Periodontal Disease and Your Health

Our practice seeks to educate the public about research findings which support what dental professionals have long suspected: Infections in the mouth can play havoc elsewhere in the body. For a long time it was thought that bacteria was the factor that linked periodontal disease to other infections in the body; however, more recent research demonstrates that inflammation may link periodontal disease to other chronic conditions.

Research has shown, and experts agree, that there is an association between periodontal diseases and other chronic inflammatory conditions, such as diabetes, cardiovascular disease and Alzheimer’s disease. Therefore, treating inflammation may not only help manage periodontal diseases but may also help with the management of other chronic inflammatory conditions.

When an inflammatory condition is suspected or diagnosed, it is important to consult with both a general physician and a dental health professional, such as a periodontist. Sometimes the only way to detect periodontal diseases is through a periodontal evaluation.

A periodontal evaluation may be especially important if you:

Have a high risk for periodontal diseases. Take the AAP risk assessment test.
Have heart disease, diabetes, respiratory disease or osteoporosis, or are thinking of becoming pregnant.
Have a family member with periodontal disease.
Have a sore or irritation in your mouth that does not get better within two weeks.

Heart Disease

Several theories exist to explain the link between periodontal disease and heart disease. One theory is that oral bacteria can affect the heart when they enter the blood stream, attaching to fatty plaques in the coronary arteries (heart blood vessels) and contributing to clot formation. Coronary artery disease is characterized by a thickening of the walls of the coronary arteries due to the buildup of fatty proteins. Blood clots can obstruct normal blood flow, restricting the amount of nutrients and oxygen required for the heart to function properly. This may lead to heart attacks.

Another possibility is that the inflammation caused by periodontal disease increases plaque build up, which may contribute to swelling of the arteries.

Researchers have found that people with periodontal disease are almost twice as likely to suffer from coronary artery disease as those without periodontal disease.

Periodontal disease can also exacerbate existing heart conditions. Patients at risk for infective endocarditis may require antibiotics prior to dental procedures. Your periodontist and cardiologist will be able to determine if your heart condition requires use of antibiotics prior to dental procedures.

Stroke

Additional studies have pointed to a relationship between periodontal disease and stroke. In one study that looked at the causal relationship of oral infection as a risk factor for stroke, people diagnosed with acute cerebrovascular ischemia were found more likely to have an oral infection when compared to those in the control group.

Diabetes

People with diabetes are more likely to have periodontal disease than people without diabetes, probably because diabetics are more susceptible to contracting infections. In fact, periodontal disease is often considered the sixth complication of diabetes. Those people who don't have their diabetes under control are especially at risk.

A study in the Journal of Periodontology found that poorly controlled type 2 diabetic patients are more likely to develop periodontal disease than well-controlled diabetics are.

Research has emerged that suggests that the relationship between periodontal disease and diabetes goes both ways - periodontal disease may make it more difficult for people who have diabetes to control their blood sugar.

Severe periodontal disease can increase blood sugar, contributing to increased periods of time when the body functions with a high blood sugar. This puts diabetics at increased risk for diabetic complications. Thus, diabetics who have periodontal disease should be treated to eliminate the periodontal infection.

Rheumatoid Arthritis

Over 1.3 million Americans suffer from rheumatoid arthritis (RA), a chronic, inflammatory disease of the joints. RA is a disabling condition, and can lead to long-term joint damage resulting in persistent pain and loss of function in affected areas. A study published in the June 2008 issue of the Journal of Periodontology, the official publication of the American Academy of Periodontology (AAP), uncovered yet another potential side effect of RA. Researchers in Berlin, Germany discovered that patients with RA have a higher incidence of periodontal disease compared to healthy controls. Study Abstract .

For some patients, adverse RA symptoms may affect manual dexterity, which can make one’s daily routine quite difficult. One area that may be affected is oral hygiene which can ultimately lead to periodontal disease. However, these research findings indicate that poor oral hygiene alone did not account for the association between RA and gum disease, suggesting that other factors may play a role as well.

The study findings indicated that RA patients were nearly eight times more likely to have periodontal disease compared to the control subjects. These findings accounted for demographic and lifestyle characteristics such as age, gender, education and tobacco use. Researchers then examined the extent to which poor oral hygiene was connected to the increased occurrence of gum disease in RA patients. The results showed that while oral hygiene was markedly a factor, it did not fully explain the association between the two diseases, suggesting that there may be other parameters responsible for the increased prevalence of gum disease in RA sufferers.

Gum Disease and Pregnancy

For a long time we've known that risk factors such as smoking, alcohol use, and drug use contribute to mothers having babies that are born prematurely at a low birth weight.

Now evidence is mounting that suggests a new risk factor – periodontal disease. Pregnant women who have periodontal disease may be seven times more likely to have a baby that is born too early and too small.

More research is needed to confirm how periodontal disease may affect pregnancy outcomes. It appears that periodontal disease triggers increased levels of biological fluids that induce labor. Furthermore, data suggests that women whose periodontal condition worsens during pregnancy have an even higher risk of having a premature baby.

All infections are cause for concern among pregnant women because they pose a risk to the health of the baby. The Academy recommends that women considering pregnancy have a periodontal evaluation.

Respiratory Disease

Bacterial respiratory infections are thought to be acquired through aspiration (inhaling) of fine droplets from the mouth and throat into the lungs. These droplets contain germs that can breed and multiply within the lungs to cause damage. Recent research suggests that bacteria found in the throat, as well as bacteria found in the mouth, can be drawn into the lower respiratory tract. This can cause infections or worsen existing lung conditions. People with respiratory diseases, such as chronic obstructive pulmonary disease, typically suffer from reduced protective systems, making it difficult to eliminate bacteria from the lungs.

Osteoporosis

Researchers have suggested that a link between osteoporosis and bone loss in the jaw. Studies suggest that osteoporosis may lead to tooth loss because the density of the bone that supports the teeth may be decreased, which means the teeth no longer have a solid foundation. However, hormone replacement therapy may offer some protection.

One study published in the June 2007 Journal of Periodontology (JOP) examined1,256 postmenopausal women and looked for a potential association between periodontal bacteria and bone loss in the oral cavity. The study results showed that women with periodontal bacteria in their mouths were also more likely to have bone loss in the oral cavity, which can lead to tooth loss if not treated.

Whoopi Goldberg talks about periodontitis