Top dental expert Nik Sisodia examines the mounting evidence to link poor oral hygiene with heart disease, stroke and premature births
Gum disease affects 70% of the population in varying degrees. In its mildest form, gingivitis, the tissues of the gum surrounding the teeth become inflamed and bleed.
Left untreated this may progress to more advanced forms of the disease known as peridonitis where the gums shrink and teeth may fall out. But increasingly gum health is now seen as a marker for more serious health problems including cardiovascular disease and diabetes. It is also increasingly implicated in problems in pregnancy such as premature births and underweight babies.
So the extent of gum disease in the general population is a real and growing health concern. US statistics reveal that by the age of 17 60% of the population have early signs of the disease and by the age of 50 this translates to periodontal disease for 70-80% of the population, with half suffering the severest form.
In the past research attempted to investigate the cause of gum disease but more recently the emphasis has switched its affect general health and its links to several serious illnesses. The evidence points to an assault on the bodys immune system from the bacterial infection in the mouth as a result of gum disease which leads to a degeneration in general health.
If we look at the total surface area of the roots of a full complement of adult teeth, the area is approximately equivalent to the size the forearm. If you then imagine this whole area is teaming with a cocktail of millions of bacteria which the body is fighting off on a 24-hour basis, you can imagine how this might undermine the immune system.
In the US research indicates that gum disease is a risk factor for atherosclerosis (furring of the arteries) and thromboembolic (blood clotting) incidences. In other words gum disease increases the risk of stroke and coronary heart disease.
Again the theory is that the bacterial load placed on the body together with the fact that some individuals have a greater predisposition to a heightened inflammatory response leads to both gum and cardiovascular problems.
So it is prudent for all of us to take preventative oral hygiene measures, as well as sophisticated diagnostic tests that screen for levels of certain substances associated with heightened health risk, such as that for the protein homeocysteine, which is implicated in both cardiovascular disease and Alzheimers. Bacterial analyses can also be carried out.
It is now accepted that treatment of gum disease can lead to an improvement in cardiovascular health and that the health of a patients gums is now seen as a risk marker for heart disease. Smoking is another modifiable risk factor for both gum and cardiovascular diseases. Scientists at the University of Helskinki recently concluded that gum disease can no longer be considered just a local problem but one for the health of the whole body.
Premature births and foetal development
Gum disease is increasingly implicated in adverse pregnancy outcomes such as premature births. The University of North Carolina identified it as a significant risk factor for preterm labour, premature rupture of membranes, small-for-gestational-age (babies who are smaller than expected even for premature babies) and low birth weight babies. Additional research at Tulane University in New Orleans in three clinical trial studies determined that the treatment of the gum condition led to a 57% reduction of preterm low birth weight and more significantly a 50% reduction in preterm births.
Evidence now suggests that severe untreated gum disease increases the risk of diabetic complications, and that these symptoms can be alleviated by treatment. It is thought that uncontrolled severe periodontal disease has an adverse effect on sugar levels and that anyone with a family history of diabetes is advised to take a blood test.
General medical physicians do not usually examine or screen their patients for signs of gum disease, but given the mounting evidence implicating it in many of the diseases of ageing they should.
Dr Sisodia is in private practice in London and serves as Congress Director for the British Academy of Cosmetic Dentistry. Contact info: firstname.lastname@example.org or alternatively visit the practice website www.tendental.com