The health of your teeth and gums can affect the health of your entire body. Maintaining good health in both your mouth and your body as a whole is much less expensive and much more enjoyable. Drs. Shad, Richard, and Clive Ingram are very concerned that all of their patients remain as healthy as possible, and all of us at VIP Smiles feel the same way. We have provided this page of information to help you understand the importance of your dental and overall health. If you have questions, and to make an appointment with our caring and experienced dentists in Syracuse, Utah, please contact us today at 801-776-3000.

Periodontal Disease and Overall Health [Developer’s note: Use H2 tags for underlined text. Bolded headings on this page are simply headings, not subpages. If you have questions, ask Emily or refer to their existing page – https://www.syracuseutdentistry.com/how-your-total-health-and-life-is-related-to-your-dental-health/ ]

Periodontal Disease and Your Heart (CLICK on the links below to learn even more):

More Effects of Gum Disease

Medical Effects Associated with Gum Disease

A recent study in a prominent cancer journal found that men with a history of gum disease are 14 percent more likely to develop cancer than men with healthy gums. In fact, researchers uncovered that men with periodontal disease may be:

  • 49% more likely to develop kidney cancer
  • 54% more likely to develop pancreatic cancer
  • 30% more likely to develop blood cancers

People with periodontal disease may be at 2-3 times the risk of having a stroke (brain attack) compared to people without periodontitis.

Periodontal organisms might be associated with the development of preeclampsia. A dangerous condition that occurs in pregnant women.

The bacteria of Periodontal disease can be found in the atherosclerotic plaque of coronary artery disease (these plaques clog the hearts blood vessels and lead to heart attack).

People with deep periodontal pockets had an increased risk for abnormal changes on their EKG’s. (A common test to examine the electrical activity of the heart.)

Periodontal diseases may contribute to the progression to prediabetes. Researchers found that having periodontal disease can cause someone to develop prediabetic characteristics, and probably disturb the glucose regulation of a non-diabetic who has prediabetic characteristics, contributing to the progression of Type 2 diabetes.

12 studies provide direct evidence of the association between pulmonary (lung) infection and oral diseases.

It has been found that diabetes and periodontal disease can lead to atherosclerosis.

Women with periodontal disease were at a greater risk for having a low birth weight and preterm birth babies than those without periodontal disease

Bacteria commonly found in the mouth and associated with periodontal diseases can be found in the amniotic fluid of some pregnant women.

79% of the women with untreated periodontal disease had delivered a preterm low birth weight baby compared to only 7.5% of the periodontally treated women and 4.1% of the healthy women.

The number of bacteria in periodontal pockets and around the teeth may contribute to an individual’s risk of a heart attack.

Researchers found that pregnant women with periodontitis had 65 percent higher C-reactive protein (CRP) levels compared to periodontally healthy women. CRP levels are a marker of systemic inflammation and are associated with periodontal disease, a chronic bacterial infection found in the gums of the mouth. CRP has also been associated with adverse pregnancy outcomes, including preeclampsia and preterm delivery.

A recent study suggests that edentulous, or toothless, adults may be more likely to have chronic kidney disease than adults with teeth. Untreated periodontal disease is the main reason for adult tooth loss in the United States.

New research confirms findings that periodontal disease may increase a person’s risk for the respiratory disorder Chronic Obstructive Pulmonary Disease (COPD), the sixth leading cause of mortality in the United States. The study also noted a correlation between the amount of periodontal disease and lung capacity.

Reality television has become a popular form of primetime entertainment. The latest topic helps people enhance their features from head-to-toe through plastic surgery. However, if a patient already has a bacterial infection in the body or mouth, the surgical procedure may have to be postponed. On one episode, the patient was unable to proceed with breast augmentation because of a bacterial infection in her mouth known as periodontal disease. The periodontist and plastic surgeon were concerned that the bacteria in the patient’s mouth may affect the outcome of her plastic surgery.

Bacteria from periodontal disease can enter the blood stream and can compromise recovery from any surgery, but is particularly problematic for patients receiving implants, transplants, or replacements of body parts since it may cause these procedures to fail.

Researchers have found that people with gum disease are almost twice as likely to suffer from coronary artery disease.

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.

One study of 1,147 men and found risk from periodontal disease for coronary heart disease, fatal coronary heart disease, and stroke to be as high as 2.8 times greater than for those without periodontal disease.

A new study shows that lifetime exposure to inflammation, including gum disease, may have a significant impact on the risk of developing Alzheimer’s disease.

Dr. Charles Mayo, the founder of the World Famous Mayo clinic was a big proponent of oral health and he understood the effect that oral health has on the rest of the body. He stated that “The presence of dental health is important. Dentistry is distinctive health services and can extend human life ten years.”

We are cheated out of 10 years when we do not have a healthy mouth. That’s 10 years lost with your spouse or children. 10 years can be the difference between seeing your grandchildren be born or grow up or them never knowing you.

Periodontal bacteria can be transmitted from one person to their spouse or their children. By leaving this disease untreated you will not only harm yourself but you may harm for spouse and children as well.

Untreated Gum Disease can lead to tooth loss.

Look at the physical effects of tooth loss:

A recent study out of London found that food “rich in nutrients like nuts, apples and raw carrots could not be eaten easily for over 50%” of people with dentures.

Research at the University of Maryland Department of Nutrition shows that the “dietary quality and intake of certain nutrients was poorer among the group with self-perceived ill-fitting dentures than those with natural teeth or will fitting dentures”.

In the first year after a tooth is extracted the jaw bone decreases 25% in width.

People with dentures can only generate 5-6 psi versus 250 psi for someone with teeth. That decreased ability to grind up food compromises nutrition and health.

People with tooth loss report it affects their social and romantic lives.

7% of people who need dentures cannot tolerate them at all and are classified as oral invalids.

88% of denture wearers reported difficulty with speech.

60% of denture wearers are aware of denture movement.

As teeth and bone are lost there can be severe facial changes.

Bacteria Cause Gum Disease and Worse

The research isn’t conclusive, but red, swollen, and bleeding gums may point to health problems from heart disease to diabetes. Sometimes, bacteria from your mouth can travel to your bloodstream, setting off an inflammatory reaction elsewhere in your body. Left untreated, gum disease can increase your risk for a host of diseases linked to inflammation. Certain diseases and medications also may cause mouth problems.

Can Mouth Bacteria Affect the Heart?

Some studies show that people with gum disease are more likely to suffer from heart disease than those with healthy, pink gums. Researchers aren’t sure why this association exists. One theory is that oral bacteria travel into the bloodstream where it may attach to fatty plaques in the arteries, causing inflammation and setting the stage for a heart attack. Are you are at risk? Talk to your doctor

Gum Disease and Diabetes

Diabetes can reduce the body’s resistance to infection. Elevated blood sugars increase the risk of developing gum disease. What’s more, gum disease can make it harder to keep blood sugar levels in check. Protect your gums by keeping blood sugar levels as close to normal as possible. Brush after each meal and floss daily. See your dentist at least once a year.

Dry Mouth and Tongue Cause Tooth Decay

The 4 million Americans who have Sjögren’s syndrome are more prone to have oral health problems, too. With Sjögren’s, the body’s immune system mistakenly attacks tear ducts and saliva glands, leading to chronically dry eyes and dry mouth (called xerostomia). Saliva helps protect teeth and gums from bacteria that cause cavities and gingivitis. So a perpetually dry mouth is more susceptible to tooth decay and gum disease.

Medications That Cause Dry Mouth

Given that a chronically dry mouth raises risk of cavities and gum disease, you may want to check your medicine cabinet. Antihistamines, decongestants, painkillers, and antidepressants are among the drugs that can cause dry mouth. Talk to your doctor or dentist to find out if your medication regimen is affecting your oral health, and what you can do about it.

Stress and Teeth Grinding

If you are stressed, anxious, or depressed, you may be at higher risk for oral health problems. People under stress produce high levels of the hormone cortisol, which wreaks havoc on the gums and body. Stress also leads to poor oral care; more than 50% of people don’t brush or floss regularly when stressed. Other stress-related habits include smoking, drinking alcohol, and clenching and grinding teeth (called bruxism).

Osteoporosis and Tooth Loss

The brittle bone disease osteoporosis affects all the bones in your body — including your jaw bone — and can cause tooth loss. Bacteria from periodontitis, which is severe gum disease, can also break down the jaw bone. One kind of osteoporosis medication — bisphosphonates — may slightly increase the risk of a rare condition called osteonecrosis, which causes bone death of the jaw. Tell your dentist if you take bisphosphonates.

