Dangers of Gum (Periodontal) Disease

Bacteria that cause inflammation and infection in the mouth can appear elsewhere in the body and cause trouble, including in the blood vessels in the heart and brain.

Medical researchers have found a link between gum disease and increased risk for atherosclerosis, the build-up of plaque in the walls of the arteries that can lead to heart attack and stroke.

In a study published in February 2005 in the journal Circulation, researchers at Columbia University Medical Center measured specific bacteria that are known to cause periodontitis, a more severe form of gum disease, as well as other bacteria, in the mouths of more than 600 people ages 55 and older with no history of stroke or heart attack. The scientists also looked at the thickness of the carotid arteries, the two major arteries on each side of the neck that supply blood to the brain. Thickening of the carotid arteries can lead to stroke and heart attacks.

The results showed a clear link between the bacteria that cause serious gum disease and thicker carotid arteries, even when other factors such as smoking, high blood pressure and diabetes were accounted for, says lead researcher Dr. Moise Desvarieux, an assistant professor of epidemiology at Columbia University's Mailman School of Public Health.

So how does what's in your mouth affect your heart? Theories vary. "Studies have shown that in people who have gum disease, the bacteria migrate to the bloodstream. So, down the line, that may lead to adverse events" like heart attack and stroke, Desvarieux speculates. The bacteria may attach to fatty plaque in the arteries of the heart, contributing to clot formation, according to the American Academy of Periodontology (AAP).

Another theory, adds Desvarieux, involves a hyperinflammatory response to the abundance of bacteria in the mouth. "People don't realize that there are no other places in the body where so many bacteria are in contact for a long period of time, which constantly stimulates the immune system." The immune system, in turn, may over-respond, creating hyperinflammation, which stresses the heart and blood vessels. Then there's C-reactive protein (CRP), a protein released by the body in response to injury or inflammation. Higher levels of CRP are a marker for increased heart-disease risk. Desvarieux says CRP levels are higher in people with periodontitis.

The research is just the latest in a series of studies pointing to a link between bad oral health and heart disease. It is the first to show a direct connection to these bacteria, Desvarieux says. "In our population it was only those bacteria that cause periodontal disease � and not the seven control bacteria" that were associated with a thicker carotid artery. "That's pretty good evidence."

At least half of Americans over age 55 have periodontitis, according to the AAP. Because the main cause of periodontal disease is bacterial plaque � a sticky film that constantly forms on your teeth � it's essential to keep plaque at bay, especially the subgingival kind that's below the gums. Root planing and scaling � a nonsurgical therapy using fine instruments to clean the roots and break up subgingival plaque � will significantly reduce the level of oral bacteria for most people, explains Gordon L. Douglass, a past president of the AAP and a periodontist in Sacramento, Calif.

Just as important is regular brushing (twice a day), regular cleanings at the dentist (twice a year) and a practice many of us neglect: flossing. "Flossing gets into the spaces between the teeth and the gums. That will break up the bacteria and never let them get established," says Douglass. Even toothpicks can be used to clean between teeth. "Most periodontitis starts between the teeth," Douglass adds.

"Both vitamin D and calcium counteract deficiencies and reduce bone resorption," said Dr. Charles Hildebolt, Department of Radiology, Washington University School of Medicine, St. Louis, "Numerous studies indicate that vitamin D and calcium deficiencies result in bone loss and increased inflammation."

Inflammation is a well recognized symptom of periodontal diseases, which is why it has been suggested that calcium and vitamin D deficiency may be a risk factor for periodontal diseases.

Medications, including painkillers, antihistamines, diuretics, antidepressants and high-blood-pressure medications, can cause side effects that increase your chances for periodontitis. If you notice changes in the soft tissue in your mouth or if food and drinks taste differently, talk to your dentist or see a periodontist � especially if side effects include a dry mouth. Explains Douglass, "Saliva buffers the effects of acid on teeth and adds lubrication to protect against gum disease. The drier the mouth, the more inflamed it gets, and it's harder to clear plaque from your mouth."

Pregnancy Complication Associated With Periodontal Destruction (3/2/05)
Periodontal inflammation plays a possible role in the development of preeclampsia, a potentially deadly condition that affects approximately 5 percent of U. S. pregnancies, according to a study in the Journal of Periodontology.

Further Evidence Reveals the Association Between Periodontal Gum Disease and Coronary Artery Disease (10/26/04)

A study published in a recent issue of the Journal of Periodontology proposes two hypotheses to explain why people with periodontal diseases are at a significant risk for coronary artery disease.

A world-first study by Australian dental researchers has discovered a link between taking aspirin and protection against gum disease.

The study, by Dr. Arthur Drouganis and Dr. Robert Hirsch at Adelaide University's Dental School, shows that even ex-smokers can benefit from small doses of aspirin.

Gum disease is a major problem in Australia, with an estimated 10% of the population suffering from its most severe form, known as periodontitis. The problem particularly affects smokers and ex-smokers. Periodontitis causes deterioration of the structures in the gums that hold the teeth in place. This can result in the teeth falling out.

In the first study of its kind, Dr. Drouganis and Dr. Hirsch investigated the dental health of 392 Adelaide men who were ex- or non-smokers. (Men were chosen for the study because mature-aged women can be affected by hormonal changes which can influence the health of the gums.)

The study found that men aged 50 and above who were taking low doses of aspirin to prevent heart attacks, strokes and other vascular diseases, had significantly better gum health than those who did not take aspirin.

Non-smokers were better off than ex-smokers, which confirmed the already well-documented findings that smoking has a negative effect on gum health. (Smokers also have fewer teeth at a given age than non-smokers, with ex-smokers being in the middle of the range.)

The implications of these findings are that low doses of aspirin may protect the fibers and ligaments that attach the gums to the teeth. This is possibly because aspirin inhibits the action of prostaglandin E2, a chemical messenger that triggers bone loss in severe gum disease.

"Our findings show that people aged over 50, particularly ex-smokers and probably smokers, may reduce their risk of deteriorating gums by taking low doses of aspirin (100mg) daily," Dr Drouganis says.

The immune reaction known as inflammation can also be a leading player in gum disease and tooth loss. Low blood concentrations of vitamin D were linked to gum disease in a study of 11,200 men and women who had taken part in the federally sponsored National Health and Nutrition Examination Survey, Thomas Dietrich of Boston University's dental school and his colleagues report.

The rate of loss in tooth-gum attachment was 25 percent higher among those participants with the least vitamin D compared to those with the most vitamin. Since poor attachment correlated with low vitamin D even when bone density was taken into account, the investigators say that the observed effect probably stemmed from the vitamin's effect on immunity. They conclude in the July 1, 2004 American Journal of Clinical Nutrition that vitamin D "may be important for preventing tooth loss."

Both Olive Leaf Extract and Yew Extract are excellent for periodontal gum disease. The mouth can harbor many types of bacteria which can lead to infections and/or dental abscess, which can contribute to heart attacks, heart disease and pain. Yew and Olive Leaf Extract can halt infection in the mouth and help with periodontal disease.

Remember, gum disease is not like a bout of the flu, which is of relatively short duration. Periodontal disease is a long-term infection, and if it's not treated -- if that bacteria isn't eliminated or at least reduced -- it can continue to cause this slow reaction in the body that builds up over time.

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