And now, far fetched as it may sound, gum disease may be linked to failed orthopedic implants. Yes, you read right – the implants used to rebuild your granny’s hip.
While you may be thinking: “Who on God’s green Earth decided to examine whether or not a person’s infected artificial knee was caused by their teeth?” – and you’d have a point – there’s actually a serious case to be made.
According to a study conducted by scientists at the University of Arkansas and the University of Missouri-Kansas City in 2007, bacteria that enter the bloodstream via the bleeding gums caused by periodontal disease can cause infections in artificial joints. These infections, as the study states “can be potentially devastating.”
Most people assume that dental research is confined to teeth and oral tissues, but a recent article in Nature proves this is far from the case. According to the article, research into oral conditions can be an indication as to overall health, especially as many of the molecules found in the blood are also found in saliva, although at much lower levels.
Saliva testing could be a much less invasive way of discovering a patient’s risk for disease, and the tests could be carried out in the dental or doctor’s office. Patients could even collect their own saliva specimens at home, and this type of sampling would be far more pleasant for older people and young children. It could prove to be very cost effective as well.
Possible links between gum disease and other serious health conditions such as heart disease and diabetes have already been well documented, and have raised the question as to whether improvements in oral health could help prevent or manage these conditions. DNA from oral bacteria has already been found in plaque which builds up in blood vessels and the synovial fluid of joints, leading to questions as to whether bacteria could cause heart attacks or prosthetic joint failure.
If you let dental plaque and calculus buildup on your teeth, then you may not only be increasing your risk of developing periodontal disease, but also your risk of developing cancer. A new study published in the online British Medical Journal, Open, has linked dental plaque with a risk of premature death due to cancer. The longitudinal study looked at the connection between dental plaque and cancer mortality in Sweden.
The study followed 1,400 randomly selected adults from Stockholm over a period of 24 years, from 1985 to 2009. At the beginning of the monitoring period the adults were in their 30s and 40s, and were interviewed to assess their risk of developing cancer. Factors taken into account included whether or not they were smokers, and levels of affluence. In addition, their oral hygiene was assessed to discover current levels of gum disease and tooth loss, as well as levels of dental plaque and calculus.
An in-depth review of over 50 women’s health journal articles has shown there is a link between female hormone production and gum disease. The review was led by Charlene Krejci, associate clinical professsor at Case Western Reserve University School of Dental Medicine. It is called “Women’s Health: Periodontitis and its Relation to Hormonal Changes, Adverse Pregnancy Outcomes and Osteoporosis” and has been published in the journal Oral Health and Preventative Dentistry. It shows that the level of female hormones, which can fluctuate considerably over the course of a lifetime, can be responsible for changing conditions in the oral cavity which can lead to gum disease.
Krejci reviewed 61 journal articles as well as nearly 100 studies, all of which dealt with the question as to whether there was a link between gum disease and an increased level of female hormones, as well as other major health concerns such as preterm births and osteporosis. “There’s definitely a gender-specific connection between women’s hormones, gum disease, and specific health issues impacting women” said Dr. Krejci. In addition she noted that although women tend to pay much more care to their oral hygiene routine, they need to be more attentive than men in order to avoid health issues that are unique to women.
If ever a man needed more incentive to take care of his oral health then this has to be it. A new study has shown there may be a link between men suffering from severe periodontal disease and erectile dysfunction.
The population based study looked at 33,000 men suffering from erectile dysfunction, and a comparison group of 162,000 men who didn’t have this condition. They tracked both groups for five years to try to ascertain if there was a link between erectile dysfunction and periodontal disease. Even though the study took into account lifestyle factors such as pre-existing medical conditions and income, it still found erectile dysfunction was linked to gum disease, particularly in men aged over 70 or younger than 30 . In spite of these findings, the study doesn’t show that periodontal disease causes erectile dysfunction, only that the two may somehow be associated in some way.
There is already speculation as to what this link, if any exists, might be. One idea put forward by Dr Aaron Katz, chairman of the Department of Urology at Winthrop University Hospital in New York, is that erectile dysfunction may be due to inflammation in the body, and that this could have caused damage to the blood vessels in the penis. This idea does make sense as periodontitis is known to cause inflammation.