Pale Gums and Anemia

Your mouth may be sore and pale if you’re anemic, and your tongue can become swollen and smooth (glossitis). When you have anemia, your body doesn’t have enough red blood cells, or your red blood cells don’t contain enough hemoglobin. As a result, your body doesn’t get enough oxygen. There are different types of anemia, and treatment varies. Talk to your doctor to find out what type you have and how to treat it.

Eating Disorders Erode Tooth Enamel

A dentist may be the first to notice signs of an eating disorder such as bulimia. The stomach acid from repeated vomiting can severely erode tooth enamel. Purging can also trigger swelling in the mouth, throat, and salivary glands as well as bad breath. Anorexia, bulimia, and other eating disorders can also cause serious nutritional shortfalls that can affect the health of your teeth.

Thrush and HIV

People with HIV or AIDS may develop oral thrush, oral warts, fever blisters, canker sores, and hairy leukoplakia, which are white or gray patches on the tongue or the inside of the cheek. The body’s weakened immune system and its inability to stave off infections are to blame. People with HIV/AIDS may also experience dry mouth, which increases the risk of tooth decay and can make chewing, eating, swallowing, or talking difficult.

Treating Gum Disease May Help RA

People with rheumatoid arthritis (RA) are eight times more likely to have gum disease than people without this autoimmune disease. Inflammation may be the common denominator between the two. Making matters worse: people with RA can have trouble brushing and flossing because of damage to finger joints. The good news is that treating existing gum inflammation and infection can also reduce joint pain and inflammation.

Tooth Loss and Kidney Disease

Adults without teeth may be more likely to have chronic kidney disease than those who still have teeth. Exactly how kidney disease and periodontal disease are linked is not 100% clear yet. But researchers suggest that chronic inflammation may be the common thread. So taking care of your teeth and gums may reduce your risk of developing chronic kidney problems.

Gum Disease and Premature Birth

If you’re pregnant and have gum disease, you could be more likely to have a baby that is born too early and too small. Exactly how the two conditions are linked remains poorly understood. Underlying inflammation or infections may be to blame. Pregnancy and its related hormonal changes also appear to worsen gum disease. Talk to your obstetrician or dentist to find out how to protect yourself and your baby.

What Healthy Gums Look Like

Healthy gums should look pink and firm, not red and swollen. To keep gums healthy, practice good oral hygiene. Brush your teeth at least twice a day, floss at least once a day, see your dentist regularly, and avoid smoking or chewing tobacco.

The Mouth-Body Connection: 6 Ways Oral Hygiene Helps Keep You Well

Taking good care of your mouth — teeth and gums — does more than help ensure you have a bright, white smile. A healthy mouth and healthy body go hand in hand. Good oral hygiene and oral health can improve your overall health, reducing the risk of serious disease and perhaps even preserving your memory in your golden years. The phrase “healthy mouth, healthy you” really is true — and backed by growing scientific evidence.

Recommended Related to Oral Health

Pulling a Tooth (Tooth Extraction)

When you were 6, losing a tooth was a rite of passage, perhaps achieved by incessant tooth jiggling, biting into a crisp apple, or tying a string around the tooth and giving it a tug. As an adult, tooth loss is hardly cause for celebration, yet having a tooth pulled is sometimes necessary.

Chronic inflammation from gum disease has been associated with the development of cardiovascular problems such as heart disease, blockages of blood vessels, and strokes.

Healthy Teeth and Gums lead to:

Experts stop short of saying there is a cause-and-effect between gum disease and these other serious health problems, but the link has shown up in numerous studies. The findings of these studies may suggest that maintaining oral health can help protect overall health.

Preserves Your Memory

Adults with gingivitis (swollen, bleeding gums) performed worse on tests of memory and other cognitive skills than did those with healthier gums and mouths, according to a report in the Journal of Neurology, Neurosurgery & Psychiatry.

Those with gingivitis were more likely to perform poorly on two tests: delayed verbal recall and subtraction — both skills used in everyday life.

Reduces Risks of Infection and Inflammation in Your Body

Poor oral health has been linked with the development of infection in other parts of the body.

Research has found an association between gum disease and rheumatoid arthritis, an autoimmune disease that causes inflammation of the joints. Experts say the mechanism of destruction of connective tissues in both gum disease and RA is similar. Eating a balanced diet, seeing your dentist regularly, and good oral hygiene helps reduce your risks of tooth decay and gum disease. Make sure you brush twice a day and floss once a day. Using an antibacterial mouthwash or toothpaste can help reduce bacteria in the mouth that can cause gingivitis.

Helps Keep Blood Sugar Stable if You Have Diabetes

People with uncontrolled diabetes often have gum disease. Having diabetes can make you less able to fight off infection, including gum infections that can lead to serious gum disease. And some experts have found that if you have diabetes, you are more likely to develop more severe gum problems than someone without diabetes. That, in turn, may make it more difficult to control blood sugar levels. Reducing your risk of gingivitis by protecting your oral health may help with blood sugar control if you have been diagnosed with diabetes.

Helps Pregnant Women Carry a Baby to Term

Women may experience increased gingivitis during pregnancy. Some research suggests a relationship between gum disease and preterm, low-birth-weight infants.

Not all studies have found a solid link, but maintaining good oral health is still the best goal. If you’re pregnant, visit your dentist or periodontist as part of your prenatal care. Consider it good practice for the role modeling that lies ahead for all new parents.

Preventing Gum Disease When You’re at Risk for Heart Disease

If you’re at risk for heart disease or have it already, good oral hygiene is key. It might seem strange, but gum disease seems to be linked with cardiovascular problems, like heart attacks and strokes.

Gum Disease & Heart Disease

Four out of 5 people in the U.S. have gum disease, or periodontal disease. It’s caused by the buildup of bacteria in the mouth. Gingivitis is a mild form. Periodontitis is more severe; it can damage the bone and cause tooth loss.

Does gum disease cause heart disease? Studies show that people with gum disease are almost twice as likely to have coronary artery disease. Of course, these studies do not prove that periodontal disease is a direct cause of heart disease. It may be that people who don’t take good care of their teeth have poor lifestyle habits in general, which leads to an increased risk of heart disease.

But some experts believe that bacteria from the mouth could get into the blood and contribute to blocked arteries. These bacteria might also trigger inflammation throughout the body. When the arteries swell, they become narrower and prone to clogging.

If you’re at risk for heart disease, it’s wise to play it safe. Here’s how:

  1. Recognize the signs. If you’re at risk for heart disease, you need to look out for signs of gum problems. What should you watch for?
  • Swollen, red, painful, or bleeding gums
  • Receding gums — which will make your teeth look longer than they used to
  • Sensitive or loose teeth
  • Painful chewing
  • Chronic bad breath or bad taste in the mouth

If you have any of these symptoms, don’t ignore them. Schedule an appointment with a dentist or periodontist to get them checked out.

  1. Brush properly. The toothbrush is one of the best weapons we have against gum disease. It helps clear plaque, a sticky combination of bacteria, acids, and bits of food.

But a lot of us don’t brush well. We might skip some days. Our technique might be rusty. (Is it up and down? Circular? Neither?) Or in a misguided attempt at thoroughness, we scrub our teeth as if we’re refinishing furniture. That can tear up your gums, worsening gum disease.

The American Dental Association recommends that you brush lightly at a 45-degree angle with short, side-to-side strokes. Do it twice a day. Don’t be bashful about asking your dentist or hygienist for a refresher during your next appointment. A good ADA-approved electric toothbrush can also help remove some of the guesswork.

