GUM DISEASE LINKED TO HEART
The most common strain of bacteria in dental plaque can cause
blood clots that induce heart attacks when they escape into the bloodstream,
researchers have reported.
Gum disease may
weaken heart meds
Finnish researchers are linking periodontitis, or gum
disease, with the long-term effectiveness of antibiotics that
prevent heart attacks. Scientists in Helsinki gave 141
patients with and without periodontitis a three-month course of
treatment with antibiotics made to decrease the recurrence of
cardiovascular events. The double-blind trial then registered
the recurrence of new cardiovascular eventsover the course of
one year. According to the article, which is in the journal
Atherosclerosis, 79 percent of patients without gum disease went
a year without new heart problems. That number dropped to 74
percent in the patients without teeth and 66 percent in those
with periodontitis. Periodontitis destroys the soft tissue and
bone that support your teeth and can cause tooth loss.
The researchers said this is the first time dental infections
have been linked to the effectiveness of long-term treatment
with these antibiotics. But other research has recently
linked gum disease with an increase
risk for heart disease, stroke and premature births.
Sat 07 Jan 2006 01:13 PM CST WASHINGTON DC (myDNA News)RESEARCH
Full-mouth Tooth Extraction Lowers Systemic
Inflammatory and Thrombotic Markers of Cardiovascular Risk
Prior studies of a link between periodontal and
cardiovascular disease have been limited by being predominantly
observational. We used a treatment intervention model to study
the relationship between periodontitis and systemic inflammatory
and thrombotic cardiovascular indicators of risk. We studied 67
adults with advanced periodontitis requiring full-mouth tooth
extraction. Blood samples were obtained: (1) at initial
presentation, immediately prior to treatment of presenting
symptoms; (2) one to two weeks later, before all teeth were
removed; and (3) 12 weeks after full-mouth tooth extraction.
After full-mouth tooth extraction, there was a significant
decrease in C-reactive protein, plasminogen activator
inhibitor-1 and fibrinogen, and white cell and platelet counts.
This study shows that
elimination of advanced periodontitis by full-mouth tooth
extraction reduces systemic inflammatory and thrombotic markers
of cardiovascular risk. Analysis of the data supports the
hypothesis that treatment of periodontal disease may lower
B.A. Taylor1,*, G.H.
Tofler2, H.M.R. Carey1, M.-C. Morel-Kopp2, S. Philcox2, T.R.
Carter1, M.J. Elliott1, A.D. Kull2, C. Ward2, and K. Schenck3 1
Sydney Dental Hospital, 2 Chalmers Street, Surry Hills NSW 2010,
Australia; 2 Royal North Shore Hospital, New South Wales,
Australia; and3 Department of Oral Biology, University of Oslo,
Norway* corresponding author,
Periodontal therapy lowers levels of heart disease inflammation
UC Davis study identifies C-reactive protein as cause of blood
New research finds link between
gum disease, acute heart attacks
Assay Characteristics of HSCRP Tests
Periodontal Disease, C-Reactive Protein
and Overall Health
cardiovascular disease: A review of shared risk factors
and new findings supporting a causality hypothesis
Periodontitis is a common
chronic disease worldwide. It is a major cause of tooth
loss among adults and recently has been suggested to
increase the risk for developing several systemic
diseases, including cardiovascular disease. Populations
are not equally affected by periodontal disease because
there are several environmental and host factors
modulating susceptibility. Cardiovascular disease shares
many of the same susceptibility factors. The purpose of
this report is to identify risk factors and indicators
common to periodontitis and cardiovascular disease, and
also to discuss their possible interrelationship in this
association. Recent findings to support a causal
association between the 2 conditions are also presented.
Mohammad S. Al-Zahrani, BDS, MSD,
PhD / Rayyan A. Kayal, BDS / Nabil F. Bissada, DDS, MSD
- Treating Severe Periodontal Disease can Improve Indothelial
Epidemiological studies have linked periodontal infections to
cardiovascular disease, Dr. Gerald Seinost of University
Hospital in Graz, Austria and colleagues write in the June issue
of the American Heart Journal.
They conducted the current study to determine whether
endothelial dysfunction, a crucial step in atherosclerosis
progression, would be worsein patients with severe periodontal
disease and whether treating the disease
would improve endothelial dysfunction.
