What can your mouth tell you about the rest of your body? Quite a lot, according to recent research that has found clear associations between periodontal disease and a range of serious medical problems, including heart disease, diabetes and premature births.
Not every researcher is prepared to say periodontal disease, a bacterial infection of the gums that can cause tooth loss, is responsible for these conditions. However, the links between oral health and the rest of your body do provide one more reason to pay attention to the state of your teeth and gums.
Periodontal disease, or periodontitis, affects between 7 percent and 20 percent of American adults, says James Beck, an epidemiologist and co-director of the Center For Oral and Systemic Disease at the University of North Carolina. It is a chronic disease, progressing slowly, often with no symptoms.
Numerous studies show people with periodontal disease are from one-third to more than two times more likely to have heart disease than people who don’t have the condition. But Beck’s not yet willing to say there is a clear cause-and-effect link.
Beck says studies haven’t yet been done comparing changes in the rate of periodonatal disease with changes in the rate of heart disease. More importantly, he says, researchers haven’t done tests to find out whether taking steps to prevent periodontal disease reduces the rate of heart disease.
But even in the absence of such studies, says Robert Genco, a dentist and researcher at the State University of New York at Buffalo, “Prevention of periodontal disease will likely reduce your risk of heart disease. Although that hasn’t been formally tested, it’s reasonable.”
Similarly, Genco is convinced that controlling periodontal disease can help the 16 million Americans who have diabetes.”Given that periodontal infections decrease diabetics’ ability to control their sugar (levels in the blood),” he says, “it would be prudent to prevent early forms of periodontal disease, which could lead to the more advanced forms (of the disease).”
Genco notes research has consistently shown that diabetics who receive treatment for periodontal disease have better control over their blood sugar levels. And research conducted by George Taylor, a dentist and epidemiologist at the University of Michigan, has shown that when periodontal disease in diabetics worsens, so does their ability to control blood sugar levels.
Early evidence also points to an association between periodontal disease and premature births, which in last years accounted for about 11 percent of all babies born in the United States.
Steven Offenbacher co-director of the Center For Oral and Systemic Disease at the University of North Carolina, has found young women with periodontal disease are seven times more likely to have premature children than women without the disease. By comparison, women who drink alcohol, considered a risk for premature births, are three times more likely to give birth prematurely than those who don’t.
How can a gum infection be linked to such a variety of health problems? The answer seems to lie in the inflammation that is a byproduct of the immune system’s assault on the bacteria associated with periodontal disease.
Offenbacher notes that periodontal disease is not caused by the bacteria themselves, but really by the way our bodies react to that infection. “It is the inflammatory process that determines the severity of the (periodontal) disease that seems to be critically important as it relates to systemic complications,” he says.
Doctors know one cause of premature births is vaginal infections, which are marked by inflammation. In heart disease, recent research shows that inflammatory molecules, regardless of their origin, can cause conditions that lead to the clumping of cells responsible for blood clotting, the thickening of arterial walls, and even heart attack. In diabetes, researchers suspect these inflammatory molecules interfere with the cells’ ability to use insulin.
But proving cause-and-effect in medicine is often a long process. Some other factor might be causing both periodontal disease and heart disease. So, it’s possible that even if periodontal disease is reduced, heart disease, diabetes and premature birth rates could remain untouched.
Still, say the researchers, early evidence of a connection gives us all another reason to floss.
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