  1. Flossing gets rid of the bacteria and plaque between the teeth, where brushes can’t reach. While it’s important for gum health, flossing is one of those things that many of us know we should do, but don’t. One survey found that only about half of Americans floss daily. If you don’t floss every day, it’s time to join the other half. Again, ask your dentist or hygienist for tips. Be gentle — vigorously sawing at your gums will make things worse. If you have trouble holding the floss correctly, a simple device called a floss holder might help
  2. Get your teeth cleaned every six months. Regular dental cleanings and checkups are crucial for everybody — and especially for people at risk of heart disease. Cleanings will keep plaque and tartar under control. If you do wind up developing gum disease, your dentist will catch it early.
  3. Generally, experts recommend dental cleanings twice a year. Some people need them more often. Ask your dentist or hygienist what he or she recommends.
  4. Consider an antiseptic mouthwash. If you have a problem with bacterial build-up in your mouth, your dentist might recommend an antiseptic mouthwash as an insurance policy. Some are available by prescription. However, don’t think that swishing some mouthwash is a good alternative to brushing and flossing. It isn’t.
  5. Stop smoking. If you don’t smoke, great. But if you do, it’s time to make an attempt — or another attempt — at quitting.
  6. You probably know that smoking is bad for your heart. You might not know that smoking is one of the top causes of gum disease; smoking also makes existing gum disease worse. People who smoke are up to seven times more likely to have bone loss in the jaw. Smoking can even prevent treatments for gum disease from working.
  7. Ask about antibiotics before surgery. Some people with serious heart problems need a course of antibiotics before they get any oral surgery — for gum disease or anything else. Why? It lowers the risk of bacteria from the mouth entering the bloodstream and causing an infection of the heart called endocarditis. This precaution only applies to people with specific conditions. If you have heart problems and need dental surgery, always check in with your dentist — or cardiologist — beforehand.
  8. Follow your treatment plan for other medical problems. Heart disease isn’t the only condition linked with gum disease. Studies have found that having diabetes increases the risk of developing periodontitis, too. In turn, gum disease seems to worsen blood sugar levels in people with diabetes — and diabetes can worsen heart disease. Oral health problems have been linked with many conditions, like respiratory disease, osteoporosis, and Alzheimer’s disease. The health of your gums may be connected not just to your heart, but to your overall health. Focusing on one medical problem while letting others slide won’t work. Good general medical and dental care — and sticking to the recommendations of your healthcare providers — can have far-reaching benefits.
  9. Tell your dentist and doctors about all the medicines and supplements you take. You might not realize it, but some of your daily medicines could contribute to gum disease. Certain drugs for diabetes, allergies, depression, pain, and high blood pressure can have an effect on your oral health. If your dentist and health care team is aware of all the medicines you take, you’ll be less likely to run into problems.
  10. Live healthfully. Try to eat a well-balanced diet. There’s no magic food that will cure gum disease, but getting enough calcium and vitamins in your diet could reduce the risk of periodontal disease. You should also make an effort to relax and lower the stress level in your life. Stress hormones like cortisol cause inflammation throughout the body — that’s bad for your gums and your heart.
  11. Build a medical team. We once considered heart health and dental health as relatively unrelated. We know better now. The body is a single organism, after all. If you have heart disease, ideally your dentist or periodontist should work directly with your cardiologist. Think of them as members of your medical team. If you can collaborate with them and develop a treatment plan, you’re bound to be healthier — in more ways than you might expect.
  12. The surgeon general’s report on oral health (“Oral Health in America: A Report of the Surgeon General”), which was released May 25, highlights the bidirectional interactions between oral and systemic health. Systemic conditions with oral manifestations include diabetes, hereditary disease, joint disease, HIV and osteoporosis. Oral disease can exacerbate certain systemic conditions, such as diabetes, respiratory disease, vascular disease and preterm low-birth weight. While a number of interactions have been identified, additional research is needed to evaluate disease pathogenesis and therapeutic interventions. Further, emphasis should be placed on educating patients, dental and medical students, and dentists and physicians regarding the importance of these relationships. These findings place oral health in the perspective of systemic health, and suggest that the dental and medical profession will develop even closer linkages in the future. Amar SHan X. Department of Periodontology & Oral Biology, Goldman School of Dental Medicine, Boston University, Boston, MA 02118, U.S.A. samar@bu.edu
  13. Systemic health is often closely linked to the state of the oral cavity: many systemic diseases and conditions have oral manifestations. Likewise, oral microbiological infections may also affect one’s general health status. Indeed, animal and population-based studies now suggest that periodontal diseases may be linked with systemic diseases and conditions including cardiovascular diseases, diabetes, respiratory diseases, adverse pregnancy outcomes, and osteoporosis. Better understanding of this correlation will help both dental and medical professionals to determine the best approach to patient care. This review will focus on the current knowledge linking periodontal infections to a set of systemic diseases. While a number of interactions have been identified, additional research will be required to determine whether these associations are causal or coincidental, and to evaluate disease pathogenesis and potential therapeutic interventions. These findings place oral health in the perspective of systemic health, and they suggest that the dental and medical professions should develop even closer ties in the future. [Article in Polish] Cabała AChomyszyn-Gajewska MDrozdz W. Katedra i Zakład Periodontologii i Klinicznej Patologii Jamy Ustnej, Instytut Stomatologii Collegium Medicum Uniwersytet Jagielloński w Krakowie.
  14. Recently, it has been recognized, that oral infection especially periodontitis may affect the pathomechanism and course of a number of systemic diseases, such as: cardiovascular, cerebrovascular diseases, atheromatous peripheral vascular disease bacterial pneumonia, diabetes mellitus, osteoporosis, or cause adverse pregnancy outcome. This review will focus on the current knowledge linking periodontal infections to a set of above mentioned systemic diseases. While a number of their mutual interactions have been already identified, additional research will be required to determine with certainty, whether these associations are casual or coincidental and to evaluate disease pathogenesis and potential therapeutic interventions. Moutsopoulos NMMadianos PN. Oral Infection and Immunity Branch, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland, USA.
  15. Increasing evidence implicates periodontitis, a chronic inflammatory disease of the tooth-supporting structures, as a potential risk factor for increased morbidity or mortality for several systemic conditions including cardiovascular disease (atherosclerosis, heart attack, and stroke), pregnancy complications (spontaneous preterm birth [SPB]), and diabetes mellitus. Cross-sectional, case-control, and cohort studies indicate that periodontitis may confer two- and up to sevenfold increase in the risk for cardiovascular disease and premature birth, respectively. Given the recently acquired knowledge that systemic inflammation may contribute in the pathogenesis of atherosclerosis and may predispose to premature birth, research in the field of periodontics has focused on the potential of this chronic low-grade inflammatory condition to contribute to the generation of a systemic inflammatory phenotype. Consistent with this hypothesis clinical studies demonstrate that periodontitis patients have elevated markers of systemic inflammation, such as C-reactive protein (CRP), interleukin 6 (IL-6), haptoglobin, and fibrinogen. These are higher in periodontal patients with acute myocardial infarction (AMI) than in patients with AMI alone, supporting the notion that periodontal disease is an independent contributor to systemic inflammation. In the case of adverse pregnancy outcomes, studies on fetal cord blood from SBP babies indicate a strong in utero IgM antibody response specific to several oral periodontal pathogens, which induces an inflammatory response at the fetal-placental unit, leading to prematurity. The importance of periodontal infections to systemic health is further strengthened by pilot intervention trials indicating that periodontal therapy may improve surrogate cardiovascular outcomes, such as endothelial function, and may reduce four- to fivefold the incidence of premature birth. Nevertheless, further research is needed to fully discern the underlying mechanisms by which local chronic infections can have an impact on systemic health, and in this endeavor periodontal disease may serve as an ideal disease model. Fowler EBBreault LGCuenin MF. DENTAC Fort Lewis, Washington, USA.
  16. Periodontal diseases are oral disorders characterized by inflammation of the supporting tissues of the teeth. Usually, periodontitis is a progressively destructive loss of bone and periodontal ligament (loss of the attachment apparatus of the teeth). Periodontitis has documented risk factors, including but not limited to specific plaque bacteria, smoking, and diabetes mellitus. Initially, the link between systemic disease and periodontal diseases was thought to be unidirectional. Currently, there is increasing evidence that the relationship between these entities may be bidirectional. Recent case-control and cross-sectional studies indicate that periodontitis may confer a 7-fold increase in risk for preterm low birth weight infants and a 2-fold increase in risk for cardiovascular disease. These early reports indicate the potential association between systemic and oral health. Additionally, these studies support the central hypothesis that periodontal disease involves both a local and a systemic host inflammatory response. This knowledge of disease interrelationships may prove vital in intervention strategies to reduce patient risks and prevent systemic disease outcomes. Based on the current evidence of the periodontal-systemic disease connection, the purpose of this report is to help establish the groundwork for closer communication between physicians and periodontists in the military health care setting. Paquette DWMadianos POffenbacher SBeck JDWilliams RC. Department of Periodontology, School of Dentistry, University of North Carolina, Chapel Hill 27599-7450, USA. david_paquette@dentistry.unc.edu
  17. Dental clinicians intuitively weigh patient risks for developing disease and use that information for making treatment decisions and recommendations. Periodontitis, for instance, is one oral disease with documented risk factors including smoking, specific plaque bacteria and diabetes mellitus. While this link between systemic disease and periodontitis was thought to be unidirectional, mounting evidence in the last decade suggests that the relationship may be bi-directional. Cross sectional and case control studies indicate that periodontitis may confer two and seven-fold elevations in risk for cardiovascular disease and premature low birth weight respectively. While these early studies indicate potential associations between oral and systemic health, they support the central hypothesis that periodontitis triggers both local and systemic host inflammatory responses. Consequently, a new discipline, periodontal medicine, has emerged in dentistry which seeks to further define these interrelationships through scientific inquiry. Ultimately, this new knowledge may prove useful in intervention strategies to reduce patient risks and prevent systemic disease outcomes. This manuscript clarifies the concept of risk, traces the emergence of periodontal medicine and serves as a resource for the oral health professional in assessing and utilizing the current evidence on periodontal-systemic disease connections. Paquette DW. Department of Periodontology, Comprehensive Center for Inflammatory Disorders, School of Dentistry, University of North Carolina at Chapel Hill, NC 27599-7450, USA. David_Paquette@dentistry.unc.edu
  18. Observational studies indicate periodontal infections as a risk factor for systemic conditions like cardiovascular disease and preterm low birth weight. This paper reviews and argues the biological plausibility for a periodontal infection-systemic disease link and reviews the available experimental data from animal models and human intervention trials. Five principal lines of evidence can be used to explain the biological plausibility of a link. First, infection in general has been implicated in the pathogenesis of both atherosclerosis and preterm delivery. Periodontal infection secondly causes transient and low-grade bacteraemias and endotoxaemias in patients. Thirdly, periodontal infection promotes systemic inflammatory and immune responses that may play roles in disease. Periodontal pathogens express specific virulence factors that can affect atherogenic or parturition events. Lastly, periodontal pathogens have also been isolated from non-oral tissues like atheromatous plaques. Experimental data derived from rodent and pig models indicate that infection or bacteraemias with the periodontal pathogen, Porphyromonas gingivalis, can increase atheroma size or reduce litter weights as compared to controls. While human intervention data are lacking for patients at risk for cardiovascular disease, early data indicate that periodontal therapy administered to pregnant mothers with periodontitis can reduce the incidence of preterm low birth weight deliveries. Nevertheless, more and larger intervention trials are needed before we can fully accept periodontal infection as a true risk factor in the causal pathways of cardiovascular disease and preterm low birth weight.

