Question:
The American Heart Association estimates approximately 20 % of
the American public (almost 60 millions) suffer from cardiovascular
disease, making it the NUMBER ONE cause of deaths in the U.S
Is there a connection between this and the common gum disease ?
When there is an inflammation of the lining on the inside of the heart
and its valves it is called endocarditis. If there is enough of bacterias
around (in the blood stream) the valves can be infected, especially if
they have been affected by an infection before.
We know now that bacterias enter the bloodstream even during tooth-
brushing. Even more so if there is an ongoing undiagnosed periodontal
disease. You notice that if there is blood when you brush your teeth.
Another type of cardiovascular disease is when the heart blood vessels
gradually thicken due to the build-up of fatty proteins. There will be a
a bacterial biofilm (plaque) making the vessels norrower which causes
the blood to clot. This obstructs normal flro of blood and the heart muscel
get less of nutrients and oxygen and thus function poorley.
The bacterias in this blood vessel plaque is made up by bacterias from
the mouth (some 20% - 25%) which has made researchers to believe
that people with periodontal disease develop coronary artery disease
twice as often than those without periodontal disease !!!
So in short; there are many known contributing factors behind heart
disease such as much blood cholesterol, years of smoking, insulin
dependent diabetes, high blood pressure, overweight, lack of excercise.
Answer:
A link has been proven between between periodontal disease and heart disease,
but we do not know if this is causal.
All we can say at the present time is that patients with periodontal disease
are more at risk to heart disease.
It may well be that periodontal disease and heart disease merely share the
same risk factors, or it might just be that the same overactive white blood
cells are responsible for both conditions. We just don't know as yet.
What we do know is that the studies have not yet been done which prove that
patients who have their gum disease treated will have a reduced risk of heart
disease.
"... To further test the association between periodontal disease and PVD
[Peripheral Vascular Disease], we repeated the analysis after removing other
vascular conditions from the non-PVD group. Table IV shows that removing other
vascular conditions from the non-PVD group did not substantially modify the
relationship between periodontal disease and PVD after adjusting for other
significant risk factors.
"COMMENTS
"In this prospective study we found that otherwise health men with clinically
significant periodontal disease at baseline had an approximate twofold increase
in their risk of subsequent development of PVD. This asociation is INDEPENDENT
(emphasis mine) of other well-established cardiovascular risk factors. Two
other interesting observations were made: SNIP (2) the strength of the
association between periodontal disease and PVD is comparable with that of
other cardiovascular risk factors such as family history of heart disease."
Mendez et al. "An Association between Periodontal Disease and Peripheral
Vascular Disease" The American Journal of Surgery vol 176 August 1998
If you read any scientific litterature you'll find similar statements was
made during the 60s. Today we know, and *should* inform our patinets
that it's possible that if they have periodontal disease, they may be at risk
for cardiovascular disease !!!! If you are a dentist this is an obligation
you have obviously and blatantly missed.
For a long time, we've known that bacteria may affect the heart, but now
evidence is mounting that suggests people with periodontal disease
may be more at risk for heart disease, and have nearly twice the risk
of having a fatal heart attack, than patients without periodontal disease.
There are many different possibilities how this works: on is that the
periodontal bacteria enter the blood through inflamed gums and cause
small blood clots that contribute to clogged arteries. Another possibility
is that the inflammation caused by periodontal disease increases plaque
build up, which may contribute to swelling of the arteries.
Sure more research is needed to confirm how periodontal bacteria is
affecting the heart but our lack of knowledge should not stop us from
acting upon what we know.
This may very well be a fact but it was not the issue that I brought up.
I am talking about increased risk, not decreased, however logical that
it may be if a risk is removed the effect of its presence is decreased
If you didn't followed me in that all you can do is to re-read my post.
Then you will see that all I did was to place periodontal disease in a
group together with other situations with a systemic effect on the body.
I feel pretty safe in stating that current data leads scientists to believe
that periodontal disease is an important risk factor for heart disease,
working in concert with other risk factors such as age, smoking,
diabetes, hypertension and elevated blood cholesterol.
