Oral Bacteria And Your Health - with Dr. Mark Burhenne | The Empowering Neurologist EP. 162

Gum disease and oral inflammation cross the placental barrier and cause complications such as preterm birth and low birth weight.

"This bug will cross the blood-brain barrier. It crosses the placental barrier as well. That's why women that have gum disease or even inflammation, gingivitis, there are a lot of complications, preterm and low birth weight births, which is pretty common." (said at 0:20:05)

The claim that periodontitis/oral inflammation is associated with adverse birth outcomes like preterm birth (PTB) and low birth weight (LBW) is supported by observational research and mechanistic models. Systematic reviews and meta-analyses of observational studies show that pregnant individuals with periodontal disease have a significantly higher risk of PTB and LBW (e.g., OR = 1.57 for PTB and OR = 2.43 for LBW in prospective/case-control meta-analyses). Preclinical and bioinformatic research also demonstrates that oral pathogens (such as *Porphyromonas gingivalis* and *Fusobacterium nucleatum*) can enter hematogenous circulation and disrupt/cross the placental barrier, inducing inflammatory signaling. However, meta-analyses of randomized controlled trials (RCTs) assessing non-surgical periodontal therapy during pregnancy show that treating periodontal disease does not consistently reduce the risk of PTB or LBW, leading major evaluations (such as those using Bradford Hill criteria) to conclude that a causal relationship remains unproven. Therefore, while oral pathogens can translocate to the placenta and are associated with increased risk of complications, calling them direct causes requires qualification due to the lack of risk reduction upon treatment.

context: An umbrella review of systematic reviews of the evidence of a causal relationship between … (Canadian journal of dental hygiene : CJDH = Journal canadien de l'hygiene dentaire : JCHD 2020) · cited 23x in the literature
"Bradford Hill criteria analysis failed to support a causal relationship between periodontal disease and adverse pregnancy outcomes based on the most current evidence available." (abstract, conclusions, passage verified)
pubmed
supports: Periodontal Disease and Adverse Neonatal Outcomes: A Systematic Review and Meta-Analysis. (Frontiers in pediatrics 2022) · cited 36x in the literature
"Based on fixed effect meta-analysis, PTB showed a significant association with PD (OR = 1.57, 95% CI: 1.39-1.77, P < 0.00001) and LBW also showed a significant association with PD (OR = 2.43, 95% CI: 1.75-3.37, P < 0.00001) in a random effect meta-analysis." (abstract, results, passage verified)
pubmed full study (doi)
supports: A scientometric analysis of research related to the 'oral-placental axis' hypothesis: curr… (Frontiers in cellular and infection microbiology 2026)
"Pathogenic bacteria including Fusobacterium nucleatum and Porphyromonas gingivalis mediated adverse pregnancy outcomes via hematogenous spread and placental barrier disruption." (abstract, results, passage verified)
pubmed full study (doi)

0:29:15 Mark Burhenneneeds contextmoderate

Endothelial production of nitric oxide in the human body significantly declines by approximately age 40.

"Typically, by age 40, you know, the endothelial cells and other cells in the body, that that production value drops, but the mouth keeps on going." (said at 0:29:15)

Endothelial nitric oxide (NO) bioavailability and whole-body NO production decline progressively with advancing age, but the timeline differs significantly by sex. Landmark physiological studies of endothelium-dependent flow-mediated dilation show that endothelial function remains relatively stable in healthy men until roughly age 40, after which it begins a steady decline. In healthy women, endothelial function typically remains preserved until the early 50s (around menopause), after which it declines at a steeper rate.

supports: Impaired plasma nitric oxide availability and extracellular superoxide dismutase activity … (Life sciences 2006) · cited 69x in the literature
"As indicated by our results, advancing age was significantly related to decreased plasma values of NOx (r = -0.877, P < 0.001), EC-SOD activity (r = -0.888, P < 0.001)" (abstract, results, passage verified)
pubmed full study (doi)
supports: Associations between Aging and Vitamin D Status with Whole-Body Nitric Oxide Production an… (The Journal of nutrition 2024) · cited 12x in the literature
"In Study 1, whole-body NO production was significantly greater in young compared with older participants (0.61 ± 0.30 μmol·h -1 ·kg -1 compared with 0.39 ± 0.10 μmol·h -1 ·kg -1 , P = 0.01)" (abstract, results, passage verified)
pubmed full study (doi)
context: Aging is associated with endothelial dysfunction in healthy men years before the age-relat… (Journal of the American College of Cardiology 1994) · cited 1336x in the literature
"In men, flow-mediated dilation was preserved in subjects aged < or = 40 years but declined thereafter at 0.21%/year. In women, flow-mediated dilation was stable until the early 50s, after which it declined at 0.49%/year (p = 0.002 compared with men)." (abstract, results, passage verified)
pubmed full study (doi)

Oral Bacteria And Your Health - with Dr. Mark Burhenne | The Empowering Neurologist EP. 162

Needs context

Gum disease and oral inflammation cross the placental barrier and cause complications such as preterm birth and low birth weight.

Endothelial production of nitric oxide in the human body significantly declines by approximately age 40.