“The Clinician’s Handbook of Natural Medicine,” by naturopathic physician, Dr. Joseph Pizzorno, describes periodontal disease as an inclusive term for the chronic inflammatory process that can destroy the gums and their underlying supportive structures (periodontium). The American Academy of Periodontists (AAP) confirms that periodontal disease can have systemic effects that are linked through inflammation. Periodontal disease can worsen diseases like diabetes, while instigating others like heart disease and stroke.

Inflammation

Infection is at the root of periodontal disease. Without proper preventative care and nutritional defense, the gums and supporting structures become vulnerable to bacterial invasion. To survive in the mouth, the invading bacteria produce chemicals that are damaging to human tissues. The infection, in turn, initiates an innate response by the immune system known as inflammation. Bacteria that invade and infect the gums and periodontium are difficult to reach. The microbes hide deep in the periodontal pocket where the roots of the teeth are situated. Deep in the darkness of the tooth pocket the bacteria thrive, replicate, and find their way into the bloodstream. As the infection is difficult to reach, the inflammatory process is prolonged, becomes detrimental to other systems in the body, and depletes immune system reserves.

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Heart Disease and Stroke

Periodontal disease can lead to cardiovascular disease. The AAP issued the warning that people with periodontal disease are two times more likely to suffer from coronary artery disease than those who do not have the disease. An article on the official AAP website titled, “Gum Disease Links to Heart Disease and Stroke,” theorizes that the bacteria circulating in the bloodstream cause damage to the inside lining of blood vessels, promoting the development of the clots, which can lead to a heart attack. Similarly, if the blood vessels that distribute blood to the brain are damaged and become occluded due to clot formation, a stroke will likely ensue. The academy discusses a second theory whereby the prolonged inflammatory process involved in chronic periodontal disease will release cascades of chemicals in the body that will eventually damage the blood vessels as well.

Diabetes

The presence of periodontal disease can be a result of diabetes in some people, while in others, the onset of periodontal disease may worsen their diabetes, rendering them less able to control their blood sugar. Diabetics are known to be more susceptible to infections than the general population. The AAP article “Gum Disease and Diabetes,” states that a depressed immune system leaves uncontrolled type-2 diabetics susceptible to developing periodontal disease. A 1997 study published in the “Journal of Periodontology” determined that when longstanding periodontal disease was treated, diabetics whose blood sugar was once difficult to control were able to better manage their disease.

Pregnancy Outcome

The AAP also warns that pregnant women are thought to be 7 times more likely to deliver a premature or low-birth weight baby if they have periodontal disease. Researchers, Agueda and Echeverria in their article “Association between Periodontitis in Pregnancy and Preterm or Low Birth Weight: Review of the literature” suggest that the circulating bacteria and inflammatory chemicals induce early labor onset by interacting with the developing fetus

Read more: http://www.livestrong.com/article/118977-effects-periodontal-disease-body/#ixzz1rB0Zd2Bx

The importance of providing oral health care for pregnant women cannot be disputed. Data suggest that maternal oral health impacts pregnancy health; further research on the causal nature of this association is ongoing to determine if there is a relationship. Current guidelines and data suggest that dental care during pregnancy is safe. However, scaling and root planing is best accomplished between 14-20 weeks’ gestational age. Providing dental care for pregnant women will help remove potentially harmful bacteria from dissemination and possibly leading to other complications. As oral health care providers, we can educate our patients regarding the importance of oral health and on important preventive measures to maintain oral health.

Stillbirth Tied to Gum Disease in New Study

By Nadja Popovich 11:58 am January 28, 2010

Pregnant women might want to keep their toothbrush and floss close at hand, according to Dr. Yiping Han, the lead researcher of a new study linking gum disease to stillbirth.

Women may want to consider getting a thorough teeth cleaning before getting pregnant.

While the connection between oral bacteria and preterm births has been established for over a decade, Han’s study provides the first direct human evidence that oral bacteria can also cause stillbirth.

The study, published in the February edition of Obstetrics & Gynecology, examined the case of a 35-year-old woman who lost her first baby to stillbirth in her 39th week of pregnancy. An autopsy found the culprit to be Fusobacterium nucleatum, a type of bacteria common in human dental plaque.

Han, an associate professor at the School of Dental Medicine at Case Western Reserve University, was not surprised.

“This isn’t the first case of stillbirth caused by F. nucleatum that I have encountered — both before and after this case. I was often referred women who had had stillbirths caused by the bacteria,” Han tells Shots, noting that this one was documented because “the patient herself contacted me right after [the birth], so we were able to act quickly enough to collect all the samples to do analysis.”

The woman, who had received routine prenatal care and whose pregnancy had been largely uncomplicated, told Han that she had experienced gum bleeding during her pregnancy, which Han notes is consistent with pregnancy-related gingivitis. The mother also reported she had been mildly ill with an upper respiratory tract infection for three days prior to the stillbirth.

Vaginal and rectal samples proved negative for F. nucleatum, but an oral sample came up positive. This led Han to the conclusion she had seen coming all along.

“The upper-repertory infection . . . weakened the immune defense, which would have allowed the bacteria transfer [from the mouth] to the placenta. So the study maybe shows that periodontal disease alone would not have caused the stillbirth without the weakened immunity,” she says.

Once the bacteria reached the placenta, it was free to proliferate, because the placenta is an “immune-suppressed” organ, she adds. This means that the immune system is, in effect, trained to ignore the placenta and the fetus so that it doesn’t attack and expel the growing baby.

And gum disease is not an idle risk. Half of all pregnant women experience gum bleeding due to gingivitis triggered in part by pregnancy.

“The message we want to send is that if you are contemplating getting pregnant, you need to get good oral healthcare,” Han says. “During pregnancy, if you have gum bleeding and come down with another condition like fever or flu, be more careful because this increases the likelihood of the bacteria getting in the bloodstream and translocating to the placenta.”

Her advice? Flossing and brushing are essential because good oral hygiene lessens gum inflammation, and therefore lowers the opportunity for bacteria to invade the placenta.

Ideally, women should also get a thorough teeth cleaning before getting pregnant.

