Expert Advice

PeriodontalHealth

November 01, 2007|By Holly Selby

An increasing number of studies indicate that periodontal health - that of the gums and the bones and ligaments that support the teeth - is related to the body's overall well- being, including cardiovascular health. Some studies also have shown a relationship between a pregnant woman's periodontal health and premature birth.

Although no one is claiming that there is a causal relationship between poor periodontal health and other systemic diseases, there is a great deal of research aimed at further defining these associations, says Harlan Shiau, assistant professor of periodontics at the University of Maryland Dental School. What is periodontal disease?

Periodontal disease is an infection of the supporting structures of the teeth. It includes the bones, the ligaments that hold the tooth to the bone and the gingiva - or the gums.

Specific oral bacteria cause chronic periodontitis, which affects about 30 percent of the population. ... Chronic periodontitis develops when our own immune system reacts. In some sense, as our bodies try to contain the infection, our immune system inadvertently causes damage to the supporting structures of the teeth. What are signs of periodontal disease?

Well, gingivitis is inflammation of the gums, and with this we often associate bleeding, tenderness and a lot of redness of the gingiva.

With chronic periodontitis, there may be similar symptoms. The main difference between the two [conditions] is that gingivitis doesn't affect the bone or ligaments that support the teeth and technically, it is reversible. So once you remove from the root surface the plaque and the bacteria causing gingivitis, the patient can actually "recover." With periodontitis, you have actual loss of the supporting structures of the teeth. There's an old saying that a dog's mouth is cleaner than a human's. Just how bacteria-laden are our mouths?

I don't know if I can substantiate that claim [about a dog's mouth], but in terms of bacteria, there are about 400 to 500 species of bacteria in a typical mouth.

Fortunately, a majority of the bacteria in our mouths are benign and do us no noticeable harm. Proper home care -that is, brushing and flossing on a regular basis - can keep the bacterial burden in check. What is the role of saliva in terms of periodontal health?

Saliva has a protective function on a number of different levels. The first and most obvious one is saliva physically is able to cleanse the teeth and the areas between the teeth. But also within the saliva are things like antibodies and other proteins that act as antimicrobials.

In cancer patients who have been treated with radiation, one of the unfortunate side effects is xerostomia - basically the condition of decreased salivary flow - so the patient has a high level of cavities because of lack of saliva. What does research indicate about the relationship between a healthy mouth and the body's overall health?

Over the past 20 years, there has been a lot of interest in the link between dental and systemic health. ... Research has established that diabetes is a risk factor for chronic periodontitis. In addition, it is now recognized that one of the most common oral symptoms of diabetes is periodontitis.

Recent research also has suggested among other things that there was a possible association between periodontal disease and cardiovascular disease. There now is quite a bit of ongoing research on just how the two interact. One of the things that the two diseases share is inflammation.

In periodontal disease, though it is caused by bacteria, it isn't actually the bacteria that cause the destruction. It is our own biological response to the bacteria: inflammation. ... And the idea is that perhaps the relationship between periodontal and cardiovascular disease is that inflammation in one place may have an effect in another place in the body. Some studies have linked low birth weight to the oral health of pregnant women. What has this research shown?

There have been studies published in the last few years about preterm, low-weight babies and mothers who have periodontal disease. The studies showed an association, but not a causal relationship (in other words, one has not yet been proven to cause the other).

Other studies have shown that there is an association between osteoporosis and periodontal health, but at this point that is all we can say. Although more investigation is needed, how should people interpret the research thus far?

Clearly our mouths are not disconnected from our bodies. I believe that as more research plays out, the connection between the health of our gums and of our bodies will be even more apparent. For now, however, we can't go wrong by giving attention to our oral health. What are risk factors for periodontal disease?

The main cause of the disease is bacterial plaque, the sticky, colorless film that forms on your teeth, but factors like smoking, diabetes, poor nutrition, stress, certain medications and genetics can affect the health of your gums. Besides not smoking, what steps can people take to prevent periodontal disease?

Eat a good diet; this obviously doesn't apply solely to periodontal disease. Eat a well-balanced diet, brush daily and go to a general dentist regularly. How is periodontal disease treated?

The most basic treatment for periodontal disease includes the procedures called scaling and root planing - some people call it a deep cleaning. The procedure basically seeks to remove tartar, calcium deposits, plaque and bacteria from the teeth. Fortunately, most mild cases of chronic periodontitis can be managed with reasonable success.

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