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The
Mouth and Body Connection
Gum disease and how it affects you
In July of
1998, the American Academy of Periodontology launched an effort to educate the public about new findings
which support what dental professionals had long suspected: Infections in the mouth can play havoc elsewhere in
the body. Periodontal (gum) disease is a bacterial infection, and all infections are cause for concern.
Periodontal bacteria can enter the blood stream and travel to major organs and begin new infections. Research is
suggesting that this may:
Ø Contribute to the development of heart disease, the nation's leading cause of
death.
Ø Increase the risk of stroke.
Ø Increase a woman's risk of having a preterm, low birth weight baby.
Ø Pose a serious threat to people whose health is compromised by diabetes, respiratory diseases,
or osteoporosis.
Heart Disease and
Stroke
Heart
Disease:
Several theories exist that 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 dentist 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.
Preterm Low Birth
Weight
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.
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.
Other research suggests that periodontal disease is not a risk factor for preterm low
birth weight babies. This recent study is conflicting with research findings listed above. However, pregnant
women should strive to have optimum health before, during, and after pregnancy for the benefit of their child
and self. Having optimum health should include oral health because of the systemic link between general
health and oral health.
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.
Respiratory
Diseases
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.
Scientists have found that bacteria that grow in the oral cavity
can be aspirated into the lung to cause respiratory diseases such as pneumonia, especially in people with
periodontal disease. This discovery leads researchers to believe that these respiratory bacteria can travel from
the oral cavity into the lungs to cause infection.
Chronic obstructive pulmonary diseases (COPD) cause persistent
obstruction of the airways. The main cause of this disease is thought to be long-term smoking. Chemicals from
smoke or air pollution irritate the airways to cause obstruction. Further damage to the tissue and working
function of the lungs can be prevented, but already damaged tissue cannot be restored - untreated or undetected
COPD can result in irreversible damage. Scientists believe that through the aspiration process, bacteria can
cause frequent bouts of infection in patients with COPD. Studies are now in progress to learn to what extent
oral hygiene and periodontal disease may be associated with more frequents bouts of respiratory disease in COPD
patients.
Osteoporosis
Researchers have suggested that a link exists 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.
A study published in the Journal of Periodontology concludes that
estrogen supplementation in women within five years of menopause slows the progression of periodontal disease.
Researchers have suspected that estrogen deficiency and osteopenia/osteoporosis speed the progression of oral
bone loss following menopause, which could lead to tooth loss. The study concluded that estrogen supplementation
may lower gingival inflammation and the rate of attachment loss (destruction of the fibers and bone that support
the teeth) in women with signs of osteoporosis, thus helping to protect the teeth.
Don't Ignore Your Oral
Health
If you value your oral as well as your overall health, a
periodontal evaluation is a good idea. Sometimes the only way to detect periodontal disease is through a
periodontal evaluation. A periodontal evaluation may be especially important if you:
- Notice any symptoms of periodontal disease (bleeding or
receding gums, bad breath, etc.)
- Have heart disease, diabetes, respiratory disease or
osteoporosis.
- Are thinking of becoming pregnant.
- Have a family member with periodontal disease. Research
suggests that the bacteria that cause periodontal disease can pass through saliva. This means the common
contact of saliva in families puts children and couples at risk for contracting the periodontal disease of
another family member.
- Have a sore or irritation in your mouth that does not get
better within two weeks.
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