Sticking
to his Gums
Almost every person may be affected by gum disease in their lifetime. Professor Jin Lijian from the Faculty of Dentistry has been crusading globally for better gum care and oral health.
This is a ‘silent’ disease that eats at your gum tissue and destroys the bones around your teeth. When you notice your teeth starting to fall out and drift, it’s too late.
Professer Jin Lijian
If the gums were to have a cheerleader, it could very well be Professor Jin Lijian, Modern Dental Laboratory Professor in Clinical Dental Science. He has been researching gum disease including gingivitis and periodontitis for nearly 30 years and chairs the Science Committee of the FDI (Fédération Dentaire Internationale) World Dental Federation in Geneva, which represents over one million dentists. Getting word out about the seriousness of gum disease is a top priority.
“Gum disease is arguably the most common disease in humans. More than 90 per cent of Hong Kong people get gum disease at some point in their lives,” he said. But even dentists may have relatively low awareness of the problem.
“Unlike caries [tooth decay], this is a ‘silent’ disease that eats at your gum tissue and destroys the bones around your teeth. When you notice your teeth starting to fall out and drift, it’s too late. Oral health awareness and prevention and early oral care are the key.”
What’s worse, gum disease can affect our overall health. Research over the last couple of decades has linked gum disease with various systemic diseases, such as diabetes, heart disease, respiratory disease, some forms of cancers, pre-term birth and dementia.
“Gum disease significantly contributes to an elevated level of systemic inflammation,” Professor Jin said. Harmful bacteria can attach to and even invade the soft tissues, and induce an abnormal inflammatory response. This can resonate through the body when the bacteria and their toxins spread from the mouth to infect other tissues and organs, and when the inflammation triggers the liver to produce yet more inflammatory molecules.
Professor Jin (fifth from right) and his research students.
Getting the word out
Effective gum disease treatment can reduce systemic inflammation, but it is easier said than done, he said. The bacteria tend to colonise into plaque biofilms, which are difficult to eradicate. Once these affect the tissue and trigger the destructive gum inflammation of periodontitis, daily brushing and flossing are not enough to control the problem and professional care is needed.
Professor Jin’s work with the FDI has involved getting the word out to the world’s dentists and bringing them up to speed on the latest scientific evidence. His committee oversees the issuing of policy statements on evidence-based dentistry and major oral health issues to dentists from about 135 member countries. He was also involved in informing governments and healthcare workers about the global gum disease profile and ill effects of poor oral health on general health, when he chaired the task group on the global impact of gum disease of the International Association for Dental Research, a leading academic organisation, from 2009 to 2012.
Chlorhexidine-containing nanoparticles effectively against the oral bacterial biofilms of S sobrinus, F nucleatum and P gingivalis (lower). No effects of the blank nanoparticles on these bacteria (upper).
(Photos used under a Creative Commons Attribution 2.5 Generic License. Source: Seneviratne CJ et al. PLoS ONE 9[8]: e103234)
Professor Jin has also contributed to research on gum disease. His team is currently working on a major project to identify new products to control the problem. A recent study applied nanotechnology to successfully improve the antimicrobial efficacy of chlorhexidine, which is commonly used by dentists to stop the growth of harmful bacteria in the mouth. Silica nanoparticles quickly absorbed pure chlorhexidine, which was then slowly released so that even after three days, it still effectively controlled stubborn and harmful mixed bacterial biofilms. This was much more effective than the conventional mouth rinse with chlorhexidine, which has only six to 10 hours of effectiveness, and he hopes to develop it for patient use.
Professor Jin noted that healthier gums contribute not only to the overall physical health of an ageing population, but also to people’s psychological health. “A healthy smile is important for self-esteem. After improving your oral health, you can uphold your spirits and improve your quality of life. That is something money can’t match.”
Expert advice
Gum disease usually starts with gingivitis, in which the gums become inflamed with swelling and redness. This is very common among all age groups, even adolescents. If left untreated, it can progress over time into periodontitis, which destroys tooth-supporting tissue and bone and is the major cause of tooth loss in adults worldwide. Professor Jin offers this advice for maintaining healthy gums and teeth:
See your dentist at least once a year to prevent and treat emerging problems at an early stage.
Brush properly with fluoride toothpaste. The Bass brushing technique is recommended (demonstration videos can be found online). Try to brush your teeth correctly in a relaxed setting, so you don’t feel rushed and can spend three or four minutes on this task twice a day.
Floss and use interdental brushes daily, to remove dental plaque between teeth.
Control the common risk factors of oral and general health, such as smoking and excessive intake of sugar and alcohol.
If you have dental implants, this advice is just as important if not more so, since most implant patients have lost their teeth due to severe gum disease.
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