Medical Disclaimer: This article explores the observed associations and shared biological pathways between psoriasis and periodontal (gum) disease as reported in scientific literature. It is for informational and educational purposes only and is not medical advice. This content does not establish that one condition causes the other. Psoriasis is a medical condition that must be diagnosed and managed by a dermatologist. Always consult your healthcare providers for personal medical advice and treatment plans.
You look in the mirror and see the story of your psoriasis written on your skin—the raised plaques, the silvery scales. Your dermatologist explains it as an immune-mediated condition, a case of systemic inflammation. But does your healthcare team ever discuss the health of your gums? Historically, medicine has operated in specialties. Yet the body is an interconnected system. Emerging research highlights a significant association between psoriasis and gum disease, suggesting shared inflammatory pathways that warrant a holistic view of health.
Psoriasis and Gum Disease: Shared Inflammatory Pathways
The link between psoriasis and periodontitis appears to be rooted in shared immune dysregulation, not a simple cause-and-effect. Think of the immune system as an orchestra. In health, it plays harmoniously. In both psoriasis and periodontitis, research has observed hyperactivity in specific pathways, particularly those involving Th17 (T-helper 17) cells and signaling proteins like Interleukin-17 (IL-17) and Interleukin-23 (IL-23). This common inflammatory thread may help explain why the two conditions are frequently observed together.
The Th17 Pathway: A Common Thread in Skin and Gums
- In Psoriasis: Th17 cells and their cytokines (IL-17, IL-23) are central drivers, accelerating skin cell turnover and local inflammation.
- In Periodontitis: The bacterial biofilm triggers a host immune response that also involves the activation of Th17 pathways and IL-17. This suggests a parallel in immune pathway activation in both skin and oral tissues.
The Systemic Inflammation Hypothesis
Chronic gum inflammation produces inflammatory molecules that can enter the bloodstream. The scientific hypothesis is that this may contribute to an individual’s overall systemic inflammatory burden. For someone with psoriasis, this added burden could potentially influence immune activity, though research does not confirm gum disease as a direct cause of psoriatic flares.
Genetic and Environmental Factors
Shared genetic predispositions (e.g., in genes affecting IL-23 signaling) may make some individuals susceptible to both Th17-mediated inflammation in the skin and the gums. Environmental factors, like oral bacteria, may interact with these genetic tendencies.
What Does the Research on Gum Therapy Show?
Some clinical studies have investigated whether professional periodontal treatment (scaling and root planing) is associated with changes in systemic inflammatory markers. Preliminary observational findings suggest such care may correlate with reductions in markers like CRP. It is crucial to note: this research does not prove that dental treatment improves psoriasis skin symptoms. It supports the broader principle that managing one source of chronic inflammation may benefit overall inflammatory load.
The Importance of Collaborative Care
This research underscores the value of coordinated care between dermatologists and dentists.
- For Patients with Psoriasis: Inform your dermatologist about your oral health and your dentist about your psoriasis diagnosis.
- For Healthcare Providers: A holistic view that includes oral health can be part of comprehensive inflammatory disease management.
Routine dental evaluations and meticulous oral hygiene are important for everyone, but may be especially pertinent for individuals with chronic inflammatory conditions like psoriasis as part of a whole-body health strategy.
A Holistic Approach to Management
Managing psoriasis requires a plan led by your dermatologist, including topical treatments, systemic medications, and lifestyle measures. Oral health care is not a substitute for this treatment. However, understanding the association with gum disease reinforces that the body is interconnected.
Your Most Important Step: Integrate Your Care
If you have psoriasis, your dermatologist is your guide for management. If you have signs of gum disease (bleeding, swelling), consult a dentist.
The goal is collaboration, not replacement. Ensure both your dermatologist and dentist are fully informed. This integrated approach allows your entire healthcare team to help you manage inflammation and protect your overall health most effectively.
This article reviews associations and hypotheses from current scientific literature. Individual treatment decisions must be made in consultation with your qualified healthcare team.
References
The Periodontal Professor — Prof. Solomon O. Nwhator, BDS (Lagos), PhD (Helsinki), FMCDS, FWACS, Professor of Periodontal Medicine
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