Periodontal disease and your health

There is growing scientific evidence for the relationship of periodontal diseases to diabetes, premature low weight births and cardiovascular disease.  So what are these links?

Diabetes:

Periodontal disease in poorly controlled type I or II diabetes patients is often more aggressive and harder to control.  This is supported by long term research.  Is the reverse, that active periodontal disease can affect blood sugar levels and thereby affect the systemic health of an individual?  Preliminary evidence suggests that improving a patients periodontal health will improve their control of blood sugar levels.  Periodontal treatment combined with antibiotics has been shown to improve blood sugar levels in diabetic patients, suggesting treating a patientís periodontal diseases could decrease insulin requirements, and therefore improved systemic health and greater freedom from diabetic complications.

Pregnancy:

Several recent studies have indicated that women with periodontal disease may be at risk to deliver a preterm low birth weight baby.  There are also indications that women whose periodontal disease worsens during pregnancy may also be at increased risk.  It would seem reasonable to recommend a periodontal examination for women who are pregnant or considering pregnancy.  Pregnant women should receive regular periodontal maintenance treatment and those with periodontal problems may be treated nonsurgically during the second trimester of pregnancy.  

Cardiovascular disease:

Large epidemiological studies provide evidence of a link between periodontal disease and cardiovascular disease, but none have included an accurate assessment of the participants periodontal health.  More recent studies have shown that there appears to be a consistent relationship between periodontal disease and cardiovascular disease, but the nature of the relationship is unsure.  Pilot intervention studies are underway to examine if improved periodontal health results in decreased risk of heart attack and stroke.  The presence of periodontal bacteria in atherosclerotic plaques has been demonstrated and bacterial toxins may directly or indirectly cause inflammation of the blood vessel wall, which may result in the blockage of a cardiac artery.

While none of these links with systemic disease are definite or clear, there appears to be no down side to improved periodontal health, and improved periodontal health will benefit the patients systemic health.  In individuals at risk (pregnant women, diabetics, patients with