Average flow-mediated dilation in the patients was 6.1% before
treatment compared to 8.5% for the controls. After successful
treatment, flow mediated dilation increased by 9.8% over
baseline, and was similar to that of healthy
controls. Treatment also resulted in a significant drop in
C-reactive protein levels.
All patients underwent
scaling and root planing, and also received instruction in
oral hygiene and several cleanings.
Chlorhexidine gluconate mouthwashes were prescribed for 14
days, and systemic antimicrobial treatment for seven days.
"These results indicate that treatment of severe
periodontitis reverses endothelial dysfunction. Whether
improved endothelial function will translate into a beneficial
effect on atherogenesis and cardiovascular
events needs further investigation," the researchers conclude.
Considering that at the very least, periodontal therapy would
improve oral health, we suggest that periodontal therapy
as an integral component of preventive cardiology treatment.
Am Heart J 2005;149:950-954,1050-1054.
Measures of Chronic Periodontitis and Carotid Artery Plaque
Chronic periodontitis (CP) is associated
with stroke and subclinical atherosclerosis, but clinical
measurement of CP can be time consuming and invasive. The
purpose of this study wasto determine whether radiographically
assessed CP is associated with nonstenotic carotid artery plaque
as an ultrasound measure ofsubclinical atherosclerosis.
Panoramic oral radiographs were obtained from 203 stroke- free
subjects ages 54 to 94 during the baseline examination
Severe periodontal bone loss is associated independently with
carotid atherosclerosis. Panoramic oral radiographs may thus
provide an efficient means to assess CP in studies of
Steven P. Engebretson, et al.,Radiographic Measures of
ChronicPeriodontitis and Carotid Artery Plaque Stroke.
Periodontal Disease and Risk for Atherosclerosis, Cardiovascular
Disease, and Stroke.
Recent studies implicate exposure to systemic
conditions involving chronic inflammation, including chronic
periodontitis,in the etiology of atherosclerosis. MEDLINE,
pre-MEDLINE, MEDLINE Daily Update,
and the Cochrane Controlled Trials Register were searched to
identify human studies that related variables associated with
atherosclerosis to periodontal disease. Searches were made for
papers published from 1966
through March 2002.
Results: Of the initial 1,526 studies identified, 31
(including 8 case-control and 18 cross-sectional reports) were
included in the analysis. Taken together, most of the
literature supports a modest association between
periodontal disease and atherosclerosis.
Reviewers' Conclusions: Periodontal disease may be modestly
associated with atherosclerosis, MI, and CVD. Additional
large-scale longitudinal epidemiologic and intervention studies
are necessary to validate this association and to determine
A Systematic Review Frank A. Scannapieco, Renee B. Bush, and
Susanna PajuAnn Periodontol 2003;8:38-53.
The Role of Inflammatory and Immunological
Mediators in Periodontitis and Cardiovascular Disease
Epidemiological studies have implicated
periodontitis (PD) as a risk factor for development of
cardiovascular disease (CVD). Persistent infections such as
periodontitis induce inflammatory and immune responses which may
contribute to coronary atherogenesis, and, in conjunction with
other risk factors, may lead to coronary heart disease (CHD).
Periodontal diseases are bacterial infections associated with
bacteremia, inflammation, and a strong immune response, all of
which may represent significant risk factors for the
development of atherogenesis, CHD, and myocardial infarction
(MI). Several mechanisms may participate in this association,
including those induced by oral organisms, and those associated
with host response factors. Ann
Periodontol Ernesto De Nardin 2001;6:30-40.
Relationship Between Infection, Inflammation, and Cardiovascular
Disease: An Overview
control of chronic infection in the mouth, stomach or lungs is
appropriate for its local effects, proving its efficacy in
prevention of CVD presents a continuing challenge to medical
Ann PeriodontolGordon D.O. Lowe
Perio as a risk factor
The current literature regarding periodontal diseases and
atherosclerosis and coronary vascular disease was searched using
theMedline and PubMed databases.An emerging concept suggests
that a pathogenic burden from different sources might overcome
an individual threshold culminating in clinical sequela. P.
gingivalis contributes directly and indirectly to
[Chun YHP, Chun KRJ, Olguin DA, H Wang HL
Biological foundation forPeriodontitis as a potential risk
factor for atherosclerosis Journal of Periodontal Research
Listen to a program on how
gum disease affects our heart health.
