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Gum Disease (Periodontal Disease) And Heart Disease

Amit Lala DDS, MS, PhD

Gum Disease (Periodontal Disease) and Heart Disease

Gum Disease (Periodontal disease)

Half of the adult population in the United States have some form of gum disease. However, the majority of these people do not even realize that they have it. Gum disease also known as Periodontal disease is a bacterial infection of the gums, bone and periodontal ligament (attachment fibers that support the teeth and hold them in the jaw). The disease is usually painless and silent, until it has progressed to advanced stages.

Causative factors of gum disease

The main cause of gum disease is dental plaque. Dental plaque is the sticky, colorless film that constantly forms on our teeth. Daily home oral care (proper brushing and flossing) is a must to prevent plaque build-up. If plaque is not removed, it can turn into a hard substance called calculus (tartar) over a period of time. Calculus is very hard and can only be removed during a professional cleaning by a hygienist or dentist. If it develops below the gums onto the tooth root, it makes plaque removal even more difficult which in turn increase the risk for gum disease.

Toxins (poisons) produced by bacteria in plaque irritate the gums and cause infection. In addition, these toxins destroy the supporting tissues around the teeth, including bone. When the bone is affected, gums separate from the teeth forming pockets that fill with even more plaque and more infection. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed.

Gum disease if left untreated may present the following symptoms:
•    Bad breadth
•    Gums bleed while brushing
•    Red, swollen and tender gums       
•    Gums pulled away from teeth
•    Loose or separating teeth
•    Pus between gum and tooth
•    A change in bite

Healthy Gums                   Plaque and calculus           Red swollen gums
Gum disease can be diagnosed and treated very effectively by the dentist. Advanced cases of gum disease may need the attention of a periodontist (A specialist with advanced training in the prevention, diagnosis and treatment of periodontal disease)
The link between gum disease and heart disease
Healthy hearts and healthy gums play vital roles in maintaining a healthy body. Because gum disease is a bacterial infection, periodontal bacteria can enter the blood stream and travel to a susceptible organ like heart and begin a focal point of infection. Heart disease affects more than 60 million Americans a year. It is important to emphasize that people of southeast asian origin are considered to display a higher prevalence of periodontitis as well as heart disease as compared to the people of other ethnic origins. Scientists and clinicians strongly believe that many form of heart diseases may be prevented simply by public awareness. Taking care of the gums may be one important step toward prevention, along with controlling the well known risk factors for heart disease.
Gum disease (periodontal disease) increases the risk for heart disease
Oral bacteria or pathogens which harbor the diseased gums can affect the heart when they enter the blood stream, attaching to the fatty plaques in the coronary arteries ( heart blood vessels) and contributing to clot formation. As we know, coronary artery disease is characterized by a thickening of the walls of the coronary arteries due to the build up of fatty proteins. Blood clots can obstruct normal blood flow, restricting the amount of nutrients and oxygen required for the heart to function properly, thereby leading to heart attacks.
Researchers have found that people with gum disease (periodontal disease) are almost twice as likely to suffer from coronary artery disease as those without periodontal disease.
Preventing gum disease

Daily oral care (proper and brushing) is a must to prevent plaque build up. The dentist will ensure whether oral home care technique is correct and effective.

Regular dental visits are also important. Daily cleaning will minimize calculus (tartar) formation but will not completely prevent it. A professional cleaning at least twice a year is necessary to remove calculus from places your toothbrush, floss and other cleaning aids may have missed.
Treatment of gum disease

The goal of treatment is to stop the progression of disease, return to good oral health and then to  maintain it.

Depending on how far the disease has progressed, treatment can vary widely. If detected in the early stages, simple procedures (scaling, root planing, polishing) are done to remove plaque and calculus from below the gumline and eliminate the infection-causing bacteria. The dentist or hygienist can instruct on how to brush and floss the teeth properly, and may introduce special brushing aids to clean hard to reach different areas in the mouth. A mouthrinse may also be recommended.

If the disease has advanced to the point where the periodontal (gum) pockets are deep and the supporting bone is lost, further treatment involving surgery may be necessary.
Periodontal disease and other systemic diseases
There seems to be a complex association between periodontal disease, heart disease and diabetes. Diabetes causes more rapid progression of periodontal disease. In addition, respiratory diseases, osteoporosis and premature and underweight births are linked to periodontal disease.

It is of utmost importance to provide to provide the dentist with a comprehensive and accurate medical history. The dentist and the physician can then work together to protect the gums and the overall health. We should always remember that without good oral health overall body cannot be healthy

(Amit Lala DDS, MS, PhD is a Lecturer in Department of Oral and Developmental Biology with Specialty in Orthodontics at the Harvard School of Dental Medicine. )

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