Relationship of Gum Disease to Overall Medical Health
Overview
Periodontal disease has been linked to heart disease, stroke, diabetes, pregnancy problems, and other health concerns.
Heart Disease
Several theories exist to explain the link between periodontal disease and heart disease. One theory is that oral bacteria can affect the heart when they enter the blood stream, attaching to fatty plaques in the coronary arteries (heart blood vessels) and contributing to clot formation. Coronary artery disease is characterized by a thickening of the walls of the coronary arteries due to the buildup of fatty proteins. Blood clots can block normal blood flow, restricting the amount of nutrients and oxygen required for the heart to function properly. This may lead to heart attacks.
Another possibility is that the inflammation caused by periodontal disease increases plaque buildup, which may contribute to swelling of the arteries.
Researchers have found that people with periodontal disease are almost twice as likely to suffer from coronary artery disease as those without periodontal disease.
Periodontal disease can also exacerbate existing heart conditions. Patients at risk for infective endocarditis may require antibiotics prior to dental procedures. Your periodontist and cardiologist will be able to determine if your heart condition requires use of antibiotics prior to dental procedures.
Stroke
Additional studies have pointed to a relationship between periodontal disease and stroke. In one study that looked at the causal relationship of oral infection as a risk factor for stroke, people diagnosed with acute reduction of blood flow to the brain were found more likely to have an oral infection when compared to those in the control group.
Diabetes
Diabetic patients are more likely to develop periodontal disease, probably because diabetics are more prone to contracting infections. This can increase blood sugar and lead to diabetic complications. Those people who don't have their diabetes under control are especially at risk. Research suggests that the relationship between periodontal disease and diabetes goes both ways - periodontal disease may make it more difficult for people who have diabetes to control their blood sugar. Therefore, it is very important for people with Diabetes to treat gum disease and maintain the long term health of their gums.
Pregnancy Problems
Pregnant women who have periodontal disease may be seven times more likely to have a baby that is born too early (premature), and too small (low birth weight). More research is needed to confirm how periodontal disease may affect pregnancy outcomes. It appears that periodontal disease triggers increased levels of biological fluids that induce labor. Furthermore, data suggests that women whose periodontal condition worsens during pregnancy have an even higher risk of having a premature baby. Hormonal changes associated with pregnancy may also increase the severity of the disease, including bleeding, swollen gums, and loss of bone.
Respiratory Problems
Scientists have found that bacteria that grow in the oral cavity can be inhaled into the lower parts of the lung to cause respiratory diseases such as pneumonia, especially in people with periodontal disease. This discovery leads researchers to believe that these respiratory bacteria can travel from the oral cavity into the lungs to cause infection.
Osteoporosis
Researchers have suggested that a link between osteoporosis and bone loss in the jaw. Studies suggest that osteoporosis may lead to tooth loss because the density of the bone that supports the teeth may be decreased, which means the teeth no longer have a solid foundation. Bone loss may progress more rapidly in softer, less dense bone. However, hormone replacement therapy may offer some protection.
Bisphosphonates: Implications for Your Periodontal Therapy
Recently, there has been information in the news about taking bisphosphonates and the implications on your periodontal health. Oftentimes, women with osteoporosis are treated with bisphosphonates such as Fosamax, Actonel, Boniva, and Reclast. Intravenous and long term use of these medications has been linked to the development of osteonecrosis of the jaw (ONJ) when undergoing certain oral surgical and periodontal procedures.