HEALTHY MOUTH / Healthy Body
In July of 1998, the American Academy of Periodontology launched an effort to educate the public about new findings which support what dental professionals had long suspected: Infections in the mouth can play havoc elsewhere in the body.

Since July of 1998, evidence has continued to mount to support these links. While more research needs to be done to say definitively that people with periodontal disease are at higher risk for developing heart disease, stroke, uncontrolled diabetes, preterm births and respiratory disease, periodontists do know that periodontal disease is a bacterial infection, and all infections are cause for concern.

Periodontal bacteria can enter the blood stream and travel to major organs and begin new infections. Research is suggesting that this may contribute to the development of the following conditions :

Heart Disease Several theories exist to explain the link between periodontal disease and heart disease. One theory is that oral bacteria can affect the heart when they enter the blood stream, attaching to fatty plaques in the coronary arteries (heart blood vessels) and contributing to clot formation. Coronary artery disease is characterized by a thickening of the walls of the coronary arteries due to the buildup of fatty proteins. Blood clots can obstruct normal blood flow, restricting the amount of nutrients and oxygen required for the heart to function properly. This may lead to heart attacks.

Another possibility is that the inflammation caused by periodontal disease increases plaque build up, which may contribute to swelling of the arteries.

Researchers have found that people with periodontal disease are almost twice as likely to suffer from coronary artery disease as those without periodontal disease.

Periodontal disease can also exacerbate existing heart conditions. Patients at risk for infective endocarditis may require antibiotics prior to dental procedures. Your periodontist and cardiologist will be able to determine if your heart condition requires use of antibiotics prior to dental procedures.

Stroke Additional studies have pointed to a relationship between periodontal disease and stroke. In one study that looked at the causal relationship of oral infection as a risk factor for stroke, people diagnosed with acute cerebrovascular ischemia were found more likely to have an oral infection when compared to those in the control group.

Preterm Low Birth Weight Births
For a long time we've known that risk factors such as smoking, alcohol use, and drug use contribute to mothers having babies that are born prematurely at a low birth weight.

Now evidence is mounting that suggests a new risk factor - periodontal disease. Pregnant women who have periodontal disease may be seven times more likely to have a baby that is born too early and too small.

More research is needed to confirm how periodontal disease may affect pregnancy outcomes. It appears that periodontal disease triggers increased levels of biological fluids that induce labor. Furthermore, data suggests that women whose periodontal condition worsens during pregnancy have an even higher risk of having a premature baby.

All infections are cause for concern among pregnant women because they pose a risk to the health of the baby. The Academy recommends that women considering pregnancy have a periodontal evaluation.

Diabetes
People with diabetes are more likely to have periodontal disease than people without diabetes, probably because diabetics are more susceptible to contracting infections. In fact, periodontal disease is often considered the sixth complication of diabetes.

Those people who don't have their diabetes under control are especially at risk. A study in the November issue of the Journal of Periodontology found that poorly controlled type 2 diabetic patients are more likely to develop periodontal disease than well-controlled diabetics are.

Research has emerged that suggests that the relationship between periodontal disease and diabetes goes both ways - periodontal disease may make it more difficult for people who have diabetes to control their blood sugar.

Severe periodontal disease can increase blood sugar, contributing to increased periods of time when the body functions with a high blood sugar. This puts diabetics at increased risk for diabetic complications. Thus, diabetics who have periodontal disease should be treated to eliminate the periodontal infection.

This recommendation is supported by a study reported in the Journal of Periodontology in 1997 involving 113 Pima Indians with both diabetes and periodontal disease. The study found that when their periodontal infections were treated, the management of their diabetes markedly improved.

Respiratory Diseases Bacterial respiratory infections are thought to be acquired through aspiration (inhaling) of fine droplets from the mouth and throat into the lungs. These droplets contain germs that can breed and multiply within the lungs to cause damage. Recent research suggests that bacteria found in the throat, as well as bacteria found in the mouth, can be drawn into the lower respiratory tract. This can cause infections or worsen existing lung conditions. People with respiratory diseases, such as chronic obstructive pulmonary disease, typically suffer from reduced protective systems, making it difficult to eliminate bacteria from the lungs.