Poor Gums Take Big Bite Out of Health

Periodontal disease ups risks for diabetes, heart disease and preemie delivery, experts warn

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By Janice Billingsley
HealthDay Reporter

FRIDAY, Feb. 24, 2006 (HealthDay News) -- Problem gums are nothing to smile about.

In fact, experts gathered at a periodontal disease conference Thursday said chronic gum infection can pose risks for diabetes, heart disease, and even premature delivery.

"There is increasing evidence that disease in the mouth has implications elsewhere in the body," said Samantha Cramoy, a member of the Board of Trustees of the American Medical Association, and a pediatric resident at Children's Hospital in Boston, Mass.

Cramoy was the first speaker at the New York City conference, sponsored by the American Dental Association and the American Medical Association and underwritten by the Colgate Palmolive Company.

Cramoy and other doctors reporting on recent research emphasized that scientists haven't yet found definitive proof that gum disease ups risks for more serious illness. But the evidence is mounting.

"The evidence is increasingly strong and deserves the attention of both the medical and dental professions," added Robert Genco, a distinguished professor of oral biology at the School of Dental Medicine at SUNY Buffalo. Genco has researched the origins of oral disease for more than 30 years.

What's unfortuunate is that periodontal disease is treatable and "represents a modifiable risk factor to moderate or reduce other illnesses," Genco said. "Also, periodontal disease is so common that even if it accounts for a small portion of conditions, the public health consequences would be great."

Genco noted that about 80 percent of Americans have some form of periodontal disease, a bacterial infection of the gums surrounding the teeth. Gingivitis is the most common and mildest form of periodontal disease, causing an inflammation of the tissues around the teeth. More serious is periodontitis, when the inflammation affects connective tissue supporting the teeth and underlying bone. Approximately 10 percent of the general population suffers from well-established periodontal disease, Genco said, with people over 65 having a 30 percent prevalence of the disease.

Chronic gum disease may affect other health conditions for several reasons, the experts said. Oral bacteria can make their way into the bloodstream, causing inflammation of other body tissues. Oral infections may also trigger inflammatory immune responses, adversely affecting the rest of the body.

Researchers are also beginning to study how periodontal disease interacts with other illnesses, noted conference moderator Michael Glick, editor of the Journal of the American Dental Association and chairman of the department of diagnostic sciences at the University of Medicine and Dentistry of New Jersey.

"Does periodontal disease initiate other illnesses, or exacerbate them?" he asked. And, if it does impact on other illnesses, he added, "does [gum disease] treatment improve systemic health?"

Among the most provocative research at the conference was the finding that poor oral health was associated with premature delivery.

A team led by Dr. Steven Offenbacher, distinguished professor of periodontics at the University of North Carolina School of Dentistry in Chapel Hill, monitored the dental health of more than a thousand pregnant women. Each of the women received dental examinations early in their pregnancies and then once again after giving birth.

Fourteen percent of the women were found to have moderate to serious periodontal disease. According to Offenbacher, this group was twice as likely to deliver early (before 37 weeks of gestation) compared to women with healthy gums. This difference held even when the researchers controlled for factors such as maternal age, prior preterm birth and socioeconomic differences.

Women whose gum disease worsened over the course of their pregnancy were almost 2.5 times more likely to deliver very early -- before 32 weeks of gestation. Babies born this early are at high risk of serious disability and even death, Offenbacher noted.

Two large, multi-centered trials are now underway to examine whether treating a mom-to-be's gums during pregnancy can reduce the risk for premature births, Offenbach said. In the meantime, these preliminary findings should encourage women to practice good dental hygiene during pregnancy, he said.

"Good dental care doesn't appear to be a threat [to a woman's pregnancy] and is an effective way to improve the mother's health," he added.

Research suggests poor gum health raises risks for other problems, too.

Diabetics may need take special care of their smile, noted Dr. Louis Rose, professor of surgery at Drexel University School of Medicine and clinical professor of periodontics at the University of Pennsylvania School of Dental Medicine. That's because untreated periodontal disease seems to exacerbate diabetes and vice-versa. It may even speed periodontal bone loss in diabetics, he said.

Healthy gums do a heart good, too, added Moise Desvarieux, an infectious disease epidemiologist at Columbia University's Mailman School of Public Health in New York City. He said the evidence for a solid link between heart disease and problem gums is growing. "We should know within five years the relationship between cardiovascular and periodontal disease," he said.

It is important, said Genco, that physicians recognize gum disease as a potentially potent contributor to poor health generally. To that end, he's one of a group of health professionals working with the U.S. Centers for Disease Control (CDC) to develop a simple questionnaire that doctors can hand out to patients to identify those with periodontal disease.

More information

For more on periodontal disease, head to the American Dental Association.

SOURCES: Robert Genco, DDS, PhD, distinguished professor, oral biology, School of Dental Medicine, State University of New York at Buffalo, N.Y.; Steven Offenbacher, DDS, PhD. MMSc, distinguished professor, department of periodontics, University of North Carolina School of Dentistry, Chapel Hill; Moise Desvarieux, M.D., MPH, PhD., infectious disease epidemiologist, Mailman School of Public Health, Columbia University, New York City; Michael Glick, DMD, editor, Journal of the American Dental Association, professor and chairman, department of diagnostic sciences, University of Medicine and Dentistry of New Jersey, Newark; Feb. 23, 2006, presentations, Oral and Systemic Health; Exploring the Connection

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