Gum Disease May Be Linked To Heart Disease And StrokeInitial Study Points to Connection< August 13, 2003 >Tooth loss caused by gum disease may be a marker of cardiovascular disease before symptoms appear, researchers report in Stroke: Journal of the American Heart Association. Some scientists believe that people with chronic gum, or periodontal, disease may be predisposed to heart disease and stroke. However, supporting this hypothesis has been difficult, in part because researchers have yet to identify a molecule or some other telltale biological marker that is somehow linked to these conditions. Now, a team of scientists reports that it may have found a possible marker. The researchers found that the more teeth a person has lost, the more likely he or she is to have both advanced periodontal infections and potentially clogging plaques in the carotid arteries, the vessels that feed the brain. The results are initial findings from the Oral Infections and Vascular Disease Epidemiology Study (INVEST). Oral Health's Link to Overall HealthDr. Moise Desvarieux, of the University of Minnesota School of Public Health and lead author on the study, said he asked the following question: In middle aged and older people with periodontal disease, is there a measurable association between tooth loss, severity of their oral infections, and subclinical cardiovascular disease? "In this population at least, the answer was most definitely yes," explains Dr. Desvarieux. Dr. Desvarieux said he and his colleagues also found that the association held true in a large subgroup of people with periodontal disease who had never smoked. He said this finding is especially noteworthy, because results from several related studies have been questioned on the grounds that a large percentage of the participants smoked. Smoking is a major risk factor for both periodontal infections and heart disease, raising the possibility that the smoking, not the gum disease, might be responsible for the reported effect in these studies. The researchers are building on the broader idea that disease-causing bacteria shed from periodontal infections enter the circulatory system, and then contribute to disease in other parts of the body, such as the heart or brain. The more chronic and severe a person’s periodontal infections are, the thinking goes, the greater the risk for secondary infections. Finding What Role Prevention May HaveWhat particularly intrigues these researchers is, if the theory proves to be correct, it may be possible to help prevent or control the development of vascular disease in some people by treating their periodontal disease. "The fact that the teeth are gone doesn't mean that the possible effect of the previous periodontal infections hasn't already occurred," Dr. Desvarieux says. The study, which is supported by the National Institute of Dental and Craniofacial Research, of the National Institutes of Health (NIH), will continue to monitor the oral and cardiovascular health of a large, ethnically diverse group of people for at least three years. The initial report covers the first 711 of what are planned to be 1,050 participants. All are 55 or over and none have a history of heart disease. Dr. Desvarieux has been counting missing teeth and looking for other signs of periodontal disease, such as the deposits called plaque. The researchers have also been looking for a different kind of plaque - deposits in the arteries that can build up in the carotid arteries, the vessels that feed the brain, to cause a stroke. So far, the study seems to be favoring the theory, Dr. Desvarieux says. Of participants missing zero to nine teeth, 45 percent have carotid artery plaque. Of those with 10 to 19 missing teeth, 60 percent have a buildup of carotid artery plaque. The researchers have checked to see whether those who have lost teeth are more likely to have the unhealthy lifestyle that contributes to both tooth loss and heart disease, such as smoking or diabetes. "We controlled for those factors and the relationship still existed," Dr. Desvarieux says. They are counting lost teeth because that is a definitive way of measuring periodontal disease, he says. "The conventional method, looking around teeth, becomes impossible once a tooth is lost," he says. "There is nothing to measure." Search Continues for Underlying CauseThe study is just beginning, Dr. Desvarieux stresses. The participants will be followed for at least three years to see whether they progress toward having definite arterial disease, and whether tooth loss correlates with cardiovascular events such as stroke. Even if all that checks out, more will be needed to establish a definite relationship, says Dr. Ann F. Bolger, of the University of California at San Francisco and a spokeswoman for the American Heart Association. "We really need to understand whether these two factors just occur together or whether there is a causal role," Dr. Bolger says. "That would take another study. If we do prove a causal role, there would have to be a treatment study." This latest study is part of a movement that supports the idea that inflammation plays a major role in cardiovascular disease. Researchers have identified high blood levels of C-reactive protein, an inflammation-related molecule, as a risk factor for heart disease and stroke, although they are not yet certain whether there is a cause-and-effect relationship. Dr. Desvarieux will be measuring blood levels of C-reactive protein and other inflammation-related molecules in the study participants to see how they correlate with the risk of stroke. Always consult your physician for more information. |
For more information on health and wellness, please visit health information modules on this Web site. What Are Periodontal Diseases?The word periodontal literally means "around the tooth." Periodontal diseases, also called gum diseases, are serious bacterial infections that destroy the gums and the surrounding tissues of the mouth. If the inflammation is left untreated, the disease will continue and the underlying bones around the teeth will dissolve, and will no longer be able to hold the teeth in place. Chronic inflammation, resulting from a periodontal disease, is responsible for 70 percent of all adult tooth losses, and affects 75 percent of people at some point in their lives. As with many other oral health diseases, bacteria and plaque build-up is often the reason. In fact, plaque build-up is the leading cause of gum disease. Other potential causes of gum disease include:
The following are the most common symptoms of gum disease:
The symptoms of gum disease may resemble other conditions or medical problems. Consult a dentist or other oral health specialist for a diagnosis. Types of Periodontal DiseaseThe different types of periodontal disease are often classified by the stage the disease has advanced to at the time of evaluation, including: gingivitis mild periodontitis moderate to advanced periodontitis Always consult your physician for more information. Online Resources(Our Organization is not responsible for the content of Internet sites.) Centers for Disease Control and Prevention (CDC) National Institute of Dental and Craniofacial Research (NIDCR) |