Periodontitis as risk factor for acute myocardial
infarction. A case control study of Spanish adults
A study was conducted of 149
Spanish patients aged between 40 and 75 years. Males, older
patients, smokers, and those with hypertension, diabetes or
hypercholesterolemia, showed an increased risk of acute
myocardial infarction. The association between
periodontitis and acute myocardial infarction was high There
is evidence of an association between periodontitis and acute
myocardial infarction after adjusting for well-known risk
factors for acute myocardial infarction.
Periodontal Research Volume 40 Issue 1 Page 36
A. Cueto, F. Mesa, M. Bravo, R. Ocaña-Riola
Further Evidence Reveals the Association
Between Periodontal Disease and Coronary Artery Disease
October 2004 – A study
published in a recent issue of the Journal of Periodontology
explains another reason why people with
periodontal diseases are at a significant risk for
coronary artery disease (CAD). The study looked at 108
patients with CAD and a group of 62 people without CAD.
results of this study showed that periodontitis in cardiac
patients was significantly more frequent than in non-cardiac
patients.” said Professor E.H. Rompen, Department of
Periodontology - Dental Surgery, C.H.U. Liège, Belgium. “We
found that 91% of patients with cardiovascular disease suffered
from moderate to severe periodontitis, while this proportion
was 66% in the non-cardiac patients.”
Periodontitis seems to influence the occurrence and the
severity of coronary artery disease and increases the risk of
heart attack or stroke.
study proposes two hypotheses for this occurrence.
study supports earlier findings, and even showed a significantly
higher prevalence of periodontal diseases in cardiac patients.
“The data in this study shows the importance of regular dental
checkups to ensure a healthy, diseased-free mouth.
One hypothesis is that periodontal pathogens could enter the
bloodstream, invade the blood vessel walls and ultimately
cause atherosclerosis. (Atherosclerosis is a multistage
process set in motion when cells lining the arteries are
damaged as a result of high blood pressure, smoking, toxic
substances, and other agents.)
Another hypothesis is based on several studies that have
shown that periodontal infections can be correlated with
increased plasma levels of inflammation such as fibrinogen
(this creates blood clots), C-reactive protein, or several
cytokines (hormone proteins).
Harvard Medical School researchers studied longevity
and found one of the most important contributing factors was
daily flossing. Because it
removes bacteria from the teeth and gums, flossing helps to
prevent periodontal disease and gingivitis. Another study
found that men with periodontitis had a whopping 72%
greater risk of developing coronary disease. Gingivitis
was associated with a 42% increased risk for men. Nov
to Acute Coronary Syndrome in Patients With Coexistent
periodontal health of patients admitted to the Coronary Care
Unit due to acute coronary syndrome is unacceptable. The mean
values for CAL and probing depth, as well as extensive bleeding
on probing sites indicate the presence of active periodontal
disease, which may affect the incidence of cardiovascular
disease. We observed that patients with acute
coronary syndrome had more advanced periodontal disease.
Patients with less advanced periodontal disease were
characterized by a faster diminution of the inflammatoryresponse
in comparison to the groups with more advanced periodontal
[J Periodontol 2004;75:1020-1026.]
July 2004 (Vol. 75, No. 7) Inflammatory Response to Acute
Coronary Syndrome in Patients With
Coexistent Periodontal Disease Maciej R. Czerniuk, Renata Górska,
Krzysztof J. Filipiak, andGrzegorz Opolski
There is some evidence now that
anti-collagenase found in Periostat
a medication used for gum disease, may also help cut down
dissemination of metastatic cancer and invasion of the artery
wall in arteriosclerosis.
Periodontal Pockets and Elevated
Cholesterol and Low Density Lipoprotein Cholesterol
: Periodontitis is associated with increased
prevalence of cardiovascular morbidity and mortality.
The presence of periodontal pockets was positively
associated with higher cholesterol and low density
lipoprotein (LDL) cholesterol blood levels in men.
