Medical and Dental Consequences of Periodontal Disease

75% of all adult tooth loss is due to periodontal disease. When your gums and bone are damaged by periodontal infection, there is less support for your teeth. As this support disappears, your teeth first become loose and then can be lost. When your dentist recommends periodontal treatment, it is important to get started right away.

Most of you reading this information are starting to get an idea of what periodontal disease is, whether from your general dentist or physician, or from reading some of the information on this site. If you have not reviewed the information about gum disease, what it is, and the causes of gum disease, we highly recommend you do so by visiting the American Academy of Periodontology's page 'Types of Gum Disease'. The goal of the Perio & Implant Center is to, not only offer excellent periodontal therapy services, but to offer educational information so that individuals can work toward preventing the onset of periodontal disease in every way possible.

Periodontal disease is a significant issue in the United States. Many people actually have gum disease and do not even realize it. As a dreadful infection, periodontal disease bacteria are released into an individual’s bloodstream and therefore causes a whole host of other health complications. Gum disease is not solely a dental issue; periodontal disease can have a myriad of effects on one’s overall health and general well being. Periodontal disease is a medical condition as well, one of a serious nature, requiring the treatment of a qualified periodontist.

There are both dental and medical consequences of periodontal disease. This section covers each briefly.

Medical Consequences of Periodontal Disease

Heart Disease & Heart Attack

Several theories exist to explain the link between periodontal disease and heart disease. One theory is that oral bacteria can affect the heart when they enter the blood stream, attaching to fatty plaques in the coronary arteries (heart blood vessels) and contributing to clot formation. Coronary artery disease is characterized by a thickening of the walls of the coronary arteries due to the buildup of fatty proteins. Blood clots can obstruct normal blood flow, restricting the amount of nutrients and oxygen required for the heart to function properly. This may lead to heart attacks.

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. Patients at risk for infective endocarditis may require antibiotics prior to dental procedures. Your periodontist and cardiologist will be able to determine if your heart condition requires use of antibiotics prior to dental procedures.

Stroke

Additional studies have pointed to a relationship between periodontal disease and stroke. In one study that looked at the causal relationship of oral infection as a risk factor for stroke, people diagnosed with acute cerebrovascular ischemia were found more likely to have an oral infection when compared to those in the control group.

Pre-Term Childbirth

For a long time we've known that risk factors such as smoking, alcohol use, and drug use contribute to mothers having babies that are born prematurely at a low birth weight.

Now evidence is mounting that suggests a new risk factor – periodontal disease. Pregnant women who have periodontal disease may be seven times more likely to have a baby that is born too early and too small.

More research is needed to confirm how periodontal disease may affect pregnancy outcomes. It appears that periodontal disease triggers increased levels of biological fluids that induce labor. Furthermore, data suggests that women whose periodontal condition worsens during pregnancy have an even higher risk of having a premature baby.

All infections are cause for concern among pregnant women because they pose a risk to the health of the baby. The Academy recommends that women considering pregnancy have a periodontal evaluation.

Diabetes

People with diabetes are more likely to have periodontal disease than people without diabetes, probably because diabetics are more susceptible to contracting infections.

A study in the Journal of Periodontology found that poorly controlled type 2 diabetic patients are more likely to develop periodontal disease than well-controlled diabetics are.

Research has emerged that suggests that the relationship between periodontal disease and diabetes goes both ways - periodontal disease may make it more difficult for people who have diabetes to control their blood sugar.

Severe periodontal disease can increase blood sugar, contributing to increased periods of time when the body functions with a high blood sugar. This puts diabetics at increased risk for diabetic complications. Thus, diabetics who have periodontal disease should be treated to eliminate the periodontal infection.

A study reported in the Journal of Periodontology in 1997 involving patients with both diabetes and periodontal disease found that when their periodontal infections were treated, the management of their diabetes markedly improved.

Osteoporosis

Researchers have suggested that a link between osteoporosis and bone loss in the jaw. Studies suggest that osteoporosis may lead to tooth loss because the density of the bone that supports the teeth may be decreased, which means the teeth no longer have a solid foundation. However, hormone replacement therapy may offer some protection.