Periodontal disease is an infection of the gums that results from inadequate oral hygiene. Pregnant women are more susceptible to gum disease than non-pregnant women because pregnancy hormones soften the gums and make them more penetrable to bacteria. There are many negative consequences of periodontal disease during pregnancy, some of which relate to the mother and some of which relate to the baby.

Read more: http://www.livestrong.com/article/225317-health-risks-of-periodontal-disease-during-pregnancy/#ixzz1rB3f9xSW

Health Risks to Mother

The health risks of periodontal disease to a pregnant woman herself are the same as the risks to a non-pregnant woman. According to the American Academy of Periodontology, there are many risks associated with periodontal disease. Diabetes, cardiovascular problems and Alzheimer’s all occur with increased frequency in patients who have untreated periodontal disease. Further, chronic gum disease affects oral health. Tooth pain increases as diseased gums recede and the roots of teeth are exposed. Teeth can begin to decay and need to be pulled. Finally, uncontrolled gum disease can spread to the jaw.

Read more: http://www.livestrong.com/article/225317-health-risks-of-periodontal-disease-during-pregnancy/#ixzz1rB47vS29

Premature Birth

Unlike men and non-pregnant women with gum disease, pregnant women have additional risks from poor oral hygiene. Premature and underweight babies are more common to women who have chronic periodontal disease during pregnancy, say Drs. Michael Roizen and Mehmet Oz in their book “You: Having A Baby.” This is because the gums are vascular, or filled with blood vessels. A bacterial infection the gums can end up in the circulatory system, and from there, can infect the fetus, leading to failure to thrive. This causes babies to be born early, and birth weight often is below normal.

Stillbirth

The most severe consequence of periodontal disease in a pregnant woman is that her baby might be stillborn. The American Dental Association says that a certain bacterial species associated with gum disease, called Fusobacterium nucleatum, can travel through the mother’s blood vessels into her uterus. Since a fetus both swallows and inhales amniotic fluid, bacteria in the uterus can infect both the lungs and the digestive tract of a fetus. In cases of severe infection, this may lead to death of the fetus and stillbirth. While stillbirth is relatively rare as a consequence of periodontal disease, according to the American Dental Association, it’s nevertheless a risk for women to consider when assessing the importance of oral hygiene during pregnancy.

Read more: http://www.livestrong.com/article/225317-health-risks-of-periodontal-disease-during-pregnancy/#ixzz1rB3wgkWG

Study Links Gum Disease and Memory Loss

Researchers say keeping your teeth brushed and flossed can help preserve memory.
The study at West Virginia University has found a link between gum disease and memory loss.
“Older people might want to know there’s more reason to keep their mouths clean, to brush and floss, than ever,” said Richard Crout, D.M.D., Ph.D., an expert on gum disease and associate dean for research in the WVU School of Dentistry.
“You’ll not only be more likely to keep your teeth, but you’ll also reduce your risk of heart attack, stroke and memory loss.
“This could have great implications for health of our aging populations,” Crout said.
“With rates of Alzheimer’s skyrocketing, imagine the benefits of knowing that keeping the mouth free of infection could cut down on cases of dementia,” he added.
The team conducted their research on 270 elderly individuals aged 70 and older. They were given oral exams and memory test.
The findings revealed that 23 percent of the group suffers from mild to moderate memory loss.
“If you have a gum infection, you’ll have an increased level of inflammatory byproducts,” Crout explained.
“We’re looking for markers in the blood that show inflammation to see if there is a link to memory problems.
“We’d like to go full circle and do an intervention, to clean up some of the problems in the mouth and then see if the inflammatory markers go down,” he added.
Read more: Study Links Gum Disease And Memory Loss | MedIndiahttp://www.medindia.net/news/Study-Links-Gum-Disease-And-Memory-Loss-53329-1.htm#ixzz1rB4mUbT7

Periodontal (Gum) Disease and Its Effects on The Body

Periodontal (gum) Health and How It Effects Your Body.

If you have been told you have periodontal disease (gum disease), you are not alone. Many adults in the US will have some form of gum disease in their lifetime. Periodontal diseases can range from simple inflammation of the gums to more severe problems causing serious damage to the soft tissue and bone supporting your teeth. But tooth loss isn’t the only effect periodontal disease can have on your body.

Research has shown evidence of an association between periodontal disease and other chronic inflammatory diseases. By releasing inflammatory molecules, bacteria, and toxins into bloodstream, or through simple aspiration (inhaling), periodontal disease can cause cardiovascular disease, diabetes, and Alzheimer’s disease. Even more alarming, periodontal health has also been linked to osteoporosis (bone loss), complications with pregnancies, and several respiratory diseases. Once the bacteria reach susceptible areas of the body, they wreak havoc and causes further inflammation and deterioration of the body’s vital tissue.

Gum Disease and Respiratory Diseases

Bacteria from the mouth can travel to the lungs causing respiratory diseases in people with periodontal disease.

Bacteria found in the throat and mouth can be pulled into the lower respiratory tract through aspiration (inhaling). Once in the lungs, the bacteria can cause infection or even worsen existing conditions such as bronchitis or emphysema. People who suffer from Chronic Obstructive Pulmonary Diseases (COPD) typically have a more difficult time eliminating bacteria from the lungs because the lung tissues have been damaged either by years of smoking or air pollution. These damaged tissues are at risk for recurrent infections of respiratory diseases like pneumonia. Studies are now being done to learn how oral hygiene and periodontal disease may be associated with more frequent recurrences of respiratory diseases in patients with COPD.

Bacteria found in the throat and mouth can be pulled into the lower respiratory tract through aspiration (inhaling). Once in the lungs, the bacteria can cause infection or even worsen existing conditions such as bronchitis or emphysema. People who suffer from Chronic Obstructive Pulmonary Diseases (COPD) typically have a more difficult time eliminating bacteria from the lungs because the lung tissues have been damaged either by years of smoking or air pollution. These damaged tissues are at risk for recurrent infections of respiratory diseases like pneumonia. Studies are now being done to learn how oral hygiene and periodontal disease may be associated with more frequent recurrences of respiratory diseases in patients with COPD.

Gum Disease and Memory Loss

Elderly people who experience tooth loss may be at increased risk for dementia.

It is hypothesized that inflammatory substances released by infected gums into the body enhance inflammation of the brain causing the death of neurons and speeds up memory loss. Current research suggests the loss of sensory receptors around the teeth have been linked to neuronal death, which in turn can cause more teeth to fall out further contributing to cognitive decline. Initial theories were only linked directly to Alzheimer’s or dementia. As research continued, they have found that it can also impair mental function and that patients who had fewer teeth were at an increased risk of memory loss or early stage Alzheimer’s disease.

Gum Disease and Osteoporosis

Women with periodontal disease are more likely to have bone loss (of the jaw) which can lead to tooth loss.

Recent studies suggest that osteoporosis decreases the density of the bone supporting your teeth. As the jaw bone deteriorates, the tooth detaches more and more, leaving it more vulnerable to infection and inevitable tooth loss.

Estrogen deficiency, in combination with osteoporosis, is also suspected to be one of the root causes in the progression of bone loss (in the mouth). Studies have concluded that women taking an estrogen supplement may be able to lower the amount of inflammation of the gums and decrease the rate of detachment from the bone.

CHICAGO—June 4, 2008—Most people already know that maintaining oral health is a vital component of achieving overall health, but a recent study reveals why it is especially crucial that men pay close attention to their teeth and gums. Research published in the June 2008 issue of The Lancet Oncology found that men with a history of gum disease are 14 percent more likely to develop cancer than men with healthy gums. In fact, researchers uncovered that men with periodontal disease may be:

  • 49 percent more likely to develop kidney cancer
  • 54 percent more likely to develop pancreatic cancer
  • 30 percent more likely to develop blood cancers

“Previous research has suggested a potential link between gum disease and other conditions such as heart disease, diabetes and rheumatoid arthritis,” says Dr. Susan Karabin, President of the AAP. “This study should prompt men to be particularly mindful of their teeth and gums now that gum disease may play a role in the onset of cancer.”

Gum disease can be managed with daily brushing and flossing, and routine visits to a dental health professional. Men who develop gum disease should consider consulting with a periodontist, the dentist specially trained in the prevention and treatment of periodontal disease. A periodontist can help develop an effective treatment plan to best manage the disease.

