MOUTH BODY CONNECTION

Cardiovascular Disease and Periodontitis

Cardiovascular disease and periodontitis were first linked in 1989 by a Finnish case-controlled study involving 202 patients. The researchers found that even after controlling for many potential confounding factors, such as smoking, diabetes, and serum lipid concentrations, heart-attack patients still had significantly worse dental health than control subjects.

Many subsequent studies have also shown a connection between heart disease and periodontitis. For example, patients with severe periodontitis have been shown to be twice as likely to have a fatal heart attack and three times as likely to have a stroke as patients without periodontal disease after adjusting for known cardiovascular risk factors such as blood lipids, cholesterol, body mass, diabetes, and smoking (Beck et al. 1996 and Beck et al. 1998).

A recent study published in the Journal of Periodontology in late 2004 found that 91% of patients with cardiovascular disease suffered from moderate to severe periodontitis, while this proportion was 66% in the non-cardiac patients. The study looked at 108 patients with coronary artery disease (CAD) with a mean age of 59.2 +/- 10.9 years and a group of 62 people without CAD with a similar mean age (57.7 +/- 8.7 years).

“The 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. Periodontitis seems to influence the occurrence and the severity of coronary artery disease and increases the risk of heart attack or stroke.

Periodontal Diseases and Diabetes

Periodontal status has been shown to have a large impact on glycemic control in patients with diabetes. It is estimated that 12 to 14 million individuals in the United States have diabetes, with only half of the affected individuals diagnosed (Harris et al. 1987). Type 2 DM accounts for 85 to 90% of the cases and Type 1 only 5 to 10%. The remaining diabetes cases are associated with pregnancy and are called gestational diabetes. In initial studies to investigate a relationship between periodontal disease and Type 1 DM, it was shown that patients with Type 1 DM have an increased risk of developing periodontal disease with age and that the severity increases with the increased duration of diabetes (Cianciola et al. 1982). Furthermore, it has been shown that poorly controlled diabetics have more attachment and bone loss than well-controlled patients (Safkan-Seppala and Ainamo, 1992). In Type II DM patients, studies have demonstrated increased attachment loss and bone loss irrespective of age (Shlossman et al. 1990). The study reported that attachment loss occurs more frequently and to a greater extent in moderate and poorly controlled diabetic patients.