In recent years a great deal of attention has been placed on evaluating risk factors that make people susceptible to various systemic conditions. These conditions include but are not limited to diabetes, cardiovascular disease, respiratory disease and pregnancy outcomes. Risk factors that are continually being evaluated are smoking, high blood pressure, high cholesterol levels, stress, heredity, age, physical inactivity, obesity and inflammation. Inflammation being the latest risk factor.
At the forefront of dentistry today is an increasing knowledge of the role of chronic inflammation and the changes it can produce in both the oral cavity and throughout the body. This has led to an enhanced appreciation of the significant interactions and associations that occur between oral diseases such as periodontal infections and systemic diseases.
In general, inflammation is a localized protective response of the body to an injury or infection. If inflammation continues for a prolonged period of time, it may produce problems for localized tissue (in the mouth) as well as the entire body.
Periodontal disease (periodontitis), one of the most common diseases of humans, is an infectious condition that can result in the inflammatory destruction of the supporting tissues around the tooth (gum and bone).
Gingivitis is infectious inflammation limited to the gingiva (gums). Periodontal diseases are generally chronic in nature and can persist in the absence of treatment. Both of these diseases are caused by bacteria , and about a dozen specific strains have been identified among the 500 or more organisms that make up the dental plaque associated with the periodontal tissues (gum, teeth, bone). If this dental plaque (build up) or biofilm, is not removed from the gum line or below in a timely manner and allowed to increase, the tissues respond to this bacteria by the process of inflammation. Breakdown of the gums and bone surrounding the teeth occurs as a result of this process.
The negative impact of oral infection on one’s overall health generally stems from the entry of oral microorganisms or their products in the bloodstream. This is referred to as bacteremia. It can be provoked by chewing and oral hygiene procedures such as tooth picking, flossing and tooth brushing. The extent to which bacteremia of oral origin occurs appears to be directly related to the severity of gum inflammation. The problem arises when the bacteria via the circulatory system travel to other parts of the body, causing widespread inflammation. If for example you had an infection in your arm and you just left it, it eventually would affect the rest of the body. It is the same with infection in your mouth.
Through years of research it has been substantiated that gum disease may well represent a far more serious threat to the health of millions of Americans than previously realized. In light of the extensive microbial dental plaques associated with periodontal (gum) infections, the chronic nature of these gum diseases and the heightened local and systemic host response to the bacterial attack, it has now been established that these gum infections can influence overall health and the course of some systemic diseases.
The relationship of periodontal disease with the following systemic conditions have been studied including bacteremia, infective endocarditis, cardiovascular disease and atheroscleroisis, prosthetic device infection, diabetes mellitus, respiratory diseases and adverse pregnancy outcomes. New research is evaluating its role with Alzeimers disease and obesity. Further, it is also clear that a number of these systemic diseases and conditions are risk factors for periodontal disease. These include diabetes mellitius, osteopenia, HIV, stress, neutrophil disorder. Most important is that studies of these various conditions and their interrelationship to periodontal disease indicates the inflammatory response is the common element.
Periodontal disease is a “silent” infection, oftentimes a person is unaware they have it as there are often no symptoms of gum disease in its early stages. Simple warning signs include: Red, swollen or tender gums; bleeding while brushing or flossing; gums that pull away from the teeth; loose or separating teeth; pus between the gums and teeth; persistent bad breath; a change in the way teeth fit together and a change in the fit of partial dentures.
While these warning signs may signal a problem, a periodontal check-up is the only way to be sure of whether or not you have periodontal disease. Don’t wait until it hurts.
Once diagnosed the major rationale for the treatment of periodontal disease is to prevent progression of the disease and to preserve teeth. This is accomplished by the removal and tight control of bacterial dental plaque thereby eliminating inflammation.
Today, people are living longer, and gum disease has supplanted tooth decay as the most common cause of tooth loss in adults. Most adults in the US show some degree of periodontal disease with the effects of inflammation. According to the American Dental Association about 80% of Americans over age 65.
Because oral diseases in general are treatable and usually not life threatening, they have erroneously been perceived as having little relationship to other aspects of health. However, oral health and systemic health are closely related.
There is a strong correlation between deterioration of oral health and deterioration of general health. This is primarily due to the fact that several oral diseases and chronic systemic diseases have common risk factors such as Inflammation.
Although definitive cause and effect have not been established, research findings indicate that some association exists between different systemic conditions and oral health.
By realizing that oral health is a critically important component of general health we, as dental practitioners , are also ensuring that it has a significant positive impact on the quality of life.
The goal is to educate Americans about periodontal disease and its associated general health risks.
The first place to start? With a thorough examination and discussion with a periodontist.