No significant association was found in women. The
findings of the study support the reports linking increased
prevalence of cardiovascular mortality among patients
with periodontal disease.
May 2002 (Vol. 73, No. 5)
Association Between Periodontal Pockets and Elevated
Cholesterol and Low Density Lipoprotein Cholesterol
Levels J Periodontol 2002;73:494- 500. Joseph Katz,
Moshe Y. Flugelman, Avishai Goldberg, and Marc
antibiotic gel lowers inflammatory
activity throughout body
infections with an antibiotic gel
decreased the presence of two chemical
markers of inflammation throughout the
body, pointing to further evidence of
the connection between oral health
and overall health.
treatment, the groups that received the
|lower levels of
oral bacteria |
|decrease in the
amounts of C-reactive
in the blood stream|
markers" of inflammatory activity
(c-reacitve protein and fibrinogen) are
associated with the development of
atherosclerosis and other chronic
diseases. This reduction in
C-reactive protein remained for six
conducted have found oral bacteria
from gum infections in arterial plaque.
Now we have shown that
therapy for periodontal disease
lessens the inflammatory burden
throughout the body.
Source: The University
at Buffalo and National Institute of
Dental and Craniofacial Research.
New Study Confirms Periodontal
Disease Linked To Heart Disease
published study in the Journal of Periodontology confirms
recent findings that people with periodontal disease
are at a greater risk of systemic diseases such as
found diseased gums released significantly higher
levels of bacterial pro-inflammatory components, such
as endotoxins, into the bloodstream in patients with
moderate to severe periodontal disease compared to
healthy patients. Additionally, those with severe
periodontal disease had approximately four times
more harmful bacterial products in their blood
than those with moderate or no periodontal disease
found the mouth can be a major source of chronic or
permanent release of toxic bacterial components in the
bloodstream during normal oral functions,"
said Dr. E.H. Rompen, director of the study.
"This could be the missing link explaining the
abnormally high blood levels of some inflammatory
markers or endotoxemia observed in patients with
"This data clearly stresses the importance of
regular dental checkups to ensure a healthy,
diseases are serious bacterial infections that destroy
the attachment fibers and supporting bone that hold
your teeth in your mouth. When this happens, gums
separate from the teeth, forming pockets that fill
with plaque and even more infection. As the disease
progresses, these pockets deepen even further, more
gum tissue and bone are destroyed and the teeth
eventually become lose. Approximately 15 percent of
adults between 21 and 50 years old and 30 percent of
adults over 50 have the disease.
American Academy of Periodontology,
Periodontal Diseases relationship to
Mark Herzberg of the University of Minnesota said the findings
are the first to link bacteria to the formation of potentially fatal blood
Previous studies had found the incidence of heart disease is
about twice as high in people with periodontal disease, but scientists didn't
"Now we show a potential biological reason."
Herzberg told the 150th annual meeting of the American Association for the
Advancement of Science.
In lab tests, Herzberg and colleagues injected bacteria from
dental plaque into the bloodstream of rabbits. The bacteria caused blood clots
to form within minutes. Rabbits are a proven model for testing hypotheses about
human heart disease and heart attacks.
Chronic inflammation of the gums due to plaque also could be
involved in the inflammation of the lining of the blood vessels that is known to
lead to the build-up of plaque in the arteries, Herzberg said.
Additional studies presented at the meeting show that bacteria
in plaque also are linked to:
|A potentially fatal disease called infective endocarditis
in which the sac around the heart becomes inflamed.
|Lung infections in people with chronic lung diseases such
as chronic obstructive pulmonary disease.
|A weakened immune system that can slow wound healing and
diminish a person's response to vaccines against hepatitis B and influenza.
|A higher risk of giving birth to premature, low
Reducing risk of diseases linked to dental bacteria is a
common lesson preached by dentists:
| Have the teeth cleaned regularly
If necessary, have bone implants to replace dental bone lost from
periodontal disease, says researcher, Frank Scannapieco, State University of New
York, Buffalo. Bacteria reside in pockets caused by bone loss where the teeth
By Tim Friend, USA Today. Reprinted with permission.
(Article from Pro-Dentec)
Scaling and Root Planing are
the procedures to help restore gum tissue to health.
February 06, 2008
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