Gum disease can be source of chronic disease

[Dave Wickware]

NIH Funds Research to Explore Gum Disease and Heart
Disease Link

The National Institutes of Health recently approved a grant
of $1.3 million to further study the link between
periodontal (gum) diseases and cardiovascular disease. This
funding will support the most comprehensive research to date
to define the link between these two diseases.

According to the grant recipient, Dr. Robert Genco,
Distinguished Professor and Chairman at State
University of New York at Buffalo and Editor of the
Journal of Periodontology, emerging research has
identified infection and inflammation caused by
periodontal disease as significantly increasing the
risk for coronary heart disease.

Supporting one of Genco's theories, a recent study in the
New England Journal of Medicine found that men with high
levels of a marker for inflammation are at an increased risk
for a heart attack.

Genco will study the link between periodontal disease and
cardiovascular disease over five years. The study includes
1,000 subjects of both men and women from Caucasian and African-
American descent, along with 2,200 control subjects. All
known risk factors for heart disease will be assessed:
stress, hostility, diabetes, smoking, weight, high blood
pressure, blood lipids, family history, diet, alcohol and
physical activity.

Genco theorizes that inflammation caused by periodontal
diseases contributes to plaque build-up in the arteries
which creates greater risk of heart disease. The study will
explore the association between these two diseases.

More than $250 billion is spent annually in direct and
indirect costs related to cardiovascular disease.

Genco's study coincides with another grant for $2.2 million
in which collaborating researchers will also explore this
link. "The emerging area of periodontal and systemic links
is one that could have significant impact on public health,"
Genco noted. "The findings may be life-saving for some of
the nearly one million people who die annually from heart
disease," he suggests.

Previous studies demonstrated a link between periodontal
disease and cardiovascular disease but were limited in size
and/or scope, or did not fully control for all risk factors.

The Journal of Periodontology, the official publication of
The American Academy of Periodontology (AAP), publishes
original papers of the highest scientific quality to support
the practice, education, and research in the dental
specialty of periodontology.

A referral to a periodontist in your area and free brochure
samples including one titled Ask Your Periodontist About
Periodontal Disease and Heart Disease are available by
calling 800-FLOSS-EM or visiting the AAP's Web site at
www.perio.org.

The AAP is a 7,900-member organization of dentists
specializing in the prevention, diagnosis and treatment of
tissues surrounding the teeth and in the placement and
maintenance of dental implants. Periodontics is one of eight
dental specialties recognized by the American Dental
Association.

For more information, contact the AAP Public Affairs
Department at
312/573-3243 or 312/573-3242.

[Dave Wickware]

Periodontal (Gum) Disease and Heart Disease by Mark
Bornfeld, DDS

Recently, there have been press reports that there is a link
between periodontal disease and cardiovascular disease. It
is natural to ask if this puts you at risk for heart
problems resulting from problems with your gums.

The relationship between the gums and the heart is neither
self-evident nor is it well understood. Over the years,
there have been many studies, which have proposed and
demonstrated this relationship. These studies have recently
been reviewed.* One should always remember that a
statistical correllation between gum disease and heart
disease does not necessarily mean that gum disease causes
heart disease.

The most well established link between the gums and heart
disease is related to bacterial endocarditis. This is a
serious infection of the lining of the heart. It has long
been known that anything that causes bleeding in the mouth
can seed bacteria into the bloodstream. Normally these germs
are cleaned out of the blood stream by white blood cells
within a few minutes. But in some people with some types of
pre-existing heart disease (usually valvular heart disease
or prosthetic heart valves) there is a predisposition to
having these bacteria latch on to the damaged heart tissue,
causing this serious infection. For this reason, it is
recommended that patients with these kinds of heart damage
be placed on antibiotics prior to having any dental
treatment that is likely to cause bleeding.

Newer studies imply that having gum disease may predispose
one to heart attack and stroke. Just why is not known, but a
few possible mechanisms have been proposed:
1) Direct action of bacteria in the blood (bacteremia)
2) Release of toxins and bacterial products into the
bloodstream
3) Increase in the number of circulating white blood cells
4) Activity of the immune system in response to these
bacteria causing damage to blood vessels.

