Gingivitis: The Genetic Connection between Gum Disease, Inflammation, and Overall Health

Key takeaways:

• Gingivitis and periodontal disease are caused by inflammation in your gum tissue.
• Bacteria in the mouth cause inflammation in the gums. Brushing and not smoking help to decrease inflammation.
• Gum disease and oral health are linked to overall health, including heart disease and neurodegenerative diseases.
• Genetic variants play a big role in how much inflammatory response you will have in the mouth.  Targeting the right genes may help with gum disease.

What is Gingivitis?

Have you ever gone to the dentist, expecting a good report, only to be fussed at by the hygienist for bleeding gums? You brushed, flossed, and stayed away from candy for the past six months — so why on earth do you still have inflamed gums?

Inflammation of the gums, known as gingivitis, is caused by an inflammatory response in the tissue of your gums. Periodontal disease is another term you may have heard mentioned by your hygienist (as she stabs your gums with the sharp poking tool). Periodontal disease is a term that includes gingivitis and then the next step – inflammation of the jawbone and loose teeth.[ref]

So what causes gingivitis? Lack of brushing and flossing… maybe. Smoking, for sure.

But what if you regularly brush and floss? And what about those people (you know who you are) who don’t brush and floss but have healthy gums?

The key here is the body’s response to the bacteria and biofilm on the teeth. The mouth is teeming with bacteria, and your immune system is on high alert to keep those bacteria from crossing into the bloodstream.

Inflammation, gingivitis, and genetics:

Some people naturally (genetically) are more prone to producing higher levels of inflammatory cytokines. This is a positive attribute when you are fighting off certain viruses or bacteria. But the flip side is that elevated inflammation causes a number of diseases – including gum disease.

Frequently, people with gingivitis have higher CRP levels on average than people without gingivitis. And people with periodontitis had even higher CRP levels.[ref]

Genetic studies reveal a lot about the underlying causes of diseases, including gingivitis and periodontal disease.

Variants that increase inflammatory cytokines, such as TNF-alpha, interleukin 1A (IL1A gene), interleukin 6 (IL6 gene), and interleukin 8 (IL8 gene), are all linked to increased risk of gingivitis.

Your body also has ways to mitigate inflammatory cytokine production. Interleukin 10 is one such mechanism for moderating the inflammatory response. Genetic variants that decrease IL-10 are thus linked to increased inflammation and an increased risk of periodontal disease.

An increased inflammatory response to bacteria causes inflammation in the gums – gingivitis or periodontal disease. And targeting the right genetic variants may help you stop the bleeding and receding gums.

Heart disease and Gingivitis:

This article isn’t just about a little bleeding when you brush or floss. Gingivitis and an increased risk of heart disease are strongly connected.

This connection may be due to increased systemic inflammation, or it may be due to bacteria entering the bloodstream when your gums bleed (flossing, brushing).[ref]

Resolving inflammation:

The resolution of inflammation – the shutting off of inflammatory cytokine production – is actually an active process. Certain lipid-based molecules called pro-resolving mediators are produced to both stop inflammatory cytokine production and also promote the healing process (stem cells, etc.). These lipid-based pro-resolving mediators are produced from DHA and EPA, which are found in marine oils.

This is a huge and really important topic that I encourage you to read all about: Specialized Pro-Resolving Lipid Mediators: Getting Rid of Chronic Inflammation.

Genes related to inflammation in the gums:

Your genetic variants in genes related to inflammatory cytokines can significantly increase your risk of having inflamed gums.

TNF-α (Tumor necrosis factor-alpha) gene:
TNF-α is an inflammatory cytokine involved in the body’s immune response. TNF is important to have in the right amounts. It helps the body destroy cells with aberrant DNA, but too much TNF is implicated in inflammatory diseases such as rheumatoid arthritis. TNF-α is stimulated by bacterial endotoxin (lipopolysaccharide) as well as other pathogens. It is one of the body’s primary mediators in protection against bacteria and viruses. Chronically elevated levels of TNF can lead to the destruction of the bone in periodontitis.[ref][ref]

IL1A gene (Interleukin 1) and IL1B gene:
Interleukin 1 is another inflammatory cytokine produced by lymphocytes or monocytes and released in response to endotoxins. Genetic variants in IL1A and IL1B increase the inflammatory response and are strongly tied to an increased risk of gingivitis.