CHICAGO—October 14, 2008—According to the National Kidney Foundation, one out of nine Americans suffers from chronic kidney disease (CKD), and millions more are at risk. A debilitating disease, CKD can affect blood pressure and bone health, and can eventually lead to heart disease or kidney failure. A study published in the Journal of Periodontology (JOP), the official publication of the American Academy of Periodontology (AAP), suggests that edentulous, or toothless, adults may be more likely to have CKD than dentate adults. In the study, conducted at Case Western Reserve University, endentulism was found to be significantly associated with CKD, indicating that oral care may play a role in reducing the prevalence of chronic kidney disease in the U.S. population. Study Abstract *

The study examined the kidney function and periodontal health indicators, including dentate status, of 4,053 U.S. adults 40 years of age and older. After adjusting for recognized risk factors of CKD such as age, race/ethnicity and smoking status, the results revealed that participants who lost all their teeth were more likely to have CKD than patients who had maintained their natural dentition.

“The rationale for examining edentulous adults in this study is to observe the long-term effects of periodontal disease on the presence of chronic kidney disease,” states study author Monica Fisher, PhD, DDS, MPH. “Periodontal disease is a leading cause of tooth loss in adults; therefore, endentulism is considered to be a marker of past periodontal disease in the study’s participants.”

While additional research is needed to fully understand why tooth loss is associated with higher prevalence of CKD, the destructive nature of chronic inflammation may play a role. Both periodontal disease and chronic kidney disease are considered inflammatory conditions, and previous research has suggested that inflammation may be the common link between these diseases. Since untreated periodontal disease can ultimately lead to tooth loss, edentulous patients may have been exposed to chronic oral inflammation.

According to David Cochran, DDS, President of the American Academy of Periodontology and Professor and Chair of the Department of Periodontics at the University of Texas Health Science Center at San Antonio, treating periodontal disease can do a lot more than save your natural teeth. “Researchers have long known that gum disease is related to other adverse health conditions, and now we can consider chronic kidney disease to be one of them. It is exciting to think that by controlling periodontal disease and therefore helping to preserve natural dentition, the incidence and progression of CKD may be reduced.”

CHICAGO—January 18, 2011—Maintaining periodontal health may contribute to a healthy respiratory system, according to research published in the Journal of Periodontology. A new study suggests that periodontal disease may increase the risk for respiratory infections, such as chronic obstructive pulmonary disease (COPD) and pneumonia. These infections, which are caused when bacteria from the upper throat are inhaled into the lower respiratory tract, can be severely debilitating and are one of the leading causes of death in the U.S.

The study included 200 participants between the ages of 20 and 60 with at least 20 natural teeth. Half of the participants were hospitalized patients with a respiratory disease such as pneumonia, COPD, or acute bronchitis, and the other half were healthy control subjects with no history of respiratory disease. Each participant underwent a comprehensive oral evaluation to measure periodontal health status.

The study found that patients with respiratory diseases had worse periodontal health than the control group, suggesting a relationship between respiratory disease and periodontal disease. Researchers suspect that the presence of oral pathogens associated with periodontal disease may increase a patient’s risk of developing or exacerbating respiratory disease. However, the study authors note that additional studies are needed to more conclusively understand this link.

“Pulmonary diseases can be severely disabling and debilitating,” says Donald S. Clem, DDS, President of the American Academy of Periodontology. “By working with your dentist or periodontist, you may actually be able to prevent or diminish the progression of harmful diseases such as pneumonia or COPD. This study provides yet another example of how periodontal health plays a role in keeping other systems of the body healthy.”

Periodontal disease is a chronic inflammatory disease that affects the gum tissue and other structures supporting the teeth. Previous research has associated gum disease with other chronic inflammatory diseases such as diabetes, cardiovascular disease, and rheumatoid arthritis.

Dr. Clem stressed the importance of routine oral care in helping to prevent periodontal disease. “Taking good care of your periodontal health involves daily tooth brushing and flossing. You should also expect to get a comprehensive periodontal evaluation every year,” he advised. A dental professional, such as a periodontist, a specialist in the diagnosis, treatment and prevention of gum disease, can conduct a comprehensive exam to assess your periodontal disease status.

Gum Inflammation Linked to Alzheimer’s Disease

ScienceDaily (Aug. 3, 2010) — NYU dental researchers have found the first long-term evidence that periodontal (gum) disease may increase the risk of cognitive dysfunction associated with Alzheimer’s disease in healthy individuals as well as in those who already are cognitively impaired.

The NYU study offers fresh evidence that gum inflammation may contribute to brain inflammation, neurodegeneration, and Alzheimer’s disease.

The research team, led by Dr. Angela Kamer, Assistant Professor of Periodontology & Implant Dentistry, examined 20 years of data that support the hypothesis of a possible causal link between periodontal disease and Alzheimer’s disease.

“The research suggests that cognitively normal subjects with periodontal inflammation are at an increased risk of lower cognitive function compared to cognitively normal subjects with little or no periodontal inflammation,” Dr. Kamer said.

Preventing gum disease may help avoid Alzheimer’s.

People may be able to avoid — or at the very least, delay — Alzheimer’s by avoiding gum (periodontal) disease, among other healthy lifestyle measures such as increasing exercise and drinking fruit and vegetable juice.

According to a recent Washington Post article, new research suggests that even though family history may predispose a person to developing Alzheimer’s, various behaviors — if started early enough in life — may help delay the onset of the disease. It is best to begin introducing healthy habits early in life, researchers say, although studies have shown that even middle-aged people can benefit from the lifestyle changes.

Nearly 5 million Americans have Alzheimer’s, and with the vanguard of the baby boom generation turning 60 this year, the number of cases is expected to increase 70 percent by 2020.

The research was compiled from three different studies. One study of middle-aged children of Alzheimer’s parents looked at healthy lifestyle factors as a way to delay the onset of the disease. A second study of Japanese Americans showed that people were much less at risk for developing Alzheimer’s after drinking fruit juice three times a week.

The third study followed 109 pairs of identical twins in Sweden to find any lifestyle factors associated with developing dementia. This study found that twins who had periodontal disease earlier in life were four times more likely to develop Alzheimer’s. Researchers believe gum disease is a sign of inflammation, which may play a role in the destruction of brain cells.

Regular dentist visits are important for prevention of gum disease. Your dentist can remove tartar, which is plaque buildup that can irritate the gums and lead to tooth loss. Dentists also can detect early signs of gum disease. However, prevention begins at home. Brushing and flossing twice daily, eating right and avoiding tobacco will help prevent gum disease.

Medical Conditions Associated With Periodontal Disease

Research has shown that there is a link between periodontal diseases and other chronic inflammatory conditions, such as cardiovascular disease and diabetes. Following are links to articles with more information about the connection between gum disease and overall health. More information

The Link Between Periodontal Disease and Upper Respiratory Diseases
Donald S. Clem, DDS

A recent study by Sharma and Shamsuddin published in the January 2011 issue of the Journal of Periodontology suggests a possible link between upper respiratory diseases— including pneumonia, acute bronchitis, and chronic obstructive pulmonary disease (COPD)— and periodontal disease. Typically occurring when bacteria are inhaled into the lungs, the bacteria that cause periodontal disease also can be inhaled into the respiratory tract and increase the risk of infection.

The study examined 200 people, 100 who had been hospitalized with a respiratory infection and 100 who were healthy. The study results demonstrated that those who were part of the healthy group had better periodontal health, while the periodontal health of those with respiratory illnesses was worse.

Several studies have suggested a link between periodontal disease and other inflammatory diseases, such as cardiovascular disease and diabetes. However, there is not a lot known about how periodontal disease can impact respiratory health. Considering that respiratory infections, including chronic obstructive pulmonary disease (COPD) and pneumonia, can be severely debilitating and are a major cause of death in the United States, research into how periodontal health and respiratory health are potentially connected is imperative.

The significance of this research study is that it provides further evidence of the perio-systemic link by demonstrating that the incidence of pathogens in the periodontium may play a role in the progression of non-oral disease. These findings suggest that the presence of bacteria associated with periodontal disease, such as Porphyromonas gingivalis, may increase a patient’s risk of developing or exacerbating respiratory infections. The occurrence of these oral pathogens, and the resulting supragingival plaque accumulation, periodontal pockets, and—I would argue—the inflammatory response diminishes the host defense, thereby increasing subjects’ risk for developing a respiratory infection.

Poor periodontal health, therefore, may be viewed as a risk factor for respiratory disease. But as the researchers note, other factors may come into play as well. Additional research is needed in this area to better understand how periodontal disease and respiratory disease are related.

