Joanna Cosgrove03.01.08
Healthy Smiles, Healthy Hearts
New research connects periodontal health to cardiovascular
disease.
By Joanna Cosgrove
Online Editor
According to a 2008 report issued by the American Heart Association, an estimated 80 million American adults (one in three) have one or more types of cardiovascular disease (CVD), which includes high blood pressure, coronary heart disease, heart failure and stroke. Although mortality data from the Centers for Disease Control and Prevention (CDC) showed that coronary heart disease and stroke age-adjusted death rates have declined almost 26% and 24%, respectively since 1999, it doesn’t mean these causes of death are on the decline for good. Rather, it indicates that more Americans are heeding their doctors’ advice to eat a healthier diet and get regular exercise.
But in combination with eating right and exercising, a study published in the December issue of the Journal of Periodontology (JOP), the official publication of the American Academy of Periodontology (AAP), suggested that good oral health—daily brushing and flossing—might play a role in the fight against CVD.
“Although there have been many studies associating gum disease with heart disease, what we have not known is exactly why this happens and under what circumstances,” said JOP editor Kenneth Kornman, DDS, PhD. “The findings of this new analysis of previously published studies suggest that the long-term effect of chronic periodontitis, such as extended bacterial exposure, may be what ultimately leads to cardiovascular disease.”
This study, conducted at Howard University, was a systematic review and meta-analysis of 11 studies dating back to 2003 that had previously examined clinically-diagnosed periodontal disease and cardiovascular disease, specifically to investigate how periodontal disease with elevated systemic bacterial exposure may be connected to cardiovascular disease.
The research team behind the study analyzed the participants’ level of systemic bacterial exposure, specifically looking for the presence of the bacteria associated with periodontal disease, as well as measuring various biological indicators of bacterial exposure. They found that individuals with periodontal disease whose biomarkers showed increased bacterial exposure were more likely to develop coronary heart disease or atherogenesis (plaque formation in the arteries).
“Specifically, the article suggested that periodontal patients whose bodies show evidence of a reaction to the bacteria associated with periodontitis may have an increased risk of developing cardiovascular disease,” explained Susan Karabin, DDS, president of the Chicago-based American Academy of Periodontology. “There are a variety of oral bacteria associated with periodontal disease. This study did not specifically examine a certain strain of bacteria, but instead measured systemic bacterial exposure by looking at the periodontal bacterial burden, periodontitis-specific serology and C-reactive protein.”
Chronic periodontal disease poses the biggest threat. Dr. Karabin said some of the symptoms congruent with periodontal disease include:
•Red, swollen or tender gums
•Bleeding when brushing or flossing
•Gums pulling away from the teeth
•Loose or separating teeth
•Pus between the gum and the tooth
•Persistent bad breath
•A change in the way your teeth fit together when you bite
•A change in the fit of partial dentures
“While more research is needed to better understand the connection between periodontal disease and cardiovascular disease, this study suggests the importance of taking of your teeth and gums and how that can help you take care of your heart,” she said. “Maintaining good oral hygiene is the best way to avoid periodontal disease. You should brush and floss every day, especially after meals and before bed, and receive professional cleanings from a dental professional at least twice a year.”