Local Dental Care - Recessed Gums

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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Periodontitis, The Leading Cause of Gum Disease

According to information from the American Dental Association, three out of four Americans over age 35 have some form of periodontal disease, the major cause of tooth loss and bad breath (halitosis) in adults. Gingivitis is the mildest form of periodontal disease that, if left untreated, can progress to periodontitis, the loss of bone and tissues that support the tooth.

Periodontal disease has three stages, categorized by the extent of bone loss: mild moderate, and advanced. If only one or a few teeth are effected, it is localized. If all the teeth are involved, it is generalized.

Bacteria that accumulate at and below the gum line cause periodontitis. The bacteria release toxic substances that trigger the breakdown of the gum and bone. The body responds with an inflammatory response in which it essentially turns on itself and destructs the bone and tissues around the teeth. This is the body's way of warding off infectious agents.

When this happens the gum separates from the teeth, forming a gap called a periodontal pocket. If left untreated, periodontitis can lead not only to tooth loss but can also aggravate systemic illnesses. The signs of periodontitis may include:

• Bleeding gums when brushing or flossing
• Red, tender or swollen gums
• Bad breath (halitosis) or bad taste
• Receding gums (gums that have pulled away from the teeth)
• Loose teeth
• Teeth that have migrated from their original positions
• Tooth loss

Very often, however, people are not aware that they should see a periodontics professional because gum disease can progress without pain. It is possible to not exhibit warning signs and still have periodontitis. That is why it is very important to have routine periodontal screenings so that the early signs of the disease can be detected and treated before it becomes a major problem.

Periodontal Treatment

Periodontitis is treated in three phases. The first phase involves stopping the disease activity and progression of bone loss. The bacterial deposits (plaque and tartar) that formed above and underneath the gums need to be removed and the root surfaces of the teeth smoothed to enhance healing and deter future plaque retention.

This periodontal treatment is called scaling and root planing. During this phase, a dentist will review the patient's oral hygiene techniques, and give them advice on how to modify certain risk factors associated with periodontal disease.

If the periodontal disease is more advanced, surgical treatment may be needed. The purpose of this phase of periodontal treatment is to create an environment that is more amenable to health and, if possible, bring back some of the bone that was lost to the disease. In some forms of periodontitis, antibiotic treatment may be used. If this is the case, a bacterial culture may be required to test for harmful bacteria and to establish what antibiotics they are susceptible to.

Periodontal disease is a chronic condition that, like many others, has to be closely monitored, even after active treatment.

The third (maintenance) phase is crucial to the success of any periodontal treatment. Daily brushing and flossing is essential in controlling ever-developing plaque and bad breath, as is periodic periodontal maintenance care with a professional scaling of the teeth. Periodontal status will be closely monitored, so that changes can be identified and treated as early as possible.

Everyone should be routinely screened for periodontitis. All dentists are qualified in detecting and treating the early stages of periodontitis, but if an individual suspects that they are at risk, or they know they have gingivitis, they may want to see a periodontist who has advanced training in the diagnosis and treatment of periodontal conditions.

By Laura Minsk, DMD