This study places a lot of emphasis on the role of bacterial pathogens in the progression of both periodontal disease and respiratory disease. While the presence of bacteria is a determinant of disease, it is often the inflammatory response to bacteria that is essential in the initiation and progression of disease states.

Individuals may be genetically predetermined to respond differently to a challenge, such as bacteria, and therefore their level of disease may be different. It seems that while an in-depth discussion of inflammation was missing in this study, there was speculation that periodontal pathogens not only are responsible for respiratory tract infection, but also that these pathogens may affect the local defense mechanisms of the region to increase these patients’ risk for respiratory disease.

Both periodontal disease and respiratory disease are often classified as inflammatory conditions, so it may be possible that inflammation may be a factor in the link between the two. Obviously, more research is required to illustrate this and better understand if and how the inflammatory response to periodontal bacteria leads to the development or aggravation of respiratory infections.

Periodontal disease is a chronic, inflammatory disease that can impact overall health, and therefore, we must treat our patients accordingly. This means conducting a comprehensive periodontal evaluation on an annual basis to ensure that periodontal disease is caught early and an appropriate treatment plan can be established. The dental team must work together to ensure that each patient receives a yearly comprehensive examination, including intraoral, extraoral, and occlusal evaluations; a thorough assessment of plaque, calculus, and gingival inflammation; probing of at least six sites per tooth; assessment and documentation of recession and attachment loss around teeth; radiographic evaluation of bone loss; and an assessment of patient-associated risk factors such as age, smoking, and the presence of other chronic, systemic conditions associated with systemic inflammatory burden.

ABSTRACT

Association Between Respiratory Disease in Hospitalized Patients and Periodontal Disease: A Cross-Sectional Study

SHARMA N, SHAMSUDDIN H.

Featured in Journal of Periodontology.2011;82(8):1155-1160.

Background: Recent research indicated that periodontal infection may worsen systemic diseases, including pulmonary disease. Respiratory infections, such as pneumonia and the exacerbation of chronic obstructive pulmonary disease, involve the aspiration of bacteria from the oropharynx into the lower respiratory tract. Methods: A group of 100 cases (hospitalized patients with respiratory disease) and a group of 100 age-, sex-, and race-matched outpatient controls (systemically healthy patients from the outpatient clinic, Department of Periodontics, Government Dental College and Hospital, Calicut, Kerala, India) were selected for the study. Standardized measures of oral health that were performed and compared included the gingival index (GI), plaque index (PI), and simplified oral hygiene index (OHI). Data regarding probing depths and clinical attachment levels (CALs) were recorded at four sites per tooth and compared statistically. The ÷(2) and Student t tests were used for statistical analyses. Results: The comparison of study population demographics on the basis of age, sex, education, and income showed no significant differences between groups. Patients with respiratory disease had significantly greater poor periodontal health (OHI and PI), gingival inflammation (GI), deeper pockets, and CALs compared to controls. In the case group, patients with a low income were 4.4 times more prone to periodontal disease compared to high-income patients. Smokers had significantly higher CALs compared to non-smokers in the control group. Conclusion: The findings of the present analysis support an association between respiratory and periodontal disease.

Effects of Untreated Gum Disease

Here are just a few of the Effects of Gum Disease

Medical Effects Associated with Gum Disease

A recent study in a prominent cancer journal found that men with a history of gum disease are 14 percent more likely to develop cancer than men with healthy gums. In fact, researchers uncovered that men with periodontal disease may be:

  • 49 percent more likely to develop kidney cancer
  • 54 percent more likely to develop pancreatic cancer
  • 30 percent more likely to develop blood cancers

People with periodontal disease may be at 2-3 times the risk of having a stroke (brain attack) compared to people without periodontitis.

Periodontal organisms might be associated with the development of preeclampsia. A dangerous condition that occurs in pregnant women.

The bacteria of Periodontal disease can be found in the atherosclerotic plaque of coronary artery disease (these plaques clog the hearts blood vessels and lead to heart attack.)

People with deep periodontal pockets had an increased risk for abnormal changes on their EKG’s. (A common test to examine the electrical activity of the heart.)

Periodontal diseases may contribute to the progression to prediabetes. Researchers found that having periodontal disease can cause someone to develop prediabetic characteristics, and probably disturb the glucose regulation of a non-diabetic who has prediabetic characteristics, contributing to the progression of Type 2 diabetes.

12 studies provide direct evidence of the association between pulmonary (lung) infection and oral diseases.

It has been found that diabetes and periodontal disease can lead to atherosclerosis.

Women with periodontal disease were at a greater risk for having a low birth weight and preterm birth babies than those without periodontal disease

Bacteria commonly found in the mouth and associated with periodontal diseases can be found in the amniotic fluid of some pregnant women.

79% of the women with untreated periodontal disease had delivered a preterm low birth weight baby compared to only 7.5% of the periodontally treated women and 4.1% of the healthy women.

The amount of bacteria in periodontal pockets and around the teeth, may contribute to an individual’s risk of a heart attack.

Researchers found that pregnant women with periodontitis had 65 percent higher C-reactive protein (CRP) levels compared to periodontally healthy women. CRP levels are a marker of systemic inflammation and are associated with periodontal disease, a chronic bacterial infection found in the gums of the mouth. CRP has also been associated with adverse pregnancy outcomes, including preeclampsia and preterm delivery.

A recent study suggests that edentulous, or toothless, adults may be more likely to have chronic kidney disease than adults with teeth. Untreated periodontal disease is the main reason for adult tooth loss in the United States.

New research confirms findings that periodontal disease may increase a person’s risk for the respiratory disorder Chronic Obstructive Pulmonary Disease (COPD), the sixth leading cause of mortality in the United States. The study also noted a correlation between the amount of periodontal disease and lung capacity.

Reality television has become a popular form of primetime entertainment. The latest topic helps people enhance their features from head-to-toe through plastic surgery. However, if a patient already has a bacterial infection in the body or mouth, the surgical procedure may have to be postponed. On one episode, the patient was unable to proceed with breast augmentation because of a bacterial infection in her mouth known as periodontal disease. The periodontist and plastic surgeon were concerned that the bacteria in the patient’s mouth may affect the outcome of her plastic surgery.

Bacteria from periodontal disease can enter the blood stream and can compromise recovery from any surgery, but is particularly problematic for patients receiving implants, transplants, or replacements of body parts since it may cause these procedures to fail.

Researchers have found that people with gum disease are almost twice as likely to suffer from coronary artery disease.

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.

One study of 1,147 men and found risk from periodontal disease for coronary heart disease, fatal coronary heart disease, and stroke to be as high as 2.8 times greater than for those without periodontal disease.

A new study shows that lifetime exposure to inflammation, including gum disease, may have a significant impact on the risk of developing Alzheimer’s disease.

Dr. Charles Mayo, the founder of the World-Famous Mayo clinic was a big proponent of oral health and he understood the effect that oral health has on the rest of the body. He stated that “The presence of dental health is important. Dentistry is distinctive health services and can extend human life ten years.”

We are cheated out of 10 years when we do not have a healthy mouth. That’s 10 years lost with your spouse or children. 10 years can be the difference between seeing your grandchildren be born or grow up or them never knowing you.

Periodontal bacteria can be transmitted from one person to their spouse or their children. By leaving this disease untreated you will not only harm yourself but you may harm for spouse and children as well.

Untreated Gum Disease can lead to tooth loss.

Look at the physical effects of tooth loss:

A recent study out of London found that food “rich in nutrients like nuts, apples and raw carrots could not be eaten easily for over 50%” of people with dentures.

Research at the University of Maryland Department of Nutrition shows that the “dietary quality and intake of certain nutrients was poorer among the group with self-perceived ill-fitting dentures than those with natural teeth or will fitting dentures”.

In the first year after a tooth is extracted the jaw bone decreases 25% in width.

People with dentures can only generate 5-6 psi versus 250 psi for someone with teeth. That decreased ability to grind up food compromises nutrition and health.

People with tooth loss report it affects their social and romantic lives.

7% of people who need dentures cannot tolerate them at all and are classified as oral invalids.

88% of denture wearers reported difficulty with speech.

60% of denture wearers are aware of denture movement.

As teeth and bone are lost there can be severe facial changes.

