Research studies have shown that there is a strong association between periodontal disease and other chronic conditions such as diabetes, heart disease, pregnancy complications and respiratory disease.
Periodontal disease is characterized by chronic inflammation of the gum tissue, periodontal infection below the gum line and a presence of disease-causing bacteria in the oral region. Halting the progression of periodontal disease and maintaining excellent standards of oral hygiene will not only reduce the risk of gum disease and bone loss, but also reduce the chances of developing other serious illnesses.
Common cofactors associated with periodontal disease:
A research study has shown that individuals with pre-existing diabetic conditions are more likely to either have, or be more susceptible to periodontal disease. Periodontal disease can increase blood sugar levels which makes controlling the amount of glucose in the blood difficult. This factor alone can increase the risk of serious diabetic complications. Conversely, diabetes thickens blood vessels and therefore makes it harder for the mouth to rid itself of excess sugar. Excess sugar in the mouth creates a breeding ground for the types of oral bacteria that cause gum disease.
There are several theories which explain the link between heart disease and periodontitis. One such theory is that the oral bacteria strains which exacerbate periodontal disease attach themselves to the coronary arteries when they enter the bloodstream. This in turn contributes to both blood clot formation and the narrowing of the coronary arteries, possibly leading to a heart attack.
A second possibility is that the inflammation caused by periodontal disease causes a significant plaque build up. This can swell the arteries and worsen pre-existing heart conditions. An article published by the American Academy of Periodontology suggests that patients whose bodies react to periodontal bacteria have an increased risk of developing heart disease.
Women in general are at increased risk of developing periodontal disease because of hormone fluctuations that occur during puberty, pregnancy and menopause. Research suggests that pregnant women suffering from periodontal disease are more at risk of preeclampsia and delivering underweight, premature babies.
Periodontitis increases levels of prostaglandin, which is one of the labor-inducing chemicals. Elevated levels prostaglandin may trigger premature labor, and increase the chances of delivering an underweight baby. Periodontal disease also elevates C-reactive proteins (which have previously been linked to heart disease). Heightened levels of these proteins can amplify the inflammatory response of the body and increase the chances of preeclampsia and low birth weight babies.
Oral bacterium linked with gum disease has been shown to possibly cause or worsen conditions such as emphysema, pneumonia and Chronic Obstructive Pulmonary Disease (COPD). Oral bacteria can be drawn into the lower respiratory tract during the course of normal inhalation and colonize; causing bacterial infections. Studies have shown that the repeated infections which characterize COPD may be linked with periodontitis.
In addition to the bacterial risk, inflammation in gum tissue can lead to severe inflammation in the lining of the lungs, which aggravates pneumonia. Individuals who suffer from chronic or persistent respiratory issues generally have low immunity. This means that bacteria can readily colonize beneath the gum line unchallenged by body’s immune system.
Osteoporosis is a common metabolic bone disease which frequently occurs in postmenopausal women, and occurs less frequently in men. Osteoporosis is characterized by bone fragility, low bone mass and a decrease in bone mineral density. Many studies have explored and identified a connection between periodontal disease and osteoporosis.
A study conducted at the University of New York at Buffalo in 1995 concluded that post-menopausal women who suffered from osteoporosis were 86% more likely to also develop periodontal disease.
Reasons for the Connection
Though studies are still being conducted in order to further assess the extent of the relationship between osteoporosis and periodontal disease, the researchers have thus far made the following connections:
Estrogen deficiency – Estrogen deficiency accompanies menopause and also speeds up the progression of oral bone loss. The lack of estrogen accelerates the rate of attachment loss (fibers and tissues which keep the teeth stable are destroyed).
Low mineral bone density – This is thought to be one of several causes of osteoporosis, and the inflammation from periodontal disease makes weakened bones more prone to break down. This is why periodontitis can be more progressive in patients with osteoporosis.
Diagnosis and Treatment
Osteoporosis and periodontal disease are much less dangerous if they are diagnosed in the early stages. Once a diagnosis has been made, the dentist will generally work with the patient’s doctor to ensure that both diseases are effectively controlled.
Here are some methods commonly used to diagnose and treat the diseases:
Routine dental x-rays – X-rays can be effectively used to screen for bone loss in the upper and lower jaw, and the dentist can provide interventions for preventing and treating periodontal disease. It is believed that minimizing periodontal disease will help treat osteoporosis.
Estrogen supplements – Providing post-menopausal women with estrogen supplements lowers the rate of attachment loss and also lowers gingival inflammation, which in turn protects the teeth from periodontal disease.
Assessment of risk factors – Dentists and doctors are able to closely monitor the patients that are at an increased risk of developing both diseases by assessing family history, medical history, X-ray results, current medications and modifiable risk factors. Tobacco use, obesity, poor diet and estrogen deficiency can all be managed using a combination of education, support and prescription medications.
If you have any questions about periodontal disease and its connection with osteoporosis, please ask your dentist.
If you have questions or concerns about periodontal disease and the mouth-body connection, please ask your dentist. We care about your overall health and your smile!