Many of these studies have hinged on gum disease and other
lifestyle factors. For instance, someone who doesn't take
care of his mouth is likely not to be very health conscious--
may smoke, may not watch his diet, etc.--all factors long
associated with cardiovascular disease. Smoking is well
established as a risk factor in periodontal disease as well
as heart disease. Diabetes is also associated with both
periodontal disease and damage to blood vessels. These
studies attempt to adjust the figures and data to filter out
these other factors--in other words, to assess the
association between gum disease and cardiovascular disease
apart from these extraneous factors. They have concluded
that gum disease alone is a powerful predictor of
cardiovascular disease and stroke.

What to think? The studies are certainly interesting. The
dental profession, not surprisingly, has grabbed onto this
issue in an effort to encourage patients to seek treatment.
I think that some of the studies seem a bit far-fetched.
One, for instance, concludes that gum disease is a more
important factor in heart disease than smoking. But the
number of suggestive studies is growing, and the growing
body of knowledge should be watched closely. I'd like to
think patients would take care of their gums in order to
retain their teeth. They may be doing something important
for their general health as well.

*Compend. Contin. Ed. Dentistry, June 2000, pp 463-482

References: http://www.perio.org/consumer/webcardio.htm

http://www.pslgroup.com/dg/F896A.htm

http://nnd40.med.navy.mil/CUpdates98/March.htm


"Dave Wickware" <dwickware@sympatico.ca> wrote in message
news:zzyFc.197119$207.2218091@news20.bellglobal.com...
> NIH Funds Research to Explore Gum Disease and Heart
> Disease Link
>
> The National Institutes of Health recently approved a
> grant of $1.3
million
> to further study the link between periodontal (gum)
> diseases and cardiovascular disease. This funding will
> support the most comprehensive research to date to define
> the link between these two diseases.
>
> According to the grant recipient, Dr. Robert Genco,
> Distinguished
Professor
> and Chairman at State University of New York at Buffalo
> and Editor of the Journal of Periodontology, emerging
> research has identified infection and inflammation caused
> by periodontal disease as significantly increasing the
> risk for coronary heart disease.
>
> Supporting one of Genco's theories, a recent study in the
> New England Journal of Medicine found that men with high
> levels of a marker for inflammation are at an increased
> risk for a heart attack.
>
> Genco will study the link between periodontal disease and
> cardiovascular disease over five years. The study includes
> 1,000 subjects of both men and women from Caucasian and
> African-American descent, along with 2,200
control
> subjects. All known risk factors for heart disease will be
> assessed:
stress,
> hostility, diabetes, smoking, weight, high blood pressure,
> blood lipids, family history, diet, alcohol and physical
> activity.
>
> Genco theorizes that inflammation caused by periodontal
> diseases
contributes
> to plaque build-up in the arteries which creates greater
> risk of heart disease. The study will explore the
> association between these two
diseases.
>
> More than $250 billion is spent annually in direct and
> indirect costs related to cardiovascular disease.
>
> Genco's study coincides with another grant for $2.2
> million in which collaborating researchers will also
> explore this link. "The emerging area
of
> periodontal and systemic links is one that could have
> significant impact
on
> public health," Genco noted. "The findings may be life-
> saving for some of the nearly one million people who die
> annually from heart disease," he suggests.
>
> Previous studies demonstrated a link between periodontal
> disease and cardiovascular disease but were limited in
> size and/or scope, or did not fully control for all risk
> factors.
>
> The Journal of Periodontology, the official publication of
> The American Academy of Periodontology (AAP), publishes
> original papers of the highest scientific quality to
> support the practice, education, and research in the
> dental specialty of periodontology.
>
>
> A referral to a periodontist in your area and free
> brochure samples including one titled Ask Your
> Periodontist About Periodontal Disease and Heart Disease
> are available by calling 800-FLOSS-EM or visiting the
> AAP's Web site at www.perio.org.
>
> The AAP is a 7,900-member organization of dentists
> specializing in the prevention, diagnosis and treatment of
> tissues surrounding the teeth and
in
> the placement and maintenance of dental implants.
> Periodontics is one of eight dental specialties recognized
> by the American Dental Association.
>
> For more information, contact the AAP Public Affairs
> Department at
> 312/573-3243 or 312/573-3242.