The Connection Between Periodontal Disease and Chronic Conditions

 

Research shows that there is a strong connection between periodontal disease and other chronic conditions such as diabetes, heart disease, and osteoporosis.

 

Diabetes and Periodontal Disease

 

Almost 1.1 million Australians have diagnosed diabetes, and at least 2 million have pre-diabetes. Medical and dental research has shown that people with diabetes are more likely to develop periodontal disease than people without diabetes.  

 

Diabetes is a serious, incurable disease involving too much glucose (sugar), in the blood, thickening of blood vessel walls, and the reduced ability to fight infections. Type I Diabetes, known as Insulin Dependent Diabetes Mellitus, occurs when the pancreas cannot produce any insulin at all. Type II Diabetes, known as Non-Insulin Dependent Diabetes Mellitus, occurs when the body is unable to regulate insulin levels, meaning too much glucose remains in the blood. 

 

People with diabetes who struggle with controlling their blood sugar also develop periodontal disease more frequently and more severely than those who manage their diabetes well. 

 

The correlation between diabetes and periodontal disease has a number of factors:

• Individuals with diabetes are more prone to experience all types of infections, including periodontal infections.

• Diabetes slows circulation thus reducing the natural cleansing of the blood vessel walls and allowing bacteria to colonise.

• Diabetes reduces the body’s resistance to infection and increases the probability of gum infections.

• The bacteria responsible for periodontal disease thrive in the presence of high blood sugar which in turn leads to high glucose levels in saliva and the periodontal pockets, which promote growth of the bacteria responsible for gum disease.

• Thickening of the blood vessels means the body is unable to efficiently provide nutrients and remove waste, weakening the resistance of gum tissue, leading to infection and disease.

• The presence of periodontal disease may make it more difficult for diabetics to control their blood sugar.

• People who are 45 or older, who smoke, and have diabetes, are 20 times more likely to develop periodontal disease than those who do not smoke.

 

It is especially important for people with diabetes to follow oral health and hygiene recommendations to reduce their risk of periodontal disease.

 

Heart Disease, Stroke and Periodontal Disease

 

Cardiovascular disease is the leading cause of death in Australia, with coronary heart disease affecting around 1.4 million Australians. People with periodontal disease are two times more likely to suffer coronary heart disease. Periodontal disease may aggravate existing heart conditions, and patients with periodontal disease have a higher chance of stroke.

 

Coronary heart disease is caused when fatty proteins and plaque form on the walls of a person’s arteries, reducing the flow of oxygen that a person's body tissue requires to stay healthy. When oxygen is restricted to the heart, a person may experience shortness of breath, chest pain, and even heart attack.

 

The correlation between heart disease and periodontal disease involves the following:

• The oral bacteria associated with periodontal disease may enter the bloodstream and may attach to the fatty plaques in the coronary arteries. 

• Periodontal disease involves inflammation, which stimulates an increase in white blood cells and C-reactive proteins (CRP), which then leads to inflamed arteries and possibly blood clots, which may give rise to heart attacks or strokes.

 

Good oral hygiene practice and receiving treatment for periodontal problems can help prevent the risk of developing coronary heart disease.

 

Pregnancy and Periodontal Disease

 

Dental professionals have documented that when a pregnant woman has periodontal disease their unborn child may be exposed to a variety of risks and possible complications. Since pregnancy causes many hormonal changes in women, the likelihood of developing periodontal disease, such as gingivitis, increases. Most importantly, these oral problems have been linked to pre-eclampsia, or low birth weight of the baby, as well as premature birth.  

 

There are several factors affecting how periodontal disease impacts the mother and her unborn child:

• Pregnant women with advanced stages of periodontal disease, particularly periodontitis, have an increase in the labour-inducing hormone, prostaglandin. Hence, mothers with periodontitis may go into labour prematurely and deliver a baby with a low birth weight.

• The presence of C-reactive protein (CRP) is another compound linked to premature births and low birth weight babies, and it has also been associated with heart disease. Periodontal disease increases CRP levels in the body, which amplifies the body’s natural inflammatory response. Although health professionals don’t understand why elevated CRP also causes pre-eclampsia, studies prove that extremely high rates of CRP in early pregnancy increase the risk of pre-eclampsia.

• The bacteria responsible for periodontal disease that invade and live in the gum pockets of a diseased mouth may travel through the bloodstream and affect other parts of the body. For pregnant women, research shows that these bacteria may colonise in the internal mammary glands and coronary arteries. 

 

The best way for a pregnant woman to protect herself, and her baby, is by practicing good oral hygiene to prevent gum disease. Treating existing problems helps to reduce the risk of periodontal disease related complications by up to 50 percent.

 

Respiratory Disease and Periodontal Disease

 

Respiratory disease occurs when people inhale fine droplets of liquid into their mouths, throats, or lungs, particularly when these droplets contain germs that can spread and multiply within the lungs and impair breathing. Research also shows that bacteria found in the mouth and throat can settle into the lower respiratory tract and cause infection or worsen existing lung conditions.

 

People with periodontal disease are more susceptible to pneumonia, as well as bronchitis and emphysema. Chronic obstructive pulmonary disease (COPD), which is caused mostly by smoking, can also become worse for people with periodontal disease.

 

The connection between respiratory problems and periodontal disease relates to a number of factors:

• People experiencing respiratory problems generally have low immunity, which allows periodontal bacteria to grow easily above and below the gum lines without protection from the body’s immune system.

• Respiratory issues progress and worsen in people who have periodontal disease.

• There is also a link to inflammation of the oral tissue and respiratory problems. Oral bacteria causing the irritation can travel to the lungs, and contribute to the inflammation of the lung lining. This creates respiratory problems because it limits the amount of air that can pass freely through the lungs.

 

If you are diagnosed with respiratory disease or periodontal disease, Dr. Elfar will work with your physician to plan how to best treat both conditions and eliminate further complications.

 

Osteoporosis, Ageing and Periodontal Disease

 

Over 1 million Australians have osteoporosis, which affects both women and men and is most common in adults over 50.  

 

Osteoporosis is a potentially debilitating condition, characterised by the thinning of bone tissue and loss of bone density. The leading cause of osteoporosis is a drop in estrogen levels in menopausal women, or a drop in testosterone levels among men. 

 

Health professionals have studied the two diseases for possible connections since periodontal disease contributes to bone loss:

• Research found that women with periodontal bacteria in their mouths were more likely to have bone loss in the oral cavity and jaw, which can lead to tooth loss.

• Studies conducted over a period of 10 years also discovered that osteoporosis patients could significantly reduce tooth loss by controlling periodontal disease.

• Research also shows that post-menopausal women who suffer from osteoporosis are 86 percent more likely to develop periodontal disease.

• One of the reasons for the connection between osteoporosis and periodontal disease is an estrogen deficiency. Low estrogen levels speed up the progression of both oral bone loss and other bone loss. It also accelerates the rate of loss of fibres and tissues that keep the teeth stable. Tooth loss occurs when these fibres are destroyed.

• Low mineral bone density is one of the several causes of osteoporosis. The inflammation from periodontal disease weakens bones. This is why periodontitis progresses faster in people with osteoporosis.

 

If you are diagnosed with osteoporosis, it is important to take preventative measures against periodontal disease to protect your teeth and oral bones.