Periodontal Disease is a Risk Factor for Systemic Disease
It is well known that periodontal (gum) diseases are a series of bacterial infections that destroy the gum tissue and bone that support the teeth. Left untreated, periodontal disease can lead to tooth loss. What is commonly not thought of is how this oral infection can also affect the rest of the body.
An infection in the mouth can affect the overall health and have serious systemic (general body) manifestations. Like other infections, the bacterial cells that cause periodontal disease, or their toxic products, can enter the blood system and affect other organs.
Research studies indicate that periodontal infections can affect the overall health and that periodontal disease is a risk factor for many health problems.
Bacteremia: Bacteremia is an infection caused by infectious organisms in the blood system. The bacteria that cause periodontal disease can enter the blood system through cuts in the gum provoked by normal chewing or brushing habits.
The bacteria can also enter the blood system directly through the infected gum tissue in a periodontal pocket. The more infected the gums are, the more likely bacteria are to enter the blood system. These bacteria can travel and infect other organs. The best way to prevent bacteremia caused by oral bacteria is by maintaining oral health.
Infective endocarditis: People that have damaged heart valves, a history of rheumatic fever with subsequent heart valve damage, aortic stenosis, certain heart murmurs, and mitral valve prolapse with regurgitation are at greater risk of developing infective endocarditis -- an infection of the lining and valves of the heart.
If not treated immediately with antibiotics, this infection can be fatal. The best way to prevent infective endocarditis is by minimizing the amount of bacteria in the mouth. Several periodontal treatments, like meticulous home care with brushing and flossing, combined with professional cleanings and modification of risk factors related to periodontal disease, are essential in controlling the bacterial infection.
In addition, the American Heart Association has recommended antibiotic treatment prior to certain dental procedures for people that are at high risk of infective endocarditis. These dental procedures include tooth extraction, surgical treatment, scaling and root planing, and implant treatment. Your dental care provider needs to be aware of your medical history in order to better treat you and prevent systemic complications.
Cardiovascular disease: Evidence suggests that having periodontal disease puts you at greater risk for cardiovascular disease. The bacteria that are normally found in the mouth have been found in the artery walls of people with cardiovascular disease. These bacteria can irritate the arteries, leading to fatty deposits and eventual blockage of the arteries resulting in heart attacks or strokes.
Heart attacks: The bacterial infection that causes periodontal disease may also affect the heart. In fact, all other conditions being equal, people with periodontal disease may have twice the risk of having a fatal heart attack as people that don't have periodontal disease.
Strokes: Strokes occur when a blood vessel in the brain becomes blocked and there is reduction in the oxygen delivery to the brain cells. This can lead to paralysis, speech problems, and even death. A research study of 10,000 people found that periodontal disease can increase your risk of having a stroke by two-fold.
Artificial joints: Artificial joints or prosthetic devices may be vulnerable to infection by the bacteria that cause periodontal disease. These bacteria can enter the blood stream through small ulcerations in the gums or as a result of dental treatment. To prevent infection of artificial joints maintain meticulous oral hygiene and consult your dentist and physician about the possibility of antibiotic treatment before dental procedures.
Diabetes: Periodontal disease can increase insulin requirements and diabetic complications. Treating periodontal disease can actually reduce the need for insulin.
Respiratory disease: People with advanced periodontal disease are four and a half times more likely to have chronic respiratory disease. The bacteria that cause periodontal disease can be aspirated into the lungs increasing the risk for pneumonia and other respiratory diseases.
Once again, to prevent the serious systemic complications related to periodontal disease infection, see your dentist or periodontist for a periodontal screening and treatment as indicated. Treatment of periodontal disease may save your life!
Premature, low-birth weight babies: If you do have periodontal disease and are pregnant, you may have a higher risk of having a premature, low-birth weight baby. Pregnant women who have periodontal disease are seven and a half times more likely to have a baby that is born too early or too small. This time, treating periodontal disease can help improve your health and that of your baby.
So, because periodontal infections can affect the overall health and periodontal disease is a risk factor for many health problems, seeking periodontal treatment can help improve your oral and overall health.
