Periodontal Disease and Systemic Illnesses
Periodontal Disease and Cardiovascular Illnesses
Strong evidence exists to support a correlation between uncontrolled periodontal disease and an increased risk for acute coronary events (heart attack and stroke). While gum disease does not cause heart disease, the common etiology is the inflammation present with both processes. A documented marker and promotor of inflammation throughout the body is C-reactive protein (CRP). This protein is released from the liver in response to any source of inflammation in the body and may even contribute to its exacerbation. Increased risk for acute coronary events has been linked to elevated CRP levels and their decrease is associated with improved cardiovascular health. CRP levels can be determined through a simple blood test.
Uncontrolled periodontal disease has been shown to increase CRP levels with treatment resulting in a documented improvement (reduction in CRP). In addition, periodontal bacteria have been isolated in coronary arteries removed during coronary bypass surgery. Further reports have even shown a widening (improvement) of the lumen (open area through which blood flows) of the coronary arteries of patients with more advanced chronic periodontal diseases following periodontal surgery.
If you have been diagnosed or have a family history of any form of cardiovascular disease, preventative management and continuing care of this condition by a physician is critical. This often includes addressing factors that may be contributing to the presence or likelihood for heart disease. While diet, exercise, and smoking cessation are commonly recognized areas of focus, the diagnosis and management of periodontal disease plays an equally important role in re-establishing sound oral and general health.
Diabetes & Oral Health
Periodontal disease and diabetes have a bi-directional relationship. This means that individuals suffering from diabetes, particularly uncontrolled diabetics, have greater incidences and severities of periodontal disease. Conversely, periodontal disease can make diabetes worse and its treatment and control more difficult. Excess sugar in the blood stream of diabetics can stimulate the immune system to become overactive and produce excess chemicals and enzymes that destroy your own tissues.
Communication with the physician treating your diabetes may need to occur and any updated measurements of diabetic control, such as an HbA1C (physician administered blood measurement of long-term sugar levels), will be important information we will need to receive.
Women & Periodontal Health
Throughout a woman’s life, hormonal changes affect tissue throughout the body. Fluctuations in levels occur during puberty, pregnancy and menopause. At these times, the chance of periodontal disease may increase, requiring special care of your oral health. Strong evidence supports an increased risk for pre-term low birth weight babies in mothers with uncontrolled periodontal disease.
During puberty, there is increased production of sex hormones. These higher levels increase gum sensitivity and lead to greater irritations from plaque and food particles. The gums can become swollen, turn red, and feel tender.
Similar symptoms occasionally appear several days before menstruation. There can be bleeding of the gums, bright red swelling between the teeth and gum, or sores on the inside of the cheek. The symptoms clear up once the period has started. As the amount of sex hormones decrease, so do these problems.
Your gums and teeth are also affected during pregnancy. Between the second and eighth month, your gums may also swell, bleed, and become red or tender. Large lumps may appear as a reaction to local irritants. However, these growths are generally painless and not cancerous. They may require professional removal, but usually disappear after pregnancy.
Periodontal health should be part of your prenatal care. Any infections during pregnancy, including periodontal infections, can place a baby’s health at risk. Scientific studies have shown up to a 7 fold increased risk for pre-term low birth weight babies in mothers with uncontrolled periodontal disease.
The best way to prevent periodontal infections is to begin with healthy gums and continue to maintain your oral health with proper home care and careful periodontal monitoring.
Swelling, bleeding, and tenderness of the gums may also occur when you are taking oral contraceptives, which are synthetic hormones.
You must mention any prescriptions you are taking, including oral contraceptives, prior to medical or dental treatment. This will help eliminate the risk of drug interactions, such as antibiotics with oral contraceptives – where the effectiveness of the contraceptive can be lessened.
Changes in the look and feel of your mouth may occur if you are menopausal or post-menopausal. They include feeling pain and burning in your gum tissue and salty, peppery, or sour tastes.
Careful oral hygiene at home and professional cleaning may relieve these symptoms. There are also saliva substitutes to treat the effects of "dry mouth".