Periodontal Diseases: An attack on your well-being

By Jaime Bulkacz D.D.S, Ph.D.

In recent years there have been a number of investigations on the repercussions of Periodontal Diseases on individual’s well-being. Many reports have pointed to possible connections between Periodontal Diseases and systemic ones. These diseases have now been linked to premature birth, low birth weight, higher sugar levels, diabetes immune problems, anemia, respiratory diseases, rheumatoid arthritis, liver and cholesterol problems as well as stroke and heart disease. What follows is a succinct account of some of the reports concerning these problems.

1) On September 19, 2006 an English newspaper published an article on the links between gum disease and systemic illnesses. They emphasized a report showing that the extraction of periodontally involved teeth resulted in a significant drop in blood of the levels of compounds (described below) associated with heart disease and stroke. The levels also dropped significantly in patients with less severe forms of the disease when they were shown how to clean their teeth properly. These findings are among the latest to suggest that good oral hygiene may lower the risk of a whole range of systemic conditions.

2) Severe forms of periodontitis, found in about 20% of the population, trigger chronic inflammation and immune reactions that have also suggested a risk factor for Alzheimer’s disease (for a review see Stein et al. in: Alzheimer‘s disease and periodontal disease: mechanisms underlying a potential bi-directional relationship. Ground Rounds Oral-Sys Med (2006) 3:14-24.

3) A study from the University of Helsinki based on a follow up of patients for more than 10 years showed that women with high levels of antibodies to a microbial agent strongly associated with Periodontal Disease were more than twice as likely to have a stroke.

4) C-Reactive protein is a blood compound elevated in Periodontal Disease which is stimulated by inflammatory cytokines. A study on pregnant women showed that this protein was 65% higher in women with periodontitis than in the control group of pregnant women without signs of disease. This C-Reactive protein was linked previously to adverse pregnancy outcomes such as low weight pre-term babies.

5) Several decades ago it was revealed that prostaglandins are elevated in Periodontal Disease. These compounds are known to induce labor in pregnant women. Researchers at the University of Alabama have been able to reduce premature births up to 84% in women that received scaling and root planning when they were less than 35 weeks pregnant.

6) Rheumatoid arthritis is yet another health problem that may have links with Periodontal Disease. An Australian study reported that patients with rheumatoid arthritis were more than twice as likely to have severe Periodontal Disease. It’s not known yet whether gum disease may be one of the triggers for arthritis, but some scientists believe that the infection associated with Periodontal Diseases may play a part in some cases.

7) Similar links emerge with diabetes. It has been known for a long time that diabetes triggers Periodontal problems in affected individuals. A recent study by a team from the US National Institute of Diabetes and Kidney Disease has shown an association between the severity of Periodontal Disease and mortality in diabetes patients. The 11 year study of patients with type 2 diabetes found that Periodontal Disease was a predictor of death from heart disease and diabetic nephropathy. After taking into account the duration of diabetes, blood pressure, tobacco use and other factors, it found that those individuals with severe Periodontal Disease had 3.2 times the risk of cardio-renal mortality.

8) Regarding heart disease and stroke, one theory is that when bacteria enter the bloodstream, they activate the immune system, resulting in the arterial walls becoming inflamed and narrowed. Another theory is that the bacteria attach themselves directly to the fatty deposits already present on the arterial walls, increasing the narrowing of the same. Some reports have also shown that DNA from periodontopathic microorganisms can be found in atherosclerotic plaques removed from carotid and femoral arteries. At the same time, antibodies to antigens from the same pathogens have been associated with coronary heart disease.

For any questions, please call me.

Jaime Bulkacz, D.D.S., Ph.D.

(818) 609-8655

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