A pink thread in the sink
It is evening and you are brushing your teeth like every day. You spit, and a pink thread runs through the foam in the sink. Maybe you scrubbed too hard, you think, and by the next morning it is forgotten.
Many people feel the same. Bleeding gums are seen as a minor thing, something that just happens now and then. Usually, though, they are a sign that the gums are inflamed. And that is more common than you might think: in the latest German Oral Health Study, almost all of the 35- to 44-year-olds examined had at least early periodontitis, an inflammation that has spread from the gums to the tissue that holds the teeth in place.
What does this have to do with your biological age? Your chronological age counts the years since you were born. Your biological age describes the actual condition of your body, for example how elastic your blood vessels are. One of the forces that push it up is low-grade inflammation that goes unnoticed for years. One of its sources sits where hardly anyone would look for it.
Periodontitis: A wound you cannot see
Between tooth and gum there is a narrow groove. If bacteria collect there, the gums respond with inflammation: they turn red, swell and bleed easily. If the plaque stays, the inflammation digs deeper. Pockets form in which more bacteria settle, and the bone around the tooth slowly recedes.
Because this happens at many teeth at the same time, it adds up. In people who came for periodontitis treatment, the inflamed area in a Japanese analysis added up to around 13 square centimetres on average, roughly the size of a matchbox. It is an open wound, just well hidden.
Through this wound, bacteria and inflammatory substances enter the bloodstream. Your immune system stays on mild alert all the time. An analysis of 39 studies with more than four million people showed: those with healthy gums developed cardiovascular disease less often and lived longer on average. But is that really down to the gums, or do people who look after their teeth simply live healthier lives overall? To find out, you need an experiment.
Can healthy teeth keep your blood vessels younger?
That is exactly the experiment a team led by periodontist Maurizio Tonetti carried out in London. 120 people with severe periodontitis were randomly divided into two groups. One group received the usual cleaning above the gum line. In the other, the gum pockets were cleaned thoroughly under local anaesthetic. Then the researchers measured not only in the mouth but also on the arm: how well the arm artery widens when more blood flows through it. This shows how elastic and healthy the blood vessels are.
On the day after treatment, things initially looked worse. The thorough cleaning had briefly stirred up the body, inflammation markers in the blood rose, and the blood vessels widened less well than in the comparison group. After two months, the picture had turned around. After six months, the blood vessels of the thoroughly treated group worked considerably better, and the more the gums had recovered, the greater the benefit.
Elastic blood vessels are one of the reasons why some bodies are biologically younger than others. Read more here (Article: Endurance).
What happens in your mouth does not stay in your mouth. Looking after your gums also does something for your blood vessels.
How to keep your gums healthy
The good news: against most gum inflammation, routine helps more than any special product. The basis is brushing twice a day for two minutes with fluoride toothpaste. A toothbrush, however, only reaches the surfaces it touches, and inflammation often starts between the teeth. That is why cleaning between your teeth once a day is part of it. Small interdental brushes did slightly better than floss in studies. Where the gaps are very narrow, though, floss is the right choice.
On top of that come check-ups at the dental practice once or twice a year. There, pockets are spotted early, long before you notice anything yourself. If your gums keep bleeding for one to two weeks despite thorough care, it is worth not waiting until your next appointment.
Smoking is one of the strongest single factors for periodontitis, and it even masks it. Because the blood vessels are narrower, the gums of smokers bleed less often, even though they are inflamed. Read more here (Article: Smoking).
In the end, it is like many things that affect your biological age: what makes the difference is not the one big effort, but the two minutes you invest again every evening.
Where you stand on teeth
How you look after your teeth and gums is one of the questions in the BioAge test. Together with 24 other questions, it gives an estimate of your biological age and an overview of where you have the most to gain.
Frequently asked questions about teeth and biological age
Electric or manual toothbrush: Which is better?
Both work if you brush thoroughly. In studies, electric toothbrushes, especially rotating models, removed slightly more plaque and reduced gum inflammation slightly more. If you brush carefully with a manual toothbrush, there is no need to switch.
What does health insurance pay for?
In Germany, statutory health insurance pays for a check-up twice a year, tartar removal once a year and a short gum examination (PSI) every two years. Professional teeth cleaning is not covered, but many insurers subsidise it. Also have your annual check-up recorded in your bonus booklet: this increases the subsidy later if you ever need dentures or crowns.
How do I recognise periodontitis?
Typical signs are bleeding gums, red or swollen gums, bad breath, exposed tooth necks and teeth that become loose. Pain often comes late or not at all. Only an examination at the dental practice gives certainty.
I have diabetes. Do my gums play a special role?
Yes. Diabetes and periodontitis reinforce each other. In an analysis of 30 studies, periodontitis treatment in people with diabetes noticeably lowered the long-term blood sugar value in the months that followed. So make a point of telling your dental practice about your diabetes.
Does mouthwash help?
It can add to your routine, but not replace it. Toothbrushes and interdental brushes remove plaque mechanically, which no rinse can do. Antibacterial mouthwashes can be useful for a short time when there is inflammation, ideally after talking to your dental practice.