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 as depicted by the pictures below.  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:

Diabetes

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.

Typically a patient with controlled diabetes is less likely to develop periodontal disease. Controlled diabetes is defined by the American Diabetes Association as a daily blood sugar count between 70 to 130 mg/dl before meals and less than 180 mg/dl one to two hours after a meal. The best to way to measure those numbers would be through a glucose meter.  If you are looking for a decent one, our office uses the Care Touch Glucose Meter when a patient either forgot to take his or her measurement for the day or did not have anything to eat before a long procedure. It is a good indicator of the current blood sugar and whether or not the patient is stable enough to continue with any dental procedure.

Another method would be to check what is called the hemoglobin a1C, which is a component in your blood that links directly to sugar. It is usually more accurate than the glucose meter and is the standard for checking how well controlled one's diabetes is. The following table shows what a good a1c range should be: 

Make sure to always let your dentist know if you have diabetes and if there are any indication that your blood sugar level is outside the normal range. It is always safer to either wait and re-stabilize your condition or even reschedule than going through episodes of dizziness or even fainting.

Heart 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. 

Heart disease is also something that your dentist will need to monitor for closely for there is risks of complications associated with the anesthetic used in dentistry. The epinephrine that is in the anesthetic is likely to cause an increase in blood pressure which can put some strain on your heart and cause symptoms of heart palpitation, dizziness, and/or sometimes feeling faint. Be aware to let your dentist know as well. 

Pregnancy Complications

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.

When it comes to dental treatment, it is important to know that pregnant women are better suited for treatment during the 2nd trimester only as the developing embryo is more stable during that period. Therefore, it is critical to be thinking about how to better schedule your dental visits in order to maximize your preventative visits and reduce risks for anything happening during that period.

Respiratory Disease

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.

Ultimately, the best way to make sure that all of those risks are reduced, if not eliminated, would be to always maintain a prevention mindset by making sure that the unwanted bacteria causing periodontal disease are being monitored closely by an oral healthcare professional (dentist or hygienist) and that any underlying condition is kept under control. Keeping informed on the different ways that exists or the different options that have been discovered to live with those conditions can also help to take steps towards a more fruitful and rewarding direction. Some literature recommendation that have helped provide insight to many people and would be considered good reads that we have found particularly interesting to suggest:

• The Prevent and Reverse Heart Disease Cookbook by Ann Crile Esselstyn and Jane Esselstyn.  A great lifestyle change with healthier and more nutritious foods
• Beat the Heart Attack Gene by Bradley Bale.  A comprehensive explanation on how everything connects. 
• Mayo Clinic Guide to a Healthy Pregnancy by Myra J. Wick M.D. Ph.D.  A great way to know how approach everything health-wise when you are pregnant.
• It's All in Your Mouth: Biological Dentistry and the Surprising Impact of Oral Health on Whole Body Wellness by Dominik Nischwitz.  A description of how everything connects and links to the mouth. Good explanation on how a lot of things relate to dentistry as well. 
• The Complete Guide to Understanding and Living with COPD: From a COPDer's Perspective by R. D. Martin.  Learning all about COPD from someone who lives with it and all the steps to take to ameliorate your life while dealing with this disease. 

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! Feel free to comment or leave us a message with any questions or concerns and we will be glad to answer them.