Cardiovascular Risk for Periodontal (Gum) Disease /Periodontitis/ Pyorrhea/ Gingivitis

Cardiovascular Risk for Periodontal (Gum) Disease /Periodontitis/ Pyorrhea/ Ging

Long-term periodontitis can lead to even more-serious problems, including higher blood sugar levels and an increased risk of heart attack and stroke. Gum disease may even affect your unborn child. Pregnant women with periodontitis are much more likely to give birth to premature babies than are women with healthy gums.

Periodontal disease is a disease affecting the tissues that support the teeth, including gum tissue and bone. The most common periodontal diseases are gingivitis and periodontitis. Gingivitis is inflammation of the gums. Periodontitis is a more serious disease that affects the underlying bone structure of the teeth. Periodontal disease is the leading cause of tooth loss in adults over 40. Periodontitis is a very common disease affecting approximately 50% of U.S. adults over the age of 30 years.However, early diagnosis and treatment can usually prevent tooth loss.

Gingivitis is a form of periodontal disease. Periodontal disease is when inflammation and infection destroy the tissues that support the teeth, including the gingiva (gums), the periodontal ligaments, and the tooth sockets (alveolar bone).Gingivitis is caused by the long-term effects of plaque deposits. Plaque is a sticky material that develops on the exposed portions of the teeth, consisting of bacteria, mucus, and food debris.

Recent evidence suggests that certain infections, among them dental infections and in particular periodontal disease, are involved in the pathogenesis of coronary artery disease.In a study, fifty patients referred for diagnostic coronary angiography were assessed for periodontal disease. All patients underwent a thorough physical examination, routine laboratory testing, cardiac evaluation and dental examination which included pantomography x-ray evaluation.

Periodontal disease was significantly associated after all the known risk factors were accounted for. The implication here is that periodontal disease could be a potential risk factor for heart disease by predisposing the individual to chronic low-grade infections. If so, then dental health becomes an important parameter for medical health.

In a study that strengthens the link between chronic gum infection and cardiovascular problems, researchers said treatment of severe periodontal disease was associated with improved blood flow and more elasticity of arteries.

The study, conducted with patients at the Eastman Dental Hospital in London, England, included 120 people with severe periodontitis, a chronic bacterial infection that affects the gums and bone supporting the teeth.

Interestingly, the immediate result was an increase in inflammation among the patients who received intensive treatment for the gum condition. There was no such reaction among patients whose condition was treated less vigorously.

"However, six months after therapy, the benefits in oral health were associated with improvement in endothelial function," the researchers reported.

The endothelium is the delicate inner lining of the blood vessels. The improvement was shown by expansion of blood vessels that allowed better blood flow and by molecular markers of endothelial health, the researchers said.

For example, the researchers reported that the arteries of those getting intensive treatment were 2 percent wider six months later than those getting ordinary treatment, an improvement they described as "significant."

"The degree of improvement was associated with improvement in measures of periodontal disease," the study said.

"This study adds a lot to a growing database that there is some sort of link" between periodontal disease and cardiovascular risk, said Dr. Preston D. Miller Jr., president of the American Academy of Periodontology.

The study "increases the link between local inflammation and inflammation of the coronary vessels that is extremely important," added Miller, clinical professor of dentistry at the University of Tennessee College of Dentistry.

The study findings call for more research to determine the effects of specific periodontal treatments on blood vessel function, he said.

But Dr. Daniel Meyer, associate executive director of the American Dental Association's division of science, said there's an important element missing in this and other studies of the effect of periodontal disease on cardiovascular problems.

"What it does not demonstrate is the relative importance of different risk factors. Implications of such things as diet, exercise and general health are not being factored into it," Meyer said. "What it is looking at is one aspect of a very complex disease."

It's too early to know how important a role periodontal disease may play in the risk of heart attack, stroke and other cardiovascular conditions, Meyer said. "There are too many individual factors involved to say that it contributes a certain percentage of risk," he said.

That lack of precision doesn't mean people should neglect their dental health, Meyer said. "We would certainly advise people to floss, but not at the expense of other things that improve their health," he said. "Someone who smokes, drinks and is obese should get their oral health taken care of, but should look at other health factors as well."

Dr. Moise Desvarieux, associate professor of epidemiology at the Columbia University Mailman School of Public Health, said, "This study adds significantly to the body of evidence linking periodontitis to vascular disease through a strong design and rigorous analysis.

"It convincingly demonstrates the potential for reversibility, since treating periodontal disease improved endothelial function," he said.

The available evidence shows that important risk factors for periodontal disease relate to poor oral hygiene, tobacco use, excessive alcohol consumption, stress, and diabetes mellitus. Integrated preventive strategies based on the common risk factors approach are recommended for public health practice.


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