The Body Mouth Connection:  Medical Consequences

Periodontal disease is no longer thought to be just a dental problem. Researchers are finding many correlations between periodontal disease and serious medical problems. Research has recently proven what dentists have long suspected: that there is a strong connection between periodontal disease and other chronic conditions such as diabetes, heart disease, osteoporosis and pancreatic cancer.

Periodontal disease is characterized by inflammation of the gum tissue, presence of disease-causing bacteria, and infection below the gum line. Infections and bacteria in the mouth can spread throughout the body and lead to a host of problematic health issues. Therefore, maintaining excellent oral hygiene and reducing the progression of periodontal disease through treatment will have benefits beyond preventing gum disease and bone loss. It can also save you from the chance of developing another serious condition.

Your Infection Can Be Transmitted

Research using DNA testing has found that 80% of all periodontal disease comes from bacteria transmitted from a parent or spouse. Patients with periodontal disease can pass their infection along to their loved ones.

Are You at a Higher Risk to Develop Periodontal Disease?

Patients in certain higher risk categories (see below) should pay particular attention to any signs of periodontal disease.

Do you have a personal or family history of:

  • Heart disease
  • Heart attack
  • Stroke
  • Premature childbirth
  • Diabetes
  • Respiratory diseases

Do you have a  higher risk lifestyles, including:

  • Chronic stress
  • Smoker
  • Sedentary 
  • Overweight
  • Frequent colds, flu, etc.

Higher Risk Patients

If you have been told you have periodontal disease (or some of its symptoms) it is vital that you seek evaluation and treatment.

At the time of your comprehensive periodontal evaluation, Dr Baldassarre will be evaluating your risk factors for periodontal disease and talk to you about what can be done to modify them to help stop your periodontal disease.

 Video information on link

Periodontal Disease and Diabetes

Diabetes is a serious, incurable disease that is characterized by too much glucose, or sugar, in the blood. Type II diabetes occurs when the body is unable to regulate insulin levels, meaning too much glucose stays in the blood. Type I diabetics cannot produce any insulin at all. Diabetes affects between 12 and 14 million Americans, and can lead to a variety of health issues, such as heart disease and stroke.

Research has shown people with diabetes are more likely to develop periodontal disease than non-diabetics. Diabetics with insufficient blood sugar control also develop periodontal disease more frequently and severely than those who have good management over their diabetes.

The connection between diabetes and periodontal disease results from a variety of factors. Diabetes sufferers are more susceptible to all types of infections, including periodontal infections, due to the fact diabetes slows circulation, allowing bacteria to colonize. Diabetes also reduces the body’s overall resistance to infection, which increases the probability of the gums becoming infected.

Moderate to severe cases of periodontal disease elevate sugar levels in the body, increasing the amount of time the body has to function with high blood sugar. Diabetics with periodontitis are most likely to suffer from increased levels, making it difficult to keep control of their blood sugar. Further, high glucose levels in saliva promote growth of gum disease-causing bacteria.

Blood vessel thickening is another concern for diabetics. Blood vessels function by providing nutrients and removing waste products from the body. When they become thickened by diabetes, these exchanges are unable to occur. As a result, harmful waste is left in the mouth and can weaken the resistance of gum tissue, leading to infection and disease.

Smoking and tobacco use is detrimental to anyone’s oral and overall health, but it is particularly harmful to diabetics. Diabetic smokers 45 and older are in fact 20 times more likely to develop periodontal disease than those who do no smoke.

It is very important for everyone to brush teeth effectively, floss daily, and visit the dentist regularly, but it is especially essential that diabetics practice these measures. When teeth are left un-brushed, harmful bacteria can ingest the excess sugar and colonize beneath the gum line.

Periodontal Disease, Heart Disease and Stroke

Studies have also shown that people with periodontal disease are 3 times more likely to suffer a stroke.

Recent studies have shown that people with periodontal disease are 2.7 times more likely to suffer a heart attack.

Coronary heart disease occurs when fatty proteins and a substance called plaque build up on the walls of your arteries. This causes the arteries to narrow, constricting blood flow. Oxygen is restricted from traveling to the heart which results in shortness of breath, chest pain, and even heart attack.