IL2 gene:
Interleukin-2 (IL-2) is a pro-inflammatory cytokine produced primarily by T-helper 1 (Th1) cells, which influence how the body reacts to bacterial infections that cause periodontitis. Specifically, IL-2 activates T-cells, B-cells, and natural killer cells, driving the cellular immune response against bacteria in the gums. Genetic variants in the IL2 gene increase inflammation and increase the relative risk of chronic periodontitis.[ref]

IL-6 gene:
Interleukin 6 acts both as an inflammatory cytokine and as an anti-inflammatory signal by moderating TNF-alpha. This is another important cytokine in infection, but if the body does not control it well, it can also cause problems.[ref]

IL8 gene:
Interleukin 8 is an essential regulator of the inflammatory response. It is released by neutrophils in response to infection in the gum tissue.[ref]

IL10 gene:
The IL10 gene codes for the anti-inflammatory cytokine IL-10 (interleukin-10). Variants causing a decrease in the amount of IL10 are associated with increased inflammation. In contrast, variants that cause an increase in IL10 are associated with less inflammation.

Lifehacks for reducing gum disease:

Here are some natural options to explore for reducing inflammation in your gums. Please talk with your dentist for advice that is personal for your situation.

Good oral hygiene:
It almost goes without saying (but I’m saying it anyway) that good oral hygiene measures, such as brushing your teeth and using a water flosser, are important in oral health and gingivitis. This is the starting point.

Reducing fluoride to reduce inflammation?
Studies show fluoride increases inflammatory cytokines, including TNF-α, IL-1β, and IL-6.[ref][ref][ref]

Does this mean that you should stop drinking fluoridated water and use toothpaste without fluoride? I’ll let you read through the research and decide for yourself.

Related article: Fluoride and genetic interactions

Swish with salt water:
Rinsing with salt water has some interesting research behind it for decreasing gingivitis. The study on saline shows that it increases type-I collagen and fibronectin in gingivitis cells.[ref]

Supplements for reducing inflammation in your gums:

Luteolin:
In a study of children with autism spectrum disorder, luteolin supplementation has been shown to decrease elevated TNF levels significantly. The supplement used in the study was NeuroProtek.[ref]

Related article:  Luteolin as a natural anti-inflammatory

Hesperidin:
A natural flavonoid from citrus fruits, hesperidin inhibits the release of TNF-alpha.[ref][ref]

Related article:  All about hesperidin.

Curcumin:
Found in the spice turmeric, curcumin is a natural TNF-alpha inhibitor.[ref]

Related article:  Curcumin: Research studies, genetic interactions.

Quercetin and Resveratrol:
Natural TNF inhibitors also include quercetin and resveratrol. Studies show that resveratrol and curcumin specifically reduce the progression of periodontitis.[ref][ref] Quercetin also inhibits the overproduction of IL-1B.[ref]

Related article: Resveratrol: Genetic Interactions and Bioavailability

Related article: Quercetin bioavailability and absorption

Glycine:
Found abundantly in bone broth, glycine has been shown to inhibit TNF-α due to endotoxins in a study.[ref]

Green tea as mouthwash:
Green tea can be used as a natural mouthwash. Components in green tea are antimicrobial. A study found that using green tea as a mouthwash worked better for reducing gingivitis than chlorhexidine gluconate (a strong germicidal mouthwash).[ref]

Vitamin C:
Getting enough vitamin C in your diet is important for gum and tooth health. One of the first symptoms of scurvy includes swollen gums and loose teeth. But what about in our modern era, when scurvy is practically non-existent? It turns out, a low intake of vitamin C shows an increase in the risk of periodontitis in several studies.[ref][ref][ref]

Foods rich in vitamin C include sweet peppers, citrus fruits, peaches, and broccoli.[ref] Plus, vitamin C is a cheap and readily available supplement if you don’t eat enough fresh fruit and vegetables.

Magnesium:
Low magnesium levels may play a role in higher TNF-alpha levels. Magnesium sulfate, in conjunction with thyroid medication, in hypothyroid rats, decreased TNF-alpha levels.[ref][ref]

Related Articles and Topics:

Dental Implants: Genetics & Reducing the Risk of Implant Failures

TNF-alpha: Inflammation, Chronic Diseases, and Genetic Susceptibility

TNF-alpha: Inflammation, Chronic Diseases, and Genetic Susceptibility

Curcumin Supplements: Decreasing Inflammation