From my observations, many people tend to be passive participants, leaving their oral health in the hands of their dental practitioners. Most people go to their dental clinic expecting that the dentist alone can prevent the onslaught of gum disease, abdicating their home care diligence in favour of bi-annual dental checkups. One dentist I know likes to use this phrase to coax patients into improving their oral hygiene practice at home: “Only brush & floss the teeth you want to keep!” While this phrase is always guaranteed to get a smile out of the patients, unfortunately, it makes light of a very serious issue. Tooth loss, after all, is not the most significant potential outcome of gum disease. In fact, gum disease has long been linked and associated with serious conditions like heart disease, stroke, cancer, arthritis, diabetes, pre-term births and others.
Given the list of unpleasant symptoms of gum disease that are both socially undesirable and physically painful:
1) Red, swollen, and puffy gums
2) Horribly bad breath
3) Bleeding gum tissue
4) Tooth and bone loss
The findings of two new studies were recently presented at the American Heart Association’s Scientific Sessions in Orlando, Florida and reinforce the links between periodontal disease and the risk for cardiovascular disease and strokes.
Researchers have found that patients who had their teeth professionally cleaned and scaled at regular intervals were at a reduced risk of heart attacks and strokes. The research was based on a nationwide study which took place over a seven-year period. Dr Emily Chen and Dr Hsin-Bang Leu examined data on 51,000 adults who had their teeth professionally cleaned on at least one occasion against a similar sized group who had never had their teeth professionally cleaned. Neither group had a history of heart attacks or strokes. The study showed those participants whose teeth were professionally cleaned at regular intervals had a 24% lower risk of heart attack and a 13% lower risk of stroke compared to those people who did not have their teeth professionally cleaned.
The results of a study were recently published in Medscape showing individuals with diabetes who received proper gum disease treatment could reduce their medical bills by an average of $2,500 a year . Although the data came from a sample of insured people suffering from both diabetes and periodontal disease and was not a randomized controlled trial, it does emphasize the association between systemic and oral health.
The study looked at data for diabetics with medical insurance, and divided them into two separate groups. The first group received treatment for their periodontal disease and then went on to receive routine dental maintenance treatments, while the second group initially received treatment for their periodontal disease but did not go on to complete the treatment or receive dental maintenance treatments.
It was found that the group of patients who were treated for gum disease on a routine basis had lower medical bills two years later compared to the group who did not receive routine treatments. The findings seem to indicate that periodontal treatment can have a lasting effect on patients with diabetes. Interestingly, the results showed men who continued with their periodontal treatment saved an average of $3,212.36 in medical costs while women who continued with their treatment saved an average of $735.27.
There is substantial evidence to support the link between gum disease and serious health conditions, such as heart attack, stroke and rheumatoid arthritis. Now, the mainstream media is taking on this issue too. In the below interview, Dr. Oz discusses how brushing your teeth daily may help prevent you from developing a heart attack.
Dr. Oz’s interview only reiterates what research has long suggested – your oral health is important to your overall health. Studies conducted in Great Britain, Canada, United States, Germany and Sweden have found people suffering from periodontitis have between a 25% and 100% increased risk of suffering from heart attacks. Other clinical studies suggest a link between periodontitis and the development of strokes. In this video, Dr. Oz discusses how bacteria from the mouth can enter the bloodstream, triggering the clumping of platelets that form blood clots, and increasing your risk of thrombosis. These blood clots can either block blood vessels supplying the heart, creating the right conditions for a heart attack, or they can block the arteries supplying blood to the brain, increasing the risk of a stroke. Periodontal disease has also been linked to other serious conditions, such as rheumatoid arthritis. Treatment for this disease has been found to not only improve oral health but to also have a beneficial effect on rheumatoid arthritis.
SRP is not always 100% effective. Calculus and bacteria can be left behind.
Dental scaling and root planing, known as SRP, is often used when a straightforward cleaning isn’t enough, and is sometimes called deep cleaning. This nonsurgical procedure aims to remove the plaque and calculus or tartar which has built up around and just under the gum line by scaling or scraping the teeth. The process can help leave nice smooth surfaces enabling the gum tissue to attach more firmly to the surface of the tooth, and is one of the most common therapies used to treat gum disease1.
While SRP is often regarded as being the gold standard in the treatment of gum disease, it isn’t always 100% effective. Part of the problem is due to the fact that the clinician cannot generally see the calculus below the gum line, and must rely on their sense of touch to scrape away the calculus. This lack of visual feedback heightens the chance some small areas of calculus being inadequately removed. When gum disease is left improperly treated, the patient can experience tissue inflammation, gum recession, and even bone loss. Not only can this put the patient’s overall health at risk, but it can also allow the gum disease to worsen to a point where it requires additional treatments. Read more »