By Laura Minsk, DMD
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Risk Factors For Gingivitis and Periodontitis
It is well established that the main cause of gingivitis, or periodontal disease, is bacterial plaque. But not everyone responds the same to the same bacterial infection. There are many factors that can contribute to making someone more or less susceptible to the progression of periodontitis. These factors are called risk factors. They can increase the risk, severity, and speed at which the disease develops. Some risk factors can be modified. If they are, gum disease and tissue destruction can be controlled and maybe even prevented with periodontal treatment.
There are several factors that can put individuals at greater risk for gingivitis or periodontal disease.
1. Poor Oral Hygiene: The bacterial plaque that continuously forms on the teeth is the main cause of periodontal infections. Without bacterial plaque there cannot be periodontitis. But as the amount of plaque increases, so does the risk for the disease. There is a shift in the bacterial population of plaque from one that is compatible with health, to one that is responsible for the disease. The best way to help control or prevent the progression of periodontal diseases is to follow a diligent plaque control program that includes daily brushing and flossing.
2. Crowded Teeth: Crowded teeth can contribute to plaque retention and interfere with oral hygiene. If this becomes a problem, it may be necessary to reshape the teeth or move them to a better position with the use of dental appliances or braces.
3. Poor Fitting Dentures, Fillings, or Crowns: These factors also may contribute to plaque retention and interfere with oral hygiene methods. If this is the case, the restorations may need to be reshaped, polished, or even replaced.
4. Occlusion (the way the teeth bite or come together): The forces created by an unbalanced bite, by clenching, or by grinding of the teeth, can accelerate the progression of bone destruction and periodontal disease. These forces can also contribute to excessive wear of the teeth, fractures, temporomandibular joint (TMJ) problems, or root canal problems. People who clench or grind their teeth may not be conscious of it, but may experience sore jaw muscles, TMJ problems, headaches, and neck or shoulder pain. Most people are more susceptible to clenching or grinding during periods of high stress. These habits can be controlled and treated with specially made dental appliances (night guards), braces, reshaping of the biting surfaces of the teeth, exercises, medications, or a combination of the above.
5. Tobacco: People who smoke or chew tobacco are more likely to have periodontitis. They also are more likely to have a poorer and slower response to periodontal treatment. The risk of acquiring periodontal disease decreases after smoking cessation and former smokers and non-smokers respond the same to treatment from a periodontist. Smoking cessation is beneficial to periodontal and overall health.
6. Poor Nutrition: Although periodontal disease is not caused by nutritional deficiency, a diet low in nutrients can diminish the effectiveness of the body's immune system. This reduces the resistance to infections such as periodontitis. To aid in the body's capacity to fight infections, maintain a well-balanced diet and avoid fad diets that exclude entire food groups and limit nutrients.
7. Stress: Stress reduces the immune response and makes it hard for the body to fight infection. A study has shown that people who are under financial stress and have poor coping ability have a two-fold increase in the incidence of periodontal disease.
8. Pregnancy and Female Hormonal Changes: The hormonal changes that occur during pregnancy, puberty, and menstruation can make the gums more sensitive to bacterial plaque and increase the risk for periodontal disease. Pre-existing periodontal problems can become more severe if plaque is not controlled. So an efficient and consistent plaque control program is essential in maintaining periodontal health through pregnancy and all stages of life.
9. Systemic Diseases: Certain systemic (general body) diseases, such as AIDS and diabetes, may decrease the body's ability to fight infection and can result in more severe periodontal disease. Always keep your dental care provider informed of changes in medical status.
10. Medication: Drugs such as birth control pills, immunosuppressants, anti-depressants, and some heart medications can also increase the risk for periodontal disease. Patients should inform their dental care provider of any changes in the medications that they may be taking.
11. Genetics: Up to 30% of the population may have a gene that is linked with an increased susceptibility to periodontal disease. Although genetics is not modifiable, knowing one's genetic profile puts individuals in a proactive position regarding dental health. Through proper home care, periodontal maintenance visits, modification of known risk factors, and early intervention, individuals have an excellent chance of keeping their teeth for a lifetime.
By Laura Minsk, DMD