Introduction
The impact of oxidative stress (OxS) and how it is implicated in periodontal diseases of your oral cavity is surprising. Periodontal diseases are some of the most commonly occurring and even globally rising inflammatory disorders currently, in both developing and developed countries alike, affecting population groups of almost all decades or age groups of life. This article will delve into the role of oxidative stress and DNA (deoxyribonucleic acid) damage and how they are increased in periodontal diseases.
What Is the Concept of Free Radicals and DNA Damage in Periodontal Disease?
Periodontal diseases are mainly characterized by gingival or gum inflammation, in which clinically the various pathogenic or periodontopathic bacteria tend to generate a primary response that is both immunological and inflammatory, resulting in localized tissue or bone destruction, resulting eventually in tooth and underlying jaw bone loss with a horizontal or vertical resorption pattern. To understand the concept of OxS resulting in periodontitis (inflammation of the gums) classically, it is equally important to know the concept of free radicals.
Given that stress directly has an impact on oral immunity, how do the counts of periodontal pathogens or the aggravation of infection occur in the oral cavity? This can be attributed to the long-term release of the reactive oxygen species (ROS) that are direct results or byproducts of the free radicals that cause OxS.
When there is innate damage to the genetic material or DNA changes in your body or your immune system, there can be a series of triggers that can influence your systemic and oral immunity to be compromised. This is the cause of several cancers as well when the OxS is uncontrolled or left untreated in the patients who are afflicted. The periodontal disease remains the classic example where the effects of OxS can be seen both locally and systemically, as periodontal diseases can result in the progression of systemic diseases, and vis-a-vis holds too.
DNA damage can also produce several ill effects on human health by slow and steady or chronic disease progression patterns in your body. For example, though periodontal diseases are not directly linked to cancers in the oral cavity; they result directly in the resorption of alveolar bone, with extensive pathogenic or anaerobic infections increasing OxS, that is again the chain initiator for cancers or the progression of benign or malignant oral tumors.
Why Oxidative Stress Is Implicated in Periodontitis?
Though several risk factors have been attributed to the development and progression of periodontal diseases in dentistry, more research facts are now coming into light in the present-day clinical practice that can offer dentists a scope into the understanding of the progression or etiologic mechanisms or causatives behind periodontal diseases. One of the important, yet underestimated factors that can cause periodontal disease is oxidative stress in an individual, which is seen in individuals suffering from general or systemic diseases and in several inflammatory conditions of the body. Oxidative stress is also common in immunocompromised individuals, where systemic immunity is considerably lowered.
Oxidative stress (OxS) is the primary culprit deemed by current medical, dental, and oncologic research to be the stimulation causative behind several types of chronic diseases and cancers. Even in the case of periodontal or gum diseases, that may be occurring either genetically in individuals as discrepancies or as a result of maternal infections that can aid in disease transmission in the newborn or infants, or in cases such as acquired juvenile periodontal diseases or in later stages of life; OxS has been implicated clearly in the pathogenesis of periodontitis.
What Is the Concept of OxS Causing Oxidation of Biomolecules Orally?
Free radicals (FR) are basically the molecular species that comprise at least one unpaired electron that possesses a very high chemical reactivity or rather molecular instability. Whenever your oral or bodily tissues see an increase in the circulating FR in blood, there will be more chances of a gradual increase in oxidative stress (OxS).
OxS is defined mainly by medical science as a disturbance or discrepancy occurring in the otherwise normal balance that is sustained between the production of reactive oxygen or nitrogen species. With the rise in free radicals and eventually in OxS, the natural antioxidant defense mechanisms of the oral cavity are counteracted or compromised. The accumulation of ROS or RNS has been shown to alter the normal metabolic processes and instead cause the peroxidation of lipids, the oxidation of proteins, and the damage in nuclear DNA, thereby even stimulating the breakage of DNA nucleosides or the strands, escalating the periodontal infections.
In a healthy oral cavity, the risk of OxS is generally low because the antioxidant or protective immune properties of buffers like saliva, the gingival and periodontally circulating fluids, etc. can all act as the immune defense against anaerobic bacterial or microbial invasion.
However, in the chain of OsX, when the number of free radicals increases, leading up to the phenomenon called "oxidation of biomolecules," there is an imminent loss in the immune and biological functioning of your oral cells or tissues. Currently, dental research shows that apart from the periodontium, that is the supporting or anchoring, cushioning and immune defense mechanism of the tooth- the oral mucosal tissues are the next most commonly affected as a result of oxidative stress or the increasing circulation of harmful free radicals.
What Is the Diagnosis of OsX Through Research-Based Methods?
In order to determine the extent of DNA damage or to find out oxidative stress levels in the human body and how it impacts the periodontium, researchers have investigated the levels of the compound "8-hydroxy-2′-deoxyguanosine," with its high levels indicating that it is one of the common and stable products occurring as a result of oxidative DNA damage in the oral cavity. It would be surprising to know that elevated levels of 8-OHdG (8-Hydroxy-2'-deoxyguanosine) are found commonly in cancer patients compared to healthy subjects and the implicated cancers are usually lung cancers, basal cell carcinomas (slow-growing type of skin cancer that arises from the basal cells in the epidermis, usually due to prolonged sun exposure), squamous cell carcinoma (type of cancer that develops in the squamous cells lining the mouth and can be linked to tobacco use, alcohol, or human papillomavirus (HPV) infection) of the mouth, colorectal cancer, renal cell carcinoma (a most common type of kidney cancer, originating in the renal tubules and often linked to smoking, obesity, and hypertension), etc. This also proves the research link that establishes the indirect yet plausible connection between periodontal diseases and OsX-causing generalized diseases, chronic illnesses, and cancers.
Conclusion
DNA damage is one of the primary effects resulting from increased OxS in affected individuals with periodontal diseases. As general health or your immune and systemic health is linked to oral health, and vis a vis, the fact that the mouth is indeed the mirror to general health is a saying that can be truest or scientifically proved by researchers in the present day, in this perspective.
