For decades, researchers have been investigating the causes of heart attacks, high blood pressure, high cholesterol, strokes and other disorders of the circulatory system.
Risk factors such as smoking and diabetes are now well known, but they don't appear to tell the whole story.
| " 'We know a lot of risk factors for heart attacks, including high blood pressure, high cholesterol, diabetes and cigarette smoking, but all those combined only explain about two-thirds of heart attacks,' [Dr. Efthymios N.] Deliargyris said. 'Since about a third of people who suffer heart attacks don't have those risk factors, there's a wide search going on for other conditions that may contribute to increased risk.' Studies at the University of North Carolina at Chapel Hill and elsewhere have linked periodontal disease -- an advanced form of gingivitis -- with increased risk of heart attacks, but it has been unclear what the two conditions have in common, the physician said. 'The one thing we know the two conditions share is that they tend to initiate an immune response, also called an inflammatory response, in the body,' he said. 'The most common marker for this response is this C-reactive protein, which is considered predictive of future adverse events like heart attack.' " |
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"New research finds link between gum disease, acute heart attacks" by David Williamson, University of North Carolina at Chapel Hill |
After examining gum health more closely, doctors are becoming more and more convinced that the health of a patient's mouth is tied to the health of the patient's heart.
| "Researchers have found that people with periodontal disease are almost twice as likely to suffer from coronary artery disease as those without periodontal disease. Periodontal disease can also exacerbate existing heart conditions." |
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"Heart Disease and Stroke" The American Academy of Periodontology |
One theory is that bacteria growing in the mouth can enter the bloodstream, where the bacteria -- and the body's attempts to destroy it -- may damage artery walls. Inflamed or bleeding gums may provide easy entry to the circulatory system.
Suspecting that gum disease might be a killer is one thing -- but investigators are also finding evidence at the "scene of the crime." Researchers studying the clogged arteries of heart disease patients are finding bacteria normally found in a person's mouth.
| "Periodontal pathogens are present in atherosclerotic plaques where, like other infectious microorganisms such as C. pneumoniae, they may play a role in the development and progression of atherosclerosis leading to coronary vascular disease..." |
| "Identification of Periodontal Pathogens in Atheromatous Plaques" V.I. Haraszthy, J.J. Zambon, M. Trevisan, M. Zeid and R.J. Genco The Journal of Periodontology October 2000 |
Red, bleeding, receding gums caused by bacterial inflammation may be a sign -- and perhaps even a cause -- of inflammation elsewhere in the body. Treating the bacterial inflammation in the mouth could reduce the patient's risk of heart attack, stroke and other other serious problems in the circulatory system.
| "Periodontitis is a common, often undiagnosed, chronic infection of the supporting tissues of the teeth, epidemiologically associated with cardiovascular diseases. Since C-reactive protein (CRP) and other systemic markers of inflammation have been identified as risk factors for cardiovascular diseases, we investigated whether these factors were elevated in periodontitis... These elevated inflammatory factors may increase inflammatory activity in atherosclerotic lesions, potentially increasing the risk for cardiac or cerebrovascular events." |
| "Elevation of Systemic Markers Related to Cardiovascular Diseases in the Peripheral Blood of Periodontitis Patients" Bruno G. Loos, Jeroen Craandijk, Frans J. Hoek, Paulien M.E. Wertheim-van Dillen and Ubele van der Velden The Journal of Periodontology October 2000 |
Dental patients with a history of heart disease, stroke, high blood pressure, high cholesterol, diabetes or other circulatory problems may benefit from personalized care from a dental practitioner experienced with these conditions.
| "Cardiovascular diseases...afflict more Americans than any other category of serious disease. More than half the population over age 75 are affected... The increased incidence of periodontal diseases in older individuals indicates that the periodontist must be prepared to provide periodontal therapeutic support for increasing numbers of cardiovascular patients. Successful and safe patient management is predicated on obtaining a thorough medical history, conducting a physical examination to identify any physical signs and symptoms of cardiac dysfunction; evaluating vital signs when appropriate, including blood pressure, pulse rate, and respiratory function; and obtaining medical consultation when indicated." |
| "Periodontal Management of Patients with Cardiovascular Diseases" The American Academy of Periodontology |