By R.J. Ignelzi
UNION-TRIBUNE STAFF WRITER
June 12, 2007
By R.J. Ignelzi
UNION-TRIBUNE STAFF WRITER
June 12, 2007
 DAN TREVAN / Union-Tribune As part of a healthy gum routine, dental hygienist Terrie Vorono cleans patient Bob Coy's teeth. |
Once again, Mom
was right. For years she hounded you to brush and floss regularly to help keep your teeth and gums healthy. Little did she or anyone else know then that following her oral hygiene advice may also protect you from serious illness and disease. There's growing evidence that gum or periodontal disease may put you at increased risk for heart attacks, stroke, diabetes and some cancers. |
In March, a study published in the New England Journal of Medicine found that
treating severe gum disease can improve the function of blood vessel walls,
improving heart health.
The April issue of the Journal of Periodontology published studies that found
periodontal bacteria in the arteries of people with heart disease and in the
placentas of pregnant women with high blood pressure. Another study in that
journal found that gum disease may predispose some people to developing early
signs of diabetes.
And earlier this year, a Harvard School of Public Health study of more than
50,000 men showed that those who had gum disease had double the risk of getting
pancreatic cancer than those without gum disease.
“Although the cause and effect of periodontal disease linked to other
diseases is not absolutely proven, the data is starting to pile up,” says
Dr. David Richards, a Hillcrest periodontist who emphasized that it's more important
than ever to “take aggressive action against periodontal disease.”
An estimated 80 percent of American adults have some form of periodontal disease,
according to the National Institute of Dental and Craniofacial Research at the
National Institutes of Health.
The main cause of gum disease is bacteria, which is found in plaque, a sticky,
colorless film that constantly forms on the teeth and tongue. Daily brushing,
flossing, tongue scraping and other forms of interdental cleaning usually remove
plaque to keep the gums healthy.
But it doesn't take long for sloppy brushing and haphazard flossing to lead
to gingivitis, the early stage of periodontal disease. Characterized by swollen
and bleeding gums, it's reversible with professional treatment and diligent
home oral care.
Left untreated, however, gingivitis can develop into periodontitis, advanced
gum disease. As tartar and plaque continue to build up, pockets form between
the teeth and gums and the gums may begin to recede. As the pockets become deeper,
the disease destroys more gum tissue and progresses to the bone, which can eventually
cause teeth to become loose or fall out.
The dentist, periodontist or dental hygienist can remove plaque through deep
cleanings called scaling and root planing. If inflammation and deep pockets
remain after cleaning and medication, it may be necessary to do flap surgery,
which involves lifting back the gums and removing the tartar. Your periodontist
may also suggest bone and tissue grafts to help replace or encourage new growth
of bone or gum tissue destroyed by the disease.
About three of every 10 adults over age 65 have lost all of their teeth because
of cavities and gum disease, according to the U.S. Centers for Disease Control
and Prevention.
“A lot of people go untreated for periodontal disease because most of
the time it doesn't hurt. By the time they feel or notice anything, it's too
late. The bacteria has already eaten away at the bone and tissue,” says
Dr. Irvin Silverstein, a La Mesa periodontist. “If periodontal disease
hurt as much as an infected finger, they'd get themselves treated early.”
A number of studies indicate that the unchecked inflammation and bacteria in
the mouth may be at the root of many problems throughout the body. The bacteria
in plaque produce toxins that trigger an immune response and the release of
chemicals called cytokines to wall off and kill the bacteria. The problem is,
when too many cytokines are released, inflammation increases, damaging tissues
in all areas of the body and causing increased blood pressure levels, high cholesterol
levels and increased blood clotting, which can lead to potentially fatal heart
attacks and strokes.
“Inflammation is a very important phenomenon in the spectrum of all kinds
of diseases,” Richards says. “The inflammatory messengers sent out
by diseased gums are taken by the bloodstream to distant sites in the body and
can affect overall health.”
Some researchers also believe that when periodontal bacteria travel from the
mouth through the bloodstream, they may lodge in the blood vessel walls, triggering
inflammation and causing the walls to thicken. A thickened blood vessel wall
can increase a person's risk of heart disease and heart attack.
To save your teeth and your general health, stopping periodontal disease before
it starts is critical, periodontists say, because you're never cured.
“Just like with diabetes, you will always be stuck with periodontal disease
once you have it. But, you can manage it,” Richards says. “You will
have to be more vigilant (about oral hygiene) than the next person who doesn't
have any deep pockets. And you may need to get your teeth cleaned four times
a year and use special mouth rinses. But, if you work at it, you can control
it.”
Staff librarian Beth Wood contributed to this article.