One study published in the June 2007 Journal of Periodontology (JOP) examined 1,256 postmenopausal women and looked for a potential association between periodontal bacteria and bone loss in the oral cavity. The study results showed that women with periodontal bacteria in their mouths were also more likely to have bone loss in the oral cavity, which can lead to tooth loss if not treated.

A follow-up study of 106 postmenopausal women over more than 10 years concluded they could significantly reduce tooth loss by controlling their periodontal disease.

Another JOP study published in August 1999 concludes that estrogen supplementation in women within five years of menopause slows the progression of periodontal disease. Researchers have suspected that estrogen deficiency and osteopenia/osteoporosis speed the progression of oral bone loss following menopause, which could lead to tooth loss. The study concluded that estrogen supplementation may lower gingival inflammation and the rate of attachment loss (destruction of the fibers and bone that support the teeth) in women with signs of osteoporosis, thus helping to protect the teeth.

Respiratory Disease

Bacterial respiratory infections are thought to be acquired through aspiration (inhaling) of fine droplets from the mouth and throat into the lungs. These droplets contain germs that can breed and multiply within the lungs to cause damage. Recent research suggests that bacteria found in the throat, as well as bacteria found in the mouth, can be drawn into the lower respiratory tract. This can cause infections or worsen existing lung conditions. People with respiratory diseases, such as chronic obstructive pulmonary disease, typically suffer from reduced protective systems, making it difficult to eliminate bacteria from the lungs.

Scientists have found that bacteria that grow in the oral cavity can be aspirated into the lung to cause respiratory diseases such as pneumonia, especially in people with periodontal disease. This discovery leads researchers to believe that these respiratory bacteria can travel from the oral cavity into the lungs to cause infection.

Chronic obstructive pulmonary diseases (COPD) cause persistent obstruction of the airways. The main cause of this disease is thought to be long-term smoking. Chemicals from smoke or air pollution irritate the airways to cause obstruction. Further damage to the tissue and working function of the lungs can be prevented, but already damaged tissue cannot be restored - untreated or undetected COPD can result in irreversible damage. Scientists believe that through the aspiration process, bacteria can cause frequent bouts of infection in patients with COPD. Studies are now in progress to learn to what extent oral hygiene and periodontal disease may be associated with more frequents bouts of respiratory disease in COPD patients.

Periodontal Infection is a Medical Problem

Periodontal disease is no longer thought to be just a dental problem. Researchers are finding many correlations between periodontal infection and serious medical problems.

Your Infection Can Be Transmitted

Research has shown that periodontal disease can be passed through saliva. Patients with periodontal disease can pass it on to their loved ones. Because of this, it is sometimes recommended that all family members see their dentist or periodontist for a periodontal disease screening.

Some Patients are At Higher Risk

Patients in certain higher risk categories (see below) should pay particular attention to any signs of periodontal disease.

Those patients having a personal or family history of:

Those patients having higher risk lifestyles, including:

Higher Risk Patients

If you have been told you have a periodontal infection (or some of its symptoms) it is vital that you seek evaluation and treatment.

Natural Teeth Must Be Replaced

If the periodontal inflammation continues, you can start to lose your teeth, one at a time. These lost teeth will have to be replaced with dental work, such as:

Dentures

If tooth loss continues, it can cause you to need dentures. Many patients do not understand the full consequences of wearing dentures. There can be many problems with dentures including:

1. Inability to eat certain foods.
2. Inability to feel and taste foods.
3. Lisping or clacking when speaking.
4. Bad breath or smell.
5. Constant pain or discomfort.
6. Unnatural looking teeth.
7. Self-consciousness and embarrassment.
8. Looking old.
9. Having to take your dentures out at night for soaking.
10. Your spouse seeing you without teeth at night.

The Good News

In most cases the progress of periodontal infection can be stopped with prompt treatment. The gums and bone around your teeth can then be saved from further damage.

Laser Gum Disease Treatment  >  Silent Killer: Gum Disease >  Medical and Dental Consequences of Periodontal Disease