Infected Gums Can Harm the Heart

Periodontal treatment improves blood flow, study finds

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HealthDay Reporter

WEDNESDAY, Feb. 28, 2007 (HealthDay News) -- In a study that strengthens the link between chronic gum infection and cardiovascular problems, researchers said treatment of severe periodontal disease was associated with improved blood flow and more elasticity of arteries.

The study, conducted with patients at the Eastman Dental Hospital in London, England, included 120 people with severe periodontitis, a chronic bacterial infection that affects the gums and bone supporting the teeth.

Interestingly, the immediate result was an increase in inflammation among the patients who received intensive treatment for the gum condition. There was no such reaction among patients whose condition was treated less vigorously.

"However, six months after therapy, the benefits in oral health were associated with improvement in endothelial function," the researchers reported.

The endothelium is the delicate inner lining of the blood vessels. The improvement was shown by expansion of blood vessels that allowed better blood flow and by molecular markers of endothelial health, the researchers said.

For example, the researchers reported that the arteries of those getting intensive treatment were 2 percent wider six months later than those getting ordinary treatment, an improvement they described as "significant."

"The degree of improvement was associated with improvement in measures of periodontal disease," the study said.

The findings are published in the March 1 issue of the New England Journal of Medicine.

"This study adds a lot to a growing database that there is some sort of link" between periodontal disease and cardiovascular risk, said Dr. Preston D. Miller Jr., president of the American Academy of Periodontology.

The study "increases the link between local inflammation and inflammation of the coronary vessels that is extremely important," added Miller, clinical professor of dentistry at the University of Tennessee College of Dentistry.

The study findings call for more research to determine the effects of specific periodontal treatments on blood vessel function, he said.

But Dr. Daniel Meyer, associate executive director of the American Dental Association's division of science, said there's an important element missing in this and other studies of the effect of periodontal disease on cardiovascular problems.

"What it does not demonstrate is the relative importance of different risk factors. Implications of such things as diet, exercise and general health are not being factored into it," Meyer said. "What it is looking at is one aspect of a very complex disease."

It's too early to know how important a role periodontal disease may play in the risk of heart attack, stroke and other cardiovascular conditions, Meyer said. "There are too many individual factors involved to say that it contributes a certain percentage of risk," he said.

That lack of precision doesn't mean people should neglect their dental health, Meyer said. "We would certainly advise people to floss, but not at the expense of other things that improve their health," he said. "Someone who smokes, drinks and is obese should get their oral health taken care of, but should look at other health factors as well."

Dr. Moise Desvarieux, associate professor of epidemiology at the Columbia University Mailman School of Public Health, said, "This study adds significantly to the body of evidence linking periodontitis to vascular disease through a strong design and rigorous analysis.

"It convincingly demonstrates the potential for reversibility, since treating periodontal disease improved endothelial function," he said.

More information

Periodontal disease and what should be done about it are described by the American Academy of Periodontology.

SOURCES: Preston D. Miller Jr., DDS, clinical professor of dentistry, University of Tennessee, Memphis; Daniel Meyer, DDS, associate executive director, American Dental Association's division of science, Chicago; Moise Desvarieux, M.D., Ph.D., associate professor of epidemiology at the Columbia University Mailman School of Public Health; March 1, 2007, New England Journal of Medicine

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