More Than 90 Percent of People with Gum Disease Are at Risk for Diabetes, Study Finds

ScienceDaily (Dec. 14, 2009) — An overwhelming majority of people who have periodontal (gum) disease are also at high risk for diabetes and should be screened for diabetes, a New York University nursing-dental research team has found. The researchers also determined that half of those at risk had seen a dentist in the previous year, concluded that dentists should consider offering diabetes screenings in their offices, and described practical approaches to conducting diabetes screenings in dental offices.

What Causes Periodontal Disease?

As with many other oral health diseases, bacteria and plaque build-up is often the culprit. In fact, plaque build-up is the leading cause of gum disease. Other potential causes of gum disease include the following:

  • Genetics
  • Poor oral hygiene
  • Food stuck in the gums frequently (possibly due to malocclusion)
  • Mouth breathing (may lead to severe drying of the gums and teeth in front of the mouth)
  • A diet low in nutrients
  • Vitamin C deficiency
  • Smoking or other tobacco use
  • Autoimmune or systemic diseases
  • Diabetes
  • Hormonal changes in the body
  • Bruxism (incessant clenching and grinding of the teeth)
  • Certain medications (some medications cause an overgrowth of the gums that can lead to periodontal disease.)

Facts About Periodontal Disease:

  • About 66% of young adults have periodontal disease
  • About 50% of children have periodontal disease
  • Periodontal disease is the most common cause of tooth loss in adults

CHICAGO—February 18, 2010—The American Academy of Periodontology (AAP) estimates that approximately three out of four Americans suffer from some form of gum disease – from mild cases of gingivitis, to the more severe form known as periodontitis. However, despite this prevalence, approximately only three percent seek treatment for their gum disease. With increasingly more research indicating that gum disease may be linked to several other diseases, including diabetes, heart disease and certain forms of cancer, maintaining healthy teeth and gums has become more important than ever.

Gum Disease: An Epidemic

Dental disease is an epidemic. Ninety percent of the population suffers from some form of this disease. Between 30 and 50 percent of the population has periodontal disease, the most destructive form of dental disease.

Study links gum disease in pets to heart problems, other health issues

In an alarming new study, gum disease, which can occur in up to 75 percent of dogs and cats by middle age, has been linked to the occurrence of heart disease.

The study, conducted by Dr. Larry Glickman at Purdue University, examined the records of nearly 60,000 dogs with gum disease and about 60,000 without. Results revealed a direct correlation between gum and heart problems.

“Our data shows a clear statistical link between gum disease and heart disease in dogs,” says Glickman.

And the news doesn’t get any better

Animal researchers have long been aware of the connection gum disease, also known as periodontal disease, and life-threatening diseases in dogs and cats. This relation is so clear, in fact, that pet health officials have coined the phrase, “Silent Killer of Pets,” when referring to periodontal disease. This condition can cause bacteria to enter the bloodstream and infect the heart, liver and kidneys — shortening a pet’s life by up to five years.

In the Purdue study, each animal was followed for average for 2.5 years, and some as long as 5 years, Glickman says. Of the pets that had no signs of periodontal disease at the onset of the study, about 0.43 percent were diagnosed with congestive heart failure by the end of the study.

On the other hand, nearly 2 percent of the subjects with periodontal disease were diagnosed with congestive heart failure. That’s a heart disease rate of more than four times higher for pets with gum disease compared to the test group that showed no signs of the disease.

As a pet owner, you play a pivotal role in helping ensure your pet’s dental health through regular teeth brushing and preventative, pro-active dental care.

The correlation was even stronger when it came to endocarditis, or inflammation of the heart valves, Glickman says. In the pets with no periodontal disease, about 0.01 percent were diagnosed with endocarditis. That compared to 0.15 percent of the subjects with periodontal disease dogs — an increased risk of 1,500 percent!

This study clearly speaks to the need for more emphasis on dental care,” Glickman said.

Gum Disease May Raise Cancer Risk

Previous studies have shown a possible link between gum disease and an increased risk of developing heart disease. Now scientists have discovered that gum disease, once thought of as a fairly benign condition, can also increase your risk of certain types of cancer!

That’s the findings of a recent study published in the prestigious medical journal Lancet Oncology. In the study, researchers tracked male health professionals for nearly two decades. All of the health professionals had a history of gum disease. By the end of the study, researchers found that the health professionals had a 14 percent overall greater risk of developing cancer compared to men who do not have gum disease.

According to lead researcher Dr. Dominique Michaud of the Imperial College London, “After controlling for smoking and other risk factors, periodontal disease was significantly associated with an increased risk of lung, kidney, pancreatic and hematological (blood) cancers.” In addition, this higher than normal risk factor was true even among health professionals in the study who never smoked. Smoking can cause gum disease and is, of course, another significant risk factor for cancer.

Also known as periodontal disease, gum disease is caused by infection of the tissues surrounding and supporting the teeth. Previous research has shown that people with gum disease not only have a higher risk of developing heart disease, but possibly diabetes, as well.

Prior to this most recent study, researchers have known that people with gum disease also show a higher level of inflammation in their blood. Inflammation is now well-known to be a risk factor for certain types of cancer (as well as heart, disease, diabetes, and many other health conditions.) But until the Lancet Oncology study, many researchers speculated that whatever causes inflammation in the body might also cause gum disease and cancer independently of each other.

The aim of the study conducted by Dr. Michaud and his colleagues was to determine whether or not gum disease by itself increases the risk of cancer. In order to conduct their study, they used data from a previous large study of male doctors and other health professionals aged 40 to 75. That study began in 1986 at Harvard University. In it, nearly 50,000 men filled out health surveys and were followed for more than 17 years. The survey included information on gum disease and bone loss, as well as various other criteria such as their number of teeth and tooth loss.

Over 5,700 of the health professionals developed cancer during the time that they were tracked, not including cases of non-melanoma skin cancers and non-aggressive prostate cancer. Dr. Michaud and his team found that men who had gum disease had 14 percent higher cancer risk compared to those who did not. Additionally, their risks were higher depending on the type of cancer.

Among the findings of Dr. Michaud and his team were that men with a history of gum disease had a:

  • 36 percent greater risk of lung cancer,
  • 49 percent higher risk of kidney cancer,
  • 54 percent higher risk of pancreatic cancer, and
  • 30 percent higher risk of blood cancers (such as non-Hodgkin lymphoma, leukemia, or multiple myeloma),

compared to men who did not have gum disease.

In addition, men who had who had fewer than the normal number of teeth (0 to 16) at the start of the study had a 70 percent higher risk of lung cancer compared with individuals with more normal teeth numbers (25 to 32).

Self-Care Tips for Preventing and Reversing Gum Disease

Based on the above findings, you can see why it is important that you take care of your teeth and gums. Here are some self-care steps you can use to do so:

  • Lifestyle – The best treatment for periodontal disease is prevention. Brush your teeth and floss after each meal, and see a dentist for checkups every six months.
  • Diet – Eat an organic, whole foods diet at least seven servings of fresh organic fruits and vegetables per day, as well as other high-fiber foods. Eliminate sugar, refined carbohydrates, processed foods, soda, and commercial fruits juices.
  • Nutritional Supplements – After flossing, rinse your mouth with several mouthfuls of liquid folic acid for one minute then swallow. To make your own liquid folic acid solution buy folic acid supplements in the form of folic acid crystals in 800 mcg capsules. Empty two capsules in pure filtered water. Also take folic acid orally, along with vitamin B complex, vitamin C, vitamin A, beta carotene, vitamin E, vitamin K, calcium, magnesium, and zinc. Co-enzyme Q10 (CoQ10) is also very helpful for gum disease. For infected gums, increase your dosage of vitamin A for three days and then slowly reduce to maintenance dose over one to two weeks. You can also massage your gums with oil from vitamin A and E capsules along with zinc oxide cream. For gums that bleed, drink pure filtered water with fresh squeezed organic lemon juice upon arising and before going to bed.
  • Topical Treatments – Brush your teeth with mixture of baking soda and hydrogen peroxide, and massage your gums with your fingers. In cases of bleeding gums make a mouthwash by combining one teaspoon of apple cider vinegar in a cup of pure filtered water. Use this to gargle with in the morning and evening. Using a toothpaste made from tea tree oil, citrus seed extract, and/or hydrogen peroxide can also be helpful.

Conclusion

Despite the findings of Dr. Michaud and his team, it remains to be seen if gum disease is in fact a definite risk factor for developing cancer. Even so, when it comes to your health, the adage “better safe than sorry” is wise advice. Therefore, take care of the health of your gums and teeth, and be willing to consult with both your physician and your dentist so that both of them can support you on your journey to achieving optimal health.