Is there a relationship between gum disease and cardiovascular disease? Many experts in cardiology and periodontology say, absolutely yes – therefore, the health of your gums is a predictor of heart disease. As a result, members of both professions are making changes to improve their patients’ overall health.
For many years, each medical or dental specialty has been separated. The physician tends to focus on the areas of the body while the dentist treats teeth. This was the old approach. Today, because of further research, collaboration and sharing of knowledge, health care providers are better armed to assist our patients.
Despite the importance of specialized care, the body is not divided into arbitrary specialties. The body is interconnected, interrelated and one area depends on the other for proper functioning.
“But these are my gums,” you may say. “How can they be related to my heart?” And the other question is, “But I brush and floss my teeth. Isn’t that enough?”
Periodontal disease destroys the bone supporting the teeth and is estimated to be present in approximately 50 percent of the adult population, with severe periodontitis seen in 15 to 20 percent of the population. It has been for many years that dentists have recommended brushing and flossing to remove bacterial plaque to control the onset of gum disease. This recommendation will always remain because bacterial plaque accumulation is required to initiate the gum disease process.
Today, we have knowledge of diseases, so we now recognize that gum disease is a chronic inflammation. In our last issue, we mentioned that periodontal disease is a “chronic disease”, therefore caused by a chronic inflammation.
A chronic disease means it cannot be prevented by vaccines or cured by medication, nor do they just disappear. They usually become progressively worse over time and tend to be painless until there is a major crisis. Common examples include diabetes, cancer, dementia, hypertension, stroke and periodontal disease.
Firstly, inflammation, in general, is the response of the body to bacterial and viral infections or other assaults on the body. Almost instantly, the body responds to such assaults with acute inflammation. The signs of acute inflammation are heat (fever), swelling, redness, pain and loss of function. Acute inflammation causes white blood cells to travel to the site of the assault to begin the healing process. Many cells will then surround and kill the offending bacteria, viruses or other agents. Also, they kill affected cells. The body then heals by producing new cells. This is the cycle of an acute inflammatory process. This is exactly how our body is supposed to function.
Chronic inflammation is a constant inflammatory response, which happens in the absence of an infection or trauma. Chronic inflammation occurs as a result of obesity, fast foods, smoking, drinking alcohol in excess, refined foods, allergens, toxins and other agents. In fact, it is chronic inflammation that is believed to be at the center of all chronic diseases.
So, what is the difference between acute and chronic infections? One important difference is that in chronic diseases, the causes and progress of the inflammations are usually controlled by the patient’s choices and behaviors.
Periodontal disease is caused by dental plaque. Once the plaque starts the disease process, the problem gets worse, causing a chronic inflammatory process in the body.
Here is where it gets interesting: the initial inflammation caused by gum disease triggers chronic inflammation in other parts of the body such as the heart. Remember, the body is deliberately interconnected.
Some examples of diseases associated with chronic inflammation are asthma, diabetes, colitis, kidney inflammation, some forms of cancer, allergies, cardiovascular disease and, of course, periodontitis.
Several articles in medical literature report an increased risk of heart disease in those patients who have periodontitis confirming it to be a predictor of heart disease. Also, the opposite relationship exists – heart disease is a risk factor for gum disease and early tooth loss. Periodontitis has also been shown to be a risk factor for strokes as well as other forms of cerebrovascular disease. Other risk factors shown to be common between cardiovascular disease and gum disease include diabetes, obesity, highs levels of lipids (fat), high cholesterol, triglycerides and hypertension.
Next issue: Are you at risk of getting periodontitis? Take the American Academy of Periodontology Questionnaire to know your risk factors.
• Dr. Kendal V. O. Major is founder and CEO of Center for Specialized Dentistry, a comprehensive family dental practice operating in New Providence and Grand Bahama. He is the first Bahamian specialist in gum diseases and dental implants since 1989. He is also a certified Fastbraces provider. His practice is located at 89 Collins Avenue; he can be reached at telephone (242) 325-5165 or firstname.lastname@example.org.