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Oral Hygiene, Periodontal Disease And Heart Disease

The well-known risks for heart disease include smoking, obesity, high cholesterol, and high blood pressure. Now evidence suggests that having gum disease puts you at greater risk for cardiovascular (heart) disease.

The bacterial infection that causes periodontal disease also may 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. By taking care of your periodontal health, you can prevent or help control one of the risk factors for heart disease.

Although the exact mechanism of infection has not been determined, it is possible that the bacteria that cause periodontal disease enter the blood stream directly through the gum tissue. This can be precipitated by normal oral activities, such as brushing and chewing, that create tiny injuries in the gum and then release bacteria into the blood stream.

The bacteria can contribute to small blood clots that clog the arteries. There also is the possibility that the inflammation caused by periodontal disease contributes to the build-up of fatty deposits inside the heart arteries and the formation of blood clots. These clots can obstruct the normal blood flow, restricting the amount of nutrients and oxygen to the heart and resulting in a heart attack.

Oral bacteria can also travel to the heart and cause an infection of the lining or valves of the heart called infective endocarditis. People with a history of rheumatic heart disease, mitral valve prolapse with regurgitation, or heart murmur associated with various heart conditions are at greater risk of developing infective endocarditis and may require antibiotic treatment before dental procedures that may induce bleeding.

These procedures include oral surgery, tooth extraction, and routine cleanings. The best way to avoid infective endocarditis is by maintaining good oral health. But if you have any of the conditions that put you at greater risk for infective endocarditis, consult your cardiologist and dentist before starting any dental treatment.

Treatment of periodontal disease may be one of the ways you can help prevent heart disease and a heart attack. With meticulous oral hygiene, daily brushing and flossing, professional cleanings, and periodontal screenings, you may help save your teeth and your life.

By Laura Minsk, DMD

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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