btw, I think I read in another thread that you smoke...if so, nicotine is a serious risk factor for periodontal disease:

Nicotine, a major component and most pharmacologically active agent in tobacco is likely to be a significant contributing factor for the exacerbation of periodontal diseases. Available literature suggests that nicotine affects gingival blood flow, cytokine production, neutrophil and other immune cell function; connective tissue turnover, which can be the possible mechanisms responsible for overall effects of tobacco on periodontal tissues.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2933534/
 
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Hip

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@Marco

Yes, my periodontitis is only the very early stages of the disease, and after a rapid onset, it then stabilized and has only progressed very slowly.

But I had absolutely no signs of periodontitis or any gum issues whatsoever prior to catching that virus, and then these issues appeared "overnight", within two months of contracting my virus. And this sudden periodontitis also happened to others who caught the same virus from me.

So just from a scientific perspective, my experience is interesting, as it shows how viral infection can trigger periodontitis.


I also find it interesting that severe periodontitis is common in those with schizophrenia, but some researchers have assumed that this is due to poor dental hygiene and smoking (smoking is a very common habit in schizophrenia). However, I think that this is more likely an indication that schizophrenia is an organic disease process which causes both the mental symptoms of schizophrenia and severe periodontitis.
 
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Sidereal

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The herb triphala is also a potent inhibitor of MMP-9.
Thanks for posting this Hip. I wasn't aware triphala did this in addition to its many other beneficial properties. I've been using it on and off for months now as a mouth wash and swallowing it. So far I have been able to avoid a root canal I was told I needed.