The link between periodontal disease and heart disease is so apparent that patients with oral conditions are nearly twice as likely to suffer from coronary artery disease than those with healthy mouths. Periodontal disease has also been proven to exacerbate existing heart conditions. Additionally, patients with periodontal disease have been known to be more susceptible to strokes. A stroke occurs when the blood flow to the brain is suddenly stopped. This may occur, for example, when a blood clot prevents blood from reaching the brain.

One of the causes of the connection between periodontal disease and heart disease is oral bacteria entering the bloodstream. There are many strands of periodontal bacteria. Some strands enter the bloodstream and attach to the fatty plaques in the coronary arteries. This attachment leads to clot formation and increased risk to a variety of issues including heart attack.

Inflammation caused by periodontal disease creates an increase in white blood cells and C-reactive proteins (CRP). CRP is a protein that has long-been associated with heart disease. When levels are increased in the body, it amplifies the body’s natural inflammatory response. Bacteria from periodontal disease may enter the bloodstream, causing the liver to produce extra CRP, which then leads to inflamed arteries and possibly blood clots. Inflamed arteries can lead to blockage, which can cause heart attacks or strokes.

Coronary heart disease is the leading cause of death in the United States for both men and women. Enacting positive oral hygiene practices and obtaining treatment for periodontal problems can help prevent the risk of developing this unfortunate condition.

Periodontal Disease and Pregnancy

Women with periodontal disease are 7-8 times more likely to give birth prematurely to a low birth-weight baby.

Pregnant women with periodontal disease expose their unborn children to a variety of risks and possible complications. Pregnancy causes many hormonal changes in women, which increase the likelihood of developing periodontal disease such as gingivitis, or gum inflammation. These oral problems have been linked to preeclampsia, or low birth weight of the baby, as well as premature birth. Fortunately, halting the progression of periodontal disease through practicing high standards of oral hygiene and treating existing problems can help reduce the risk of periodontal disease-related complications by up to 50%.

There are several factors that contribute to why periodontal disease may affect the mother and her unborn child. One is an increase in prostaglandin in mothers with advanced stages of periodontal disease, particularly periodontitis. Prostaglandin is a labor-inducing compound found in the oral bacteria associated with periodontitis. Because periodontitis increases the levels of prostaglandin, the mother may go into labor prematurely and deliver a baby with a low birth weight.

Another compound that has recently been linked to premature birth and low birth weights is C-reactive protein (CRP). CRP is a protein that has long-been associated with heart disease. Periodontal disease increases CRP levels in the body, which then amplify the body’s natural inflammatory response. Bacteria from periodontal disease may enter the bloodstream, causing the liver to produce extra CRP, which then leads to inflamed arteries and possibly blood clots. Inflamed arteries can lead to blockage, which can cause heart attacks or strokes. Although it is not completely understood why elevated CRP also causes preeclampsia, studies have overwhelmingly proven that an extremely high rates of CRP in early pregnancy definitely increases the risk.

Finally, the bacteria that invade and live in the gum sockets in a diseased mouth can travel through the bloodstream and affect other parts of the body. For pregnant women, research has shown that these bacteria may colonize in the internal mammary glands and coronary arteries.

If you are pregnant, it is important to practice effective home care for preventing gum disease. Dr. Baldassarre can help assess your level of oral health and develop preventative measures and treatment plans to best protect you and your baby.

Periodontal Disease and Respiratory Disease

Periodontal infection in the mouth can be breathed in and increase the severity of such respiratory diseases as pneumonia, bronchitis and emphysema.

Respiratory disease occurs when fine droplets are inhaled from the mouth and throat into the lungs. These droplets contain germs that can spread and multiply within the lungs to impair breathing. Recent research had also proven that bacteria found in the mouth and throat can be drawn into the lower respiratory tract and cause infection or worsen existing lung conditions.

Bacteria that grow in the oral cavity and travels into the lungs can cause respiratory problems such as pneumonia. This occurs mostly in patients with periodontal disease. Periodontal disease has also been proven to have a role in the contraction of bronchitis and emphysema. Chronic obstructive pulmonary disease (COPD), a respiratory condition characterized by blockage of the airways, and caused mostly by smoking, has also been proven to worsen if the patient also has periodontal disease.

One of the reasons for the connection between respiratory problems and periodontal disease is low immunity. Patients who experience respiratory problems generally have low immunity, meaning bacteria can easily grow above and below the gum lines without being confronted by the body’s immune system. Once periodontal disease is contracted in this way, it will only progress and worsen respiratory issues.

Inflammation of the oral tissue has also been linked to respiratory problems. Oral bacteria causing the irritation can travel to the lungs, and contribute to the inflammation of the lung lining. This creates respiratory problems because it limits the amount of air that can be passed freely through the lungs.

If you are diagnosed with respiratory disease or periodontal disease, it is possible Dr. Smith will work with your physician to plan how to best treat both conditions and eliminate further complications.

Periodontal Disease and Osteoporosis

Osteoporosis is a condition common in older patients, and particularly women, that is characterized by the thinning of bone tissue and loss of bone density over time. Osteoporosis occurs when the body fails to form enough new bone, or when the body absorbs too much old bone. The leading cause of osteoporosis is a drop in estrogen in menopausal women, or a drop in testosterone among men. Sufferers of osteoporosis must take extra care in daily activities, as they are at increased risk for bone fractures.

Because periodontal disease can also lead to bone loss, the two diseases have been studied for possible connections. Research found that women with periodontal bacteria in their mouths were more likely to have bone loss in the oral cavity and jaw, which can lead to tooth loss. Studies conducted over a period of 10 years also discovered that osteoporosis patients could significantly reduce tooth loss by controlling periodontal disease. Further, it was found that post-menopausal women who suffer from osteoporosis are 86% more likely to also develop periodontal disease.

One of the reasons for the connection between osteoporosis and periodontal disease is an estrogen deficiency. Estrogen deficiency speeds up the progression of both oral bone loss and other bone loss. It also accelerates the rate of loss of fibers and tissues which keep the teeth stable. Tooth loss occurs when these fibers are destroyed.

Low mineral bone density is one of the several causes of osteoporosis. The inflammation from periodontal disease weakens bones more prone to break down. This is why periodontitis can be particularly detrimental and progressive to patients with osteoporosis.

If you are diagnosed with osteoporosis, it is extremely important to take preventative measures against periodontal disease to protect your teeth and oral bones.

Periodontal Disease and Pancreatic Cancer

The links between Periodontal Disease and your general health continue to grow.  It is now generally accepted by researchers that periodontal disease increases your risk to develop pancreatic cancer by upwards of 59% depending on the bacteria you have in your mouth, which is one of the reasons we recommend the use of Salivary Diagnostics in our treatment of periodontal disease

There are many articles available but I thought the several below were well presented and offer good references for the information presented.

We are happy to answer your questions, see you for a consultation to determine if you have periodontal disease or see you for periodontal cleanings.

FROM THE ADA

Research Finds Association Between Certain Oral Bacteria, Higher Risk Of Pancreatic Cancer.

The Washington Post (4/20, McGinley) reported certain oral bacteria may be linked to a higher risk of pancreatic cancer, according to new research released Tuesday. Investigators “analyzed oral-wash samples collected over several years as part of two large cancer prevention and screening studies conducted by the National Cancer Institute and the American Cancer Society.”

        CBS News (4/20, Marcus) reported that the researchers “found that two oral bacteria were elevated in the pancreatic cancer patients: Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans.” Individuals “who carried Porphyromonas gingivalis had an overall 59 percent greater risk of developing pancreatic cancer, and those who carried Aggregatibacter actinomycetemcomitans were at least 50 percent more likely overall to develop the disease.” The findings were presented at the annual meeting of the American Association for Cancer Research.

        The Daily Mail (4/19) reported that Dr Nigel Carter, CEO of the UK Oral Health Foundation, said, “Further investigation into this association needs to be carried out but if confirmed there’s no reason why a saliva test to detect for pancreatic cancer could not be taken by your dentist.”

        MouthHealthy.org mentions that researchers are looking into using saliva for the diagnosis of certain cancers. MouthHealthy.org also provides information on cancer and dental health.