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DENTAL DANGERS: Effects of severe gum disease can be far reaching
produced by Tammy Glenn and Alana Pollack
reported by Lucky Severson
story by Shawn O’Leary
video edited by Sarah Morris-Lom
Severe gum disease has now repeatedly been seen in research as causing
increased risk for disease in other areas of the body
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Helen Oswalt is cooperating with her dentist as best she can in an attempt to slow down her gum disease and the effects of her diabetes. The news that she was suffering a serious case of periodontitis, a form of gum disease, was an unexpected revelation.
“I didn’t realize that you could have periodontal disease without having swollen gums or infection,” says Oswalt. “So I didn’t think I had it. I was very surprised.”
Factors like disease, medications, and diet can contribute to the risk of gum disease, which affect more than half of adults over age 55, according to American Academy of Periodontology statistics.
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| Helen Oswalt, here following an exercise tape, was surprised by her gum disease diagnosis |
BACTERIA IN BLOODSTREAM
A growing number of studies suggest bacteria living under the gums can break into the bloodstream, making bad health situations worse--situations like diabetes.
Disease in the body and gum disease appear to contribute mutually, one to the other, in causing a slow downward spiral toward more serious conditions that can include stroke.
“Gum disease is an infection of the body,” says periodontist Gary Sigafoos, DDS of the Scripps Center for Dental Care in La Jolla, California. “When gum disease is occurring chronically, that has a tendency to throw the control of the diabetes off.”
Dr. Sigafoos says that advanced bone loss in the mouth can mean that oral bacteria can become dominant and can cause chronic ulcerations below the gumline, pockets which can’t be seen.
Periodontitis, the most severe form of gum disease, is linked in studies to heart disease and stroke.
University at Buffalo researchers, in a study of periodontal and cerebrovascular disease, found those with acute periodontitis double their risk of stroke, or brain attack.
Bacteria riding in the bloodstream from the gums promotes fatty plaque build-up, causing blood clots and blocked vessels that lead to stroke.
“If, unluckily, one of these larger clots gets caught in one of the narrowed openings, it will wind up with a chance of heart attack or stroke,” explains Sigafoos.
For diabetics who don’t have good control over their insulin levels, there tends to be a higher, chronic concentration of sugar in the blood. “They much more prone for infections, for losing their teeth,” says Sigafoos, who urges dentists to educate themselves and their patients on the dangers diabetics face.
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| Periodontist Gary Sigafoos, DDS calls gum disease “an infection of the body” because gumline bacteria moves into the bloodstream to potentially do further harm |
HEADS FOR THE LUNGS
Now oncologists are learning that gum disease can contribute to the risk of lung disease.
“When the patient breathes or breathes deeply, they have a tendency to bring that oral bacteria, those pathogens, into the lung,” reports Sigafoos, who regularly treats patients with gum disease at his private practice.
A nationwide study in the US of the lungs and mouths of almost 14,000 people found that those with the worst gum disease had a higher risk of developing deadly lung diseases like emphysema and bronchitis.
Those with lowered immune systems, chronic obstructive pulmonary disease, and other lung condition can “overreact” to infection, states Sigafoos: “There will be more of a tendency to have further damage that can be not just temporary damage, but permanent.”
Bleeding gums, often a sign of the mildest form of gum disease, gingivitis, could indicate more serious problems ahead, says the periodontist. “When they’re flossing and brushing, they see bleeding occurring on a somewhat regular basis--that’s just what’s showing on the surface.”
Halitosis, or bad breath, is another possible indicator. Gum disease sufferers like Helen Oswalt, says Dr. Sigafoos, “can brush, floss, rinse, have fresh breath for about an hour or two, and then the ‘morning breath’ comes back again.”
Loose teeth, swollen gums with bluish or reddish hues, and special fittings that no longer fit properly, are other signs of possible gum problems, Dr. Sigafoos reports. “Most people don’t know they have problems,” he says.
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| Future studies will continue to emphasize the cause-effect relationship of periodontitis and disease in the rest of the body |
FORTIFYING AGAINST DISEASE
Evidence from early research suggests gum disease may also play a part in Helen Oswalt’s osteoporosis.
“I’m very grateful that I found out,” says Oswalt of her gum disease diagnosis.
Oswalt builds her bones with exercise and hopes an extra dose of dental care will help keep her healthy all around. “I’d much rather work hard at eliminating the problem than work hard at trying to live with it,” she says. “If I find out what’s wrong, and I can treat it, I will do that. I want to have a good quality of life.”
This story originally aired on: Friday, April 20, 2001
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Periodontal disease activity may contribute to COPD
Last Updated: 2001-02-02 11:15:53 EST (Reuters Health)
WESTPORT, CT (Reuters Health) - Poor oral health may contribute to the deleterious effects of factors known to exacerbate chronic obstructive pulmonary disease (COPD), according to analysis of data from the National Health and Nutrition Examination Survey III (NHANES III).
Dr. Frank A. Scannapieco and Dr. Alex W. Ho, of the State University of New York at Buffalo, analyzed data on 13,792 individuals who underwent a dental examination and measures of lung function. A history of chronic bronchitis or emphysema was reported by 810 subjects. The investigators report their findings in the January issue of the Journal of Periodontology.
Mean periodontal attachment loss was 1.17 mm in subjects without COPD and 1.48 mm in those with COPD. This difference was statistically significant, the investigators determined.
The odds ratio for COPD was 1.35 for subjects with attachment loss of at least 2.0 mm compared with those whose attachment loss was less, after adjustment for such factors as gender, age, race, diabetes status, and smoking. The odds ratio increased to 1.45 for those who had 3.0 mm or more attachment loss.
The investigators also observed a trend of diminishing lung function as the amount of attachment loss increased.
Drs. Scannapieco and Ho suggest that oral bacteria that adhere to mucosal surfaces may stimulate cytokine production. This in turn may recruit inflammatory cells that damage the epithelium and increase its susceptibility to infection by respiratory pathogens.
J Periodontol 2001;72:50-56.
-Westport Newsroom 203 319 2700