Is there an autoimmune component to periodontal disease?

By Alvin Danenberg, DDS, contributing writer

October 3, 2018 -- Periodontal disease can be viewed as both an acute and a chronic infection. Is the chronic phase actually related to an autoimmune reaction?

An autoimmune disease is a disease in which the body produces antibodies that attack its own tissues, leading to the deterioration and, in some cases the destruction, of its healthy tissue.

Alvin Danenberg, DDS
Alvin Danenberg, DDS.

In the acute phase of periodontal disease, bacteria can initiate an infection and inflammation with significant swelling, bleeding, and pain. Taking an antimicrobial medication or removing the irritant causing the distress could relieve the acute symptoms and destroy some of the offending microbes.

In the chronic phase of periodontal disease, inflammation exists for a long time or is constantly recurring. Chronic diseases don't heal by themselves, and they grow worse over time. A chronic disease usually doesn't have one single cause but rather several factors that give rise to the disease. Individuals with chronic disease generally also have complex symptoms.

Which leads to the question: Could chronic periodontal disease have many components, one of which being an autoimmune response?

“A chronic disease usually doesn't have one single cause but rather several factors that give rise to the disease.”

In the journal Physiological Reviews (January 2011, Vol. 91:1, pp. 151-175), Dr. Alessio Fasano suggested that autoimmune diseases are a result of three elements:

  • Genetic predisposition
  • Environmental trigger (such as diet or bacteria)
  • Leaky gut

In his conclusion, he suggested that if you could eliminate any one of these, then you could potentially eliminate the autoimmune reaction.

It is interesting to note that many inflammatory markers in patients with periodontal disease are the same ones present in patients with rheumatoid arthritis. Rheumatoid arthritis is considered an autoimmune disease. Some researchers have raised the question, "Which came first: rheumatoid arthritis or periodontal disease?"

Several researchers published a paper in the journal eLife (November 5, 2013) demonstrating that specific intestinal bacteria were strongly correlated with newly acquired rheumatoid arthritis in their patient base. Also, these researchers showed that those specific bacteria when placed into the guts of sterile mice caused inflammatory reactions like those in their rheumatoid arthritis patients.

It is not a big leap to consider that specific unhealthy bacteria in the gut are actually initiating or contributing to the development and progression of chronic periodontal disease.

Therefore, it would not be a big leap to consider improving the diet to eliminate the offending "foods" that cause unhealthy changes in the gut lining and also in the healthy microbiome of the gut.

Alvin Danenberg, DDS, practices at the Bluffton Center for Dentistry in Bluffton, SC. He is also on the faculty of the College of Integrative Medicine and created its integrative periodontal teaching module. He also spent two years as chief of periodontics at Charleston Air Force Base earlier in his career. His website is

The comments and observations expressed herein do not necessarily reflect the opinions of, nor should they be construed as an endorsement or admonishment of any particular idea, vendor, or organization.

Copyright © 2018

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