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 contribute to problems elsewhere in the body.
Periodontal disease is a bacterial infection, and all infections are cause for concern. Periodontal bacteria can enter the bloodstream and travel to major organs and begin new infections. Research is suggesting 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 baby.
Heart Disease and Stroke
Several theories exist to explain the link between periodontal disease and heart disease. One theory is that oral bacteria can affect the heart when they enter the blood stream, attaching to fatty plaques in the coronary arteries 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 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.
Pre-term Low Birth Weight Births
For a long time we've known that risk factors such as smoking, alcohol use, and drug use contribute to mothers having babies that are born prematurely at a low birth weight. Now evidence is mounting that suggests a new risk factor - periodontal disease. Pregnant women who have periodontal disease may be seven times more likely to have a baby that is born too early and too small.
It appears that periodontal disease triggers increased levels of biological fluids that induce labor. Furthermore, data suggests that women whose periodontal condition worsens during pregnancy have an even higher risk of having a premature baby.
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 diabetes patients are more likely to develop periodontal disease than those who are well-controlled. Research has emerged that suggests that the relationship between periodontal disease 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 lungs 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 Disease (COPD) causes 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 frequent bouts of respiratory disease in COPD patients.
Researchers have suggested that a link between osteoporosis and bone loss in the jaw. Studies suggest 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 deviancy 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.
Some warning signs of gum disease include: tender, bleeding gums, persistent bad breath, receding gums, changes in your bite, and tooth movements such as migration and mobility.
David R. Williams, DDS, MS | Periodontic & Implant Dentistry