Contributing Authors: Joseph Kelly, Sr., DMD, Joseph Kelly, Jr., DMD
In August of 1859, twenty-six men representing several existing dental organizations gathered at Niagara Falls, NY and formed what would become the American Dental Association (ADA). In 2009, 150 years later the ADA boasts 156,000 members who have become an integral part of the health care team in the United States. Today, it is well recognized that complete wellness includes good dental health!
While this column might normally discuss the role of diet and exercise for wellness and the prevention of cardiovascular disease, today it will demonstrate how dental health has a direct relationship to cardiovascular health. Your dentist may be one of the most important health care providers maintaining the health of your heart. If one has periodontal (gum and bone) disease, it may have a detrimental effect on his/her heart and blood vessels. It may be that your dentist can help to keep you healthier by detecting and treating this aspect of your health.
According to the American Heart Association, it is estimated that nearly 80 million Americans had one or more forms of cardiovascular disease in 2004. Cardiovascular disease involves a complex interplay of many risk factors. Controlling or treating periodontal disease may very well help in the treatment of this national health issue. Consequently, people with heart or blood vessel disease who also have periodontal disease may want to discuss coordinated medical-dental treatment with their cardiologist, physician and dentist.
Dentists can readily identify periodontal disease. Thorough examination includes x-ray analysis for bone loss and accumulation of calculus (hard deposits formed by bacteria under the gums), plaque (soft accumulations of bacteria on the teeth and gums), measurement of gum pocket depth around each tooth, evaluation of bleeding during the exam, and gum recession (loss of gum tissue).
Periodontitis is a chronic bacterial infection of the gums and bone that is often unseen. This can lead to tooth loss by weakening the jawbone support around any or all of the teeth in the mouth. More importantly, this constant bacterial assault is in contact with arteries and veins of the jaws which are ultimately in communication with all the blood vessels in the body. Thus the bacteria which are involved in this oral disease may be able to travel anywhere in the body, including to the heart. In addition, the negative immunological effects of this chronic infection may contribute to atherosclerosis (hardening of the arteries).
An article published in the December, 2007 issue of the Journal of Periodontology (JOP), the official publication of the American Academy of Periodontology, suggests that periodontal patients whose bodies show evidence of a reaction to the bacteria associated with gum disease, may have an increased risk of developing cardiovascular disease.
“Although there have been many studies associating gum disease with heart disease, what we have not known is exactly why this happens and under what circumstances,” said JOP editor Kenneth Kornman, DDS, PhD. “The findings of this new analysis of previously published studies suggest that the long-term effect of chronic periodontitis, such as extended bacterial exposure, may be what ultimately leads to cardiovascular disease.”
Research presented last year by Tonetti et al in the New England Journal of Medicine suggests that intensive treatment of periodontal disease may reverse atherosclerosis by improving elasticity of the arteries. This study is important because it furthers understanding of the potential relationship between periodontal disease and heart blood vessel disease. An additional article presented in 2007 in the JOP reported evidence of periodontal bacteria in the coronary arteries in nine out of fifteen patients who had been previously diagnosed with coronary artery disease.
The focus of treatment of periodontal disease lies in the removal of infection. The ultimate goal is to retain all of the teeth in a state of health for a lifetime. The method includes education of the patient as to the cause of the disease and the treatment needed, removal of the bacterial calculus and plaque in the dental office, and making every surface of each tooth accessible to diligent daily cleaning by the patient. Discussing the state of your periodontal health with your physician and dentist may lead to keeping your teeth and making your heart healthier. Complete wellness includes good dental health!
CONTRIBUTING AUTHORS: Joseph T. Kelly, Sr., D.M.D. practices dentistry in Clarks Summit with his son Joseph T. Kelly, Jr., D.M.D.