Periodontal disease, heart disease and stroke may seem to be unlikely bedfellows, but researchers have found that gum disease sufferers are nearly twice as likely to also suffer from coronary heart disease. In addition, research studies have discovered that oral infection is indeed a risk factor for stroke. People diagnosed with acute cerebrovascular ischemia were more likely to also be experiencing some degree of periodontal disease.
Periodontal disease is a progressive condition in which the gingival tissue surrounding the teeth is infected by the colonization of bacteria. Bacteria found in plaque colonize first above, then below the g gumline causing the tissue to pull away from the teeth. If periodontal disease is left untreated, deep pockets form between the gums and the teeth and the tissue of the underlying jawbone is also destroyed. The destruction of bone tissue causes the teeth to shift, wobble or completely detach from the bone.
Coronary heart disease occurs when the walls of the coronary arteries become progressively thicker due to the buildup of fatty proteins. The heart then suffers from a lack of oxygen and must labor significantly harder to pump blood to the rest of the body. Coronary heart disease sufferers sometimes experience blood clots which obstruct normal blood flow and reduce the amount of vital nutrients and oxygen the heart needs to function properly. This phenomenon often leads to heart attacks.
Reasons for the Connection
There is little doubt that the presence of periodontal disease can exacerbate existing heart conditions. The periodontist and cardiologist generally work as a team in order to treat individuals experiencing both conditions.
There are several theories which may explain the link between heart disease, stroke and periodontal disease, which include the following:
- Oral bacteria affect the heart – There are many different strains of periodontal bacteria. Researchers assert that some of these strains of bacteria enter the bloodstream and attach to the fatty plaques in the heart blood vessels (coronary arteries). This attachment then contributes to clot formation causing grave danger to the individual.
- Inflammation – Periodontal disease causes severe inflammation in the gum tissue which elevates the white blood cell count and also the high sensitivity C-reactive protein levels. Research studies have shown that elevated levels of C-reactive proteins have been linked to heart disease.
Infectious susceptibility – Individuals who experience particularly high levels of oral bacteria may have weaker immune systems and an inadequate host inflammatory response. These factors may induce specific vascular effects which have previously been shown to contribute in the onset of certain forms of heart disease.
Researchers have shown that periodontal disease in expectant mothers actually exposes their unborn child to many different risks; particularly if they also happen to be diabetes sufferers.
Periodontal disease generally begins with a bacterial infection in the gum (gingival) tissue, which progressively destroys the tissue and the underlying bone. If left untreated, the bacterial infection causes an inflammatory reaction in the body, which can significantly deepen the gum pockets (space between the teeth and gums) and forces the gum and jawbone to recede. Eventually, the progressive nature of periodontal disease causes the teeth to become loose and unstable, and eventually fall out.
Pregnancy causes many hormonal changes which increase the risk of the expectant mother to develop gingivitis (inflammation of the gum tissue) and periodontal disease. These oral problems have been linked in many research studies to preeclampsia, low birth weight of the baby and premature birth. Expectant women should seek immediate treatment for periodontal disease in order to reduce the risk of pre-natal and post-natal complications.
Reasons for the Connection
There are many different reasons why periodontal disease may affect the health of the mother and her unborn child:
- Prostaglandin – Periodontal disease appears to elevate levels of prostaglandin in mothers who are suffering from the more advanced forms of the condition. Prostaglandin is a labor-inducing compound found in one of the oral bacteria strains associated with periodontitis. Elevated levels of prostaglandin can cause the mother to give birth prematurely and deliver a baby with a low birth weight.
- C - reactive protein (CRP) – This protein, which has been previously linked to heart disease, has now been associated with adverse pregnancy outcomes including preeclampsia and premature birth. Periodontal infections elevate C-reactive protein levels and amplify the body’s natural inflammatory response. Periodontal bacteria may enter the bloodstream causing the liver to produce CRP which leads to inflamed arteries as well as possible blood clots. These inflammatory effects can then lead to blocked arteries causing strokes or heart attacks.
- Bacteria spread – The bacteria which colonize in the gum pockets can readily travel through the bloodstream and affect other parts of the body. In pregnant women, research has found that oral bacteria and associated pathogens have colonized in the internal mammary glands and coronary arteries.
Diagnosis and Treatment
There are many safe, non surgical treatment options available for pregnant women. It is of paramount importance to halt the progress of periodontal disease in order to increase the chances of a safe and healthy delivery.
Initially, the dentist will assess the exact condition of the gums and jawbone in order to make a precise diagnosis. Scaling and root planing are two common non-surgical procedures used to rid the tooth-root surfaces of calculus (tartar) and remove the bacterial toxins from the gum pockets.
The advantages to the pregnant woman are plentiful. The risks of pregnancy complications caused by periodontal disease are reduced by as much as 50%, and these treatments will alleviate many unpleasant and harmful effects associated with gingivitis and periodontal infection.
Dentists can provide dental education and recommendations to the pregnant women on effective home care which can reduce risks that may affect her and/or her child’s health. Risks of periodontal disease can be vastly reduced by proper home care, smoking cessation, dietary changes and the ingestion of supplementary vitamins.
If you have any questions or concerns about periodontal disease and its affect on pregnancy, please ask your dentist.
Diagnosis and Treatment
Since periodontal disease appears to be a risk factor for both heart attack and stroke, it is extremely important to seek immediate treatment. Initially, the periodontist will conduct thorough examinations to assess the exact condition of the teeth, gums and jawbone. X-rays can be helpful in determining whether bone loss is prevalent in the upper and lower jaw.
The dentist is able to conduct deep cleaning treatments such as scaling and root planing to remove hardened calculus (tartar) deposits from the gum pockets. An antibiotic may be prescribed to ensure that the bacterium is completely destroyed and the periodontal infection does not spread. In most cases, periodontal disease can be prevented with regular cleanings and proper home care.
If you have questions or concerns about periodontal disease and its relation to heart disease and stroke, please ask your dentist.