Brushing your teeth regularly can prevent deadly liver disease

No system in the human body functions in isolation. The health of any body part has impacts on the well-being of other parts, sometimes in surprising and unexpected ways.

A recent scientific review has turned attention to the mouth – and how gum disease might be playing a surprising role in liver health.

This review, led by a group of scientists from First Hospital of Jilin University, looks at how gum disease, especially advanced periodontitis, may worsen chronic liver conditions like cirrhosis, metabolic dysfunction-associated steatotic liver disease (MASLD), and alcohol-related liver disease.

Though the mouth and liver are far apart in both distance and function, researchers believe they may be more connected than we thought.

Mouth’s connection to liver disease

Gum disease, particularly periodontitis, is a chronic inflammation caused by bacterial infection in the tissues supporting the teeth.

It’s extremely common worldwide and tends to worsen with age, smoking, alcohol use, and poor dental care, which are the same risk factors seen in people with liver disease. Because of this overlap, oral health often gets overlooked in these patients.

But this could be a serious mistake.

The review explains how bacteria from the mouth might reach and affect the liver. One key route is through what scientists call the “oral-gut-liver axis.”

Harmful oral bacteria can be swallowed or enter the bloodstream during everyday actions like brushing or chewing. Once in the gut, they may disrupt the gut microbiome, causing an imbalance and weakening the gut lining.

This so-called “leaky gut” allows bacterial toxins to escape into the bloodstream and reach the liver, where they can trigger inflammation and scarring.

Animal models add weight

Animal studies support this idea.

Researchers have shown that introducing periodontal bacteria like Porphyromonas gingivalis into the mouths of mice with metabolic disease can make their liver conditions worse.

In some cases, the bacteria or their toxins have even been detected in liver tissue, suggesting that the trip from mouth to liver is not just possible, but biologically real.

Inflammation as a common thread

The immune system plays a big role too.

Periodontal inflammation releases molecules like TNF-alpha and IL-6, which are well-known culprits in liver disease.

The review also points to Th17 cells, a type of immune cell triggered by oral bacteria, that may travel to the liver and worsen any damage.

It creates a vicious cycle: poor oral health contributes to liver disease, and this makes oral health harder to manage.

Real-world evidence is emerging

Though the research is still developing, clinical findings are beginning to show a pattern.

People with cirrhosis often have much worse oral health than others, with issues like gum overgrowth, bone loss, and tissue breakdown. In fact, up to 72 percent of people waiting for liver transplants may have periodontitis.

Studies also show that severe gum disease can raise the risk of death in cirrhosis patients.

For MASLD – the most common chronic liver disease – the pattern continues.

Large-scale studies show that people with advanced gum disease are more likely to have MASLD, even when adjusting for obesity, diabetes, and other shared factors.

In a small clinical trial, treating gum disease actually improved liver enzyme levels in the short term. It’s not proof, but it’s a hopeful sign.

More questions to answer

The scientists behind the review are careful to note that the research is still in its early stages.

Most of the data comes from observational studies, which can’t prove cause and effect. It’s also difficult to untangle lifestyle and economic issues that may impact both oral and liver health.

Still, the combination of biological plausibility, consistent results, and early trial data makes a strong case. Gum health might deserve a bigger consideration when managing liver disease.

Preventing liver disease with a toothbrush

The review ends with a clear recommendation: doctors and dentists need to work together.

Liver specialists may not ask about oral health, and dentists may not know that their patients’ livers are at risk. Better collaboration between the two could mean earlier detection and better outcomes for patients.

In the meantime, one message is clear. Good dental hygiene – brushing, flossing, and regular dental visits – is more than just a routine. It may be a small but important step in protecting liver health.

Researchers are now pushing for large-scale trials to see if treating gum disease can actually slow the deterioration of the liver, or at least reduce complications.

If proven, the toothbrush could become a powerful tool in an unexpected battle – the fight against liver failure.

The full study was published in the journal eGastroenterology.

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