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:
Contribute to the development of heart disease, the nation's leading
cause of death.
Increase the risk of stroke.
Increase a woman's risk of having a preterm, low birth weight
Pose a serious threat to people whose health is compromised by
diabetes, respiratory diseases, or osteoporosis.
Heart Disease and
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.
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
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
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.
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.
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.
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
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,
- 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
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