Is there a relationship between gum disease and cardiovascular disease? A consensus panel of experts in cardiology and periodontology say absolutely yes. And as a result, both professions are making changes in the interest of improving their patients’ overall health.
For many years, each of the specialties of the body have been separated. In other words, you see a cardiologist for your heart, a gastroenterologist for your digestive tract, a periodontist for your gums. These designations were made so that training and expertise could be developed in each area. This gives particular advantage to the patient who can then see the specialist in that particular area of disease.
But as that separation of specialties makes it convenient for patients to seek the proper practitioner, the body itself is not divided into those arbitrary specialties. The body is the body. We are whole beings.
But these are my gums, you say. How can they be related to my heart? And the other question is, But I floss my teeth. Isn’t that enough?
Periodontitis, the disease that destroys the bone support for the teeth, is estimated to be present in 30-50% of the adult population, with severe periodontitis present in 5-15% of the population. Dentists for years have recommended brushing and flossing to remove bacterial plaque control the onset of gum disease. That continues, because bacteria is required to initiate the gum disease process. For years, that was the entire story as far as patients and their dentists were concerned. It is not that way any longer. The reason lies in the term, chronic inflammation.
Inflammation is the response to bacterial and viral infections and other assaults on the body. The body responds almost instantly responds to such traumas with acute inflammation, the signs of which are heat, swelling, redness, pain, and loss of function. Acute inflammation brings the necessary white blood cells to the site of the assault to begin the healing process. As part of the initial healing process, the cells wall off and eventually engulf and kill the offending bacteria, viruses, or other assaulting agents, also killing the cells that have been infected by those agents. That is acute inflammation, and that is good. The body then creates new cells to complete the healing response.
Chronic inflammation is a continual inflammatory response which occurs in the absence of infection or trauma. Chronic inflammation occurs as a result of obesity, fast foods, smoking, drinking alcohol in excess, refined foods, allergens, environmental toxins and other agents. In fact, it is chronic inflammation that is believed to be at the center of all of the above diseases and more. It could be said that every chronic degenerative disease in the body has chronic inflammation as a component.
Specifically, periodontitis is caused by dental plaque. But once the plaque has started the gum lesion, the problem worsens in the presence of chronic inflammation of the body. In addition, the chronic inflammation caused by gum disease may create chronic inflammation in other parts of the body. Examples of diseases associated with chronic inflammation are asthma, diabetes, colitis, nephritis (inflammation of the kidney), some forms of cancer, allergies, and periodontitis and cardiovascular disease.
Several articles in the medical literature show an increased risk of cardiovascular disease in those patients who have periodontitis. And conversely, cardiovascular disease is a risk factor for gum disease and tooth loss. Such a gum risk factor is independent of other traditional risk factors. Periodontitis has been shown to be a risk factor for strokes as well as other forms of cerebrovascular disease. Other risk factors shown to be common between cardiovascular disease and gum disease include diabetes, obesity, lipids including cholesterol and triglycerides, and hypertension.
The American Academy of Periodontology has developed a questionnaire to determine your risk of periodontitis.
How old are you?
Gum disease risk increases as we age.
Do your gums bleed?
That is a sign of gum disease. However, if you smoke, your may have gum disease even if your gums do not bleed.
Are your teeth loose?
Periodontitis is a chronic inflammatory process and causes loose teeth.
Do you smoke?
Smoking is one of the largest risk factors for gum disease.
Have you seen a dentist in the past two years?
Dental visits allow the removal of dental calculus from the teeth, thus reducing the risk of gum disease. Most should see a dentist every 6 months. In the presence of gum disease, 3 month intervals are often recommended.
How often do you floss?
Studies have shown that daily flossing reduces the bacteria that cause gum disease.
Do you currently have any of the following health conditions?
i.e. Heart disease, osteoporosis, osteopenia, high stress, or diabetes If you do, your gum disease risk increases.
Have you ever been told that you have gum problems, gum infection or gum inflammation?
Once that it shown, continual assessment and monitoring is necessary as gum disease is an ongoing disease in most people.
Have you had any adult teeth extracted due to gum disease?
If a tooth was recently lost due to gum disease, your likelihood of losing another tooth increases.
Have any of your family members had gum disease?
Research has shown not only a genetic link to gum disease, but also a salivary link. Saliva passed from one family member with gum disease to another may increase that person’s risk. People whose parents have gum disease are 6-12 times more likely to have the disease than the general population.
There is a link to nutrition and all chronic degenerative diseases. And one thing can be said for sure. It is whole food nutrition that makes the difference. So if it is in a can or in a box, that’s not whole food nutrition. The American Heart Association recommends 7-10 servings (a serving is ½ cup.) of fruits and vegetables every day. Add that to 6 servings of grains (at least half of them whole grains), as well as fish, lean meats and other foods, and you have a lot to eat in a day. Such foods provide the ammunition to battle chronic inflammation. And the better we fight chronic inflammation, the better your opportunity for a healthy life.
For more information on the link between your gums and your heart, please visit the website of the American Academy of Periodontology at www.perio.org.
Lee N. Sheldon, DMD