Gum Disease and Heart Disease

posted in: Periodontics | 0

….and perhaps other diseases, too…..

For a long time there have been some vague ideas about gum disease being related to heart disease. Physicians not too long ago used to recommend extraction of all teeth for many cardiac patients but that practice gradually stopped, lacking hard scientific evidence of that connection. During the past decade a dozen or so scientific research papers have pieced together most – if not all – of the story. There is a connection!

Periodontal or gum disease is a bacterial infection affecting an estimated 56 million Americans, and is about as widespread as the common cold. It is the major cause of tooth loss after the age of 35. Until recently, the prospect of losing one’s teeth was the main thing a person suffering from gum disease had to worry about. Now, a building body of research has uncovered possible links between gum disease, heart disease, and stroke.

The mouth – teeth and gums and tonsils – has long been recognized as one of the most frequent ports of entry of infection into the body. Gum disease can be a significant bacterial colonization. In moderate gum disease with gum pockets measuring 4 to 5 mm deep throughout the mouth, the surface area of infection in the pockets would be equivalent to creating an infected, ulcerated surface the size of your palm with fingers extended on the side of your face!!!!! That’s pretty gross, but we tend to find it easier to ignore and rationalize when it’s in the mouth, not so easily seen….

In July of 1998, the American Academy of Periodontology launched an effort to educate the public about new findings which support what dental professionals had long suspected: Infections in the mouth can play havoc elsewhere in the body. Since July of 1998, evidence has continued to mount to support these links.

In 2000, the first Surgeon General’s Report on Oral Health in America suggested there are strong associations between oral infections – primarily periodontal infections – and other more serious diseases, such as heart disease, stroke, diabetes and pre-term, low infant birth weight.

University of Michigan Study

Dr. Walter Loesche, a professor of dentistry from the University of Michigan, and his colleagues, studied a sample of 400 men at the Ann Arbor VA hospital in Michigan to establish if a relationship exists between gum disease and heart disease. Dr. Loesche has established that men over 60 years of age whose gums bleed around almost every tooth (a main symptom of gum disease) were four and a half times more likely to have coronary heart disease.

Dr. Loesche has also established a link between more advanced gum disease and cerebral vascular accident or stroke. People who had lost more than six millimeters of bone around the tooth roots and had gum disease involving many teeth (15 to 28) were highly associated with stroke risk. People, who had had regular dental examinations, at least once a year, were four times less likely to have a history of stroke.

In January 11, 1998 ABC’s Good Morning America Sunday featured a show entitled GUM DISEASE-HEART DISEASE LINK. The show highlighted findings by dentists at Newcastle University reviewing several studies which strongly suggest that gum disease caused by bacterial plaque could have a harmful effect on the heart.

University of Louisville Study

According to Dr. Drisko at University of Louisville, “This type of research will help us get one step closer to determining if gum disease is a risk factor for cardiovascular disease. Even if the link is weak, since both diseases are so prevalent in the adult population, we may find that keeping your gums healthy and free of infection may diminish your risk for cardiovascular disease.”

Each year in Kentucky more than 12,000 people die of heart disease. It is one of the highest rates in the country. In addition, Kentucky has the second highest rate of tooth loss in the country. “Smoking exacerbates gum disease as well as cardiovascular disease, and in Kentucky we have the highest smoking rate of any state,” Drisko said.

Dental records included in the Louisville portion of the study came from patients who had received heart transplants in the past five years under the care of Geetha Bhat, director of the Heart Failure/Cardiac Transplant Center at U of L and Jewish Hospital. The 78 patients had had full dental x-rays before undergoing heart transplantation.

After studying the dental x-rays researchers determined that of the 78 subjects, 59 had moderate to advanced gum disease. Of the remaining transplant patients, only one had no signs of gum disease; the other 18 showed signs of early gum disease.

These are just a few of many studies being done that tie the risk of periodontal disease to other major health problems.

Oral Health and Older Adults

People are living longer and healthier lives. And, older adults also are more likely to keep their teeth for a lifetime than they were a decade ago. However, studies indicate that older people have the highest rates of periodontal disease and need to do more to maintain good oral health. Almost one out of four people age 65 and older have lost all of their teeth and at least half of non-institutionalized people over age 55 have periodontitis. Plus a major cause of failure in joint replacements is infection, which can travel to the site of the replacement from the mouth in people with periodontal disease.

While your likelihood of developing periodontal disease increases with age, the good news is that research suggests that these higher rates may be related to risk factors other than age. So, periodontal disease is not an inevitable aspect of aging. Risk factors that may make older people more susceptible include general health status, diminished immune status, medications, depression, worsening memory, diminished salivary flow, functional impairments and change in financial status.

Whatever your age, it’s important to keep your mouth clean, healthy and feeling good. And it’s important to know the state of your periodontal health.

Signs of gum disease

You may not realize that persistent swollen, red or bleeding gums, tooth sensitivity, and bad breath are warning signs of periodontal (gum) disease. Ask yourself the following questions:

Do your gums ever bleed when you brush your teeth or when you eat hard food? Have you noticed pus between your teeth and gums?

Have you noticed any spaces developing between your teeth or have your teeth “fanned out”? Have you noticed any change in the way your teeth fit together when you bite?

Do your gums ever feel swollen or tender? Do you ever develop sores in your mouth?

Do you have persistent bad breath?

If you answer yes to any these questions and don’t know the state of your periodontal health, it is time for an evalualtion to determine your risk. And it is important to find a dental office that is attuned to periodontal issues.

The implication is clear… gum disease is bad for you! Not only for yout teeth, but for the rest of your body also.