A Healthy Smile May Promote a Healthy Heart
 

Research continues to suggest the importance of periodontal health as related to cardiovascular health CHICAGO—January 08, 2008—Each year, cardiovascular disease kills more Americans than cancer. And while most people are aware that lifestyle choices such as eating right, getting enough exercise and quitting smoking can help prevent cardiovascular disease, they may not know that by just brushing and flossing their teeth each day, they might also be avoiding this potentially lethal condition.

An article published in the December issue of the Journal of Periodontology (JOP), the official publication of the American Academy of Periodontology (AAP), suggests that periodontal patients whose bodies show evidence of a reaction to the bacteria associated with periodontitis may have an increased risk of developing cardiovascular disease.


“Although there have been many studies associating gum disease with heart disease, what we have not known is exactly why this happens and under what circumstances,” said JOP editor Kenneth Kornman, DDS, PhD. “The findings of this new analysis of previously published studies suggest that the long-term effect of chronic periodontitis, such as extended bacterial exposure, may be what ultimately leads to cardiovascular disease.”

Researchers at Howard University identified 11 studies that had previously examined clinically-diagnosed periodontal disease and cardiovascular disease. The team then analyzed the participants’ level of systemic bacterial exposure, specifically looking for the presence of the bacteria associated with periodontal disease, as well as measuring various biological indicators of bacterial exposure. They found that individuals with periodontal disease whose biomarkers showed increased bacterial exposure were more likely to develop coronary heart disease or atherogenesis (plaque formation in the arteries).

“While more research is needed to better understand the connection between periodontal disease and cardiovascular disease, this study suggests the importance of taking of your teeth and gums and how that can help you take care of your heart,” said Susan Karabin, DDS, President of the AAP. “With the number of people with heart disease continuing to increase, it is important to understand that simple activities like brushing and flossing twice a day, and regular visits to your dental professional can help lower your risk of other health conditions.”

Periodontal Therapy Helps Patients With Type 2 Diabetes
Researchers find oxidative stress levels reduced to those of non diabetic patients
 

“Our research emphasized one of the benefits of having periodontal therapy for patients with diabetes,” said Dr. Kazuo Sonoki, M.D. PhD at Kyushu Dental College, one of the study authors. “However, this was just a preliminary study and more research should be conducted to evaluate how periodontal disease affects both people with and without diabetes.”

It has been found that diabetes and periodontal disease can lead to atherosclerosis, which occurs when deposits of fatty substances, cholesterol, and other substances build up in the inner lining of an artery. This buildup is called plaque. It has been thought that oxidative stress is linked to heart disease because oxidation of LDL (low-density lipoprotein) in the endothelium is a precursor to plaque formation. Recently, oxidative stress has emerged as an important factor for atherosclerosis in patients with diabetes.

“We hear every day about how more and more people are being diagnosed with diabetes,” said Preston D. Miller, DDS and AAP president. “This research confirms that patients with diabetes should be especially conscious of their periodontal health. While more research needs to be done to evaluate the relationship between periodontal disease and diabetes, we do know that treating periodontal diseases can save teeth, and can promote overall health.”

New Evidence Finds an Association Between Periodontal Disease and Stroke
 

“We found that patients 60 years and older who were edentulous, partially edentulous and/or had significant clinical attachment loss were more likely to have a history of stroke compared to dentate adults without significant clinical attachment loss,” said Dr. Martha E. Nunn, Goldman School of Dental Medicine, Boston University. “However, based on the results of this study, it is unclear whether periodontal disease is an independent risk factor for stroke or simply a risk marker that reflects negative effects of risk factors common to both periodontal disease and stroke.”

Age, tobacco use, hypertension, diabetes, serum glucose, C-Reactive protein (CRP) and alcohol intake were also included as additional risk factors in this study. These confounders are independent risk factors for cardiovascular disease and if left untreated, periodontitis has been shown to have harmful effects on the control of diabetes, serum glucose levels and increases CRP levels.

Evidence continues to accumulate associating severe periodontitis with an increased risk of forming atherosclerotic plaques, which are responsible for myocardial infarction and ischemic stroke. According to past JOP studies, this relationship could be due to elevated CRP levels in patients with chronic periodontal disease.

Further investigation is needed to support periodontal treatment intervention as a means of controlling systemic inflammation. Based on findings from another study in the same issue of the Journal, CRP levels may now be reduced by periodontal treatment such as scaling and root planing in patients with severe periodontal disease.

“Studies evaluating additional treatment methods such as repeated scaling and root planing or surgical treatment are needed to conclusively demonstrate that CRP can be improved by periodontal treatment,” said Preston D. Miller, DDS and AAP president. “Until science presents a definitive direction, the periodontists ultimate goal is to lead patients to the right side of health. What we do know is that eliminating periodontal infection saves teeth.”


People With Rheumatoid Arthritis Have More Periodontal Disease

CHICAGO – June 21, 2001 – Swollen joints and missing teeth often go hand in hand, according to a new study in the Journal of Periodontology. In the Australian study of 130 people, the 65 people who had rheumatoid arthritis were more than twice as likely to have periodontal disease with moderate to severe jawbone loss as the control subjects. In addition, they averaged 11.6 missing teeth, compared to 6.7 in the control group.

"Periodontal disease and rheumatoid arthritis have very similar pathologies," said Robert Genco, D.D.S., Ph.D., editor of the Journal of Periodontology. "Damage caused by the immune system and chronic inflammation are central to both diseases. A better understanding of the biological processes common to these diseases may help us find new ways to treat them with medications that modify the body's response to inflammation."

At this point, researchers are not saying the relationship between the two diseases is causal. However, some scientists think a bacterial infection may trigger the disease process in some of the estimated 2.1 million people with rheumatoid arthritis.

Some dental professionals had speculated that people with arthritis have more periodontal disease because limited dexterity decreases oral hygiene. However, researchers in this study found no difference in plaque deposits between the group with rheumatoid arthritis and the control group, indicating that the progression of periodontal disease in the arthritis group was due to factors other than a difference in oral hygiene.

"People with rheumatoid arthritis should take note of this connection," said Michael McGuire, D.D.S., president of the American Academy of Periodontology (AAP). "They should be on a close lookout for signs of periodontal disease, such as red, swollen gums that bleed easily. The earlier you detect periodontal disease and treat it, the better off you are."