Periodontal Disease…A Link to Other Health Problems? (Part 2)

In last month’s newsletter, we learned that an estimated 200 million Americans have periodontal disease, and that “bugs” were the simple answer as to the cause of periodontal disease.
 
To recap, there are certain bugs or bacteria in the mouth that are always associated with bone destruction caused by periodontal disease. To differentiate the “bugs” in my patients’ mouths as well as to monitor and assess their periodontal health, I screen for infection with the use of a microscope. The use of a microscope allows me to know if an infection is still present and whether bone loss was historical or an on-going problem.

Two big reasons it’s important to treat periodontal disease, and to hopefully treat it at its earliest stage are:

1) Periodontal disease can be a sign that there is a problem in host resistance and

2) The bacteria and their toxic by-products that are in the pockets (the measurable distance between the edge of your gum and bone) do not necessarily stay there. The same blood which travels in your gums travels all over your body. In fact, periodontal bacteria have been found in the atherosclerotic plaque in the heart.

Bacteria are a big problem. In my experience, as people become more and more toxic, the bacteria often play more and more of a role in their chronic disease. Is this a revolutionary observation? No. In the book Death in Dentistry, by Dr. Martin Fisher, the role of bacteria in many, many diseases is chronicled.

Most people have heard that stomach ulcers are now treated with antibiotics. Ulcers are caused by bacteria, not too much acid. Dr. Barry Marshall proposed this a number of years ago, and was ridiculed. He proved it by self administering H-pylori to cause an ulcer and then curing it with antibiotics.

Guess what? Dr. Billings proved this back in 1906. The main source of H-pylori is the mouth! H-pylori is normally in the mouth, but when periodontal disease is present, there is much higher concentration, which can then be transported to the stomach, just by swallowing.Today, many studies have been done which confirm what was known in the days before antibiotics.

The mouth is the cause of a lot of systemic disease.

People with periodontal disease have a higher risk of stroke. One study found those having periodontal disease have more than 200% greater risk for stroke. Another study found that stroke victims are 3X more likely to have periodontal disease. Other investigators have related periodontal disease to insulin resistance, and obesity.

Heart disease has been associated with periodontal disease.

Several types of bacteria found in pockets have been associated with heart damage. If these bacteria are present in periodontal pockets, there is a 2-300% higher risk of heart disease. There are many studies proving a link. There is something called C-reactive protein. This is an inflammatory protein associated with heart disease. Research has shown that C-reactive protein levels correlate with periodontal disease. Giving a low dose of antibiotic has been shown to suppress periodontal breakdown and lower C-reactive protein. Research is also showing that C-reactive protein may be involved in atherosclerosis.

Cardiologist and co-author of the upcoming book, Spa Medicine, Stephen Sinatra, MD took time out of his busy schedule to talk with me about periodontal disease and the heart. He observes that, “As a cardiologist I’ve always been struck by the number of people I see with documented coronary artery disease who have periodontal problems. I’m over vigilant when I see patients with periodontal disease and am much more aggressive with investigating cardiovascular disease.”

Dr. Sinatra reiterates my observation that, periodontal disease is a source of inflammation and chronic inflammation is the major factor in coronary artery disease. Dr. Sinatra cites, “In one study performed in patients undergoing coronary arteriography there was a definite correlation between the extent of coronary artery disease and periodontal disease at the same time.”

Preterm low birth weight babies are at risk for all sorts of problems because of their systems not reaching maturity before birth. Studies show that mothers with periodontal disease have a higher incidence of preterm low birth weight babies. Also, bacteria can cross the placental barrier, placing the fetus at risk for infection.

The leading cause of death in nursing homes and in those over 65 is pneumonia. Again, there is a relationship with oral bacteria especially with those with periodontal disease.

So doesn’t it seem like a good idea to keep your gums healthy? Also one can appreciate how important it is to treat not just the pockets, but the entire host. Next month, we will answer the questions that many of my patients ask, “How did I get this?”, “Where did these bacteria come from?” and “Doc, what are you going to do about this?”

© 2004, Mark A. Breiner, DDS

The information presented is for educational purposes only. You should consult a qualified dentist or health practitioner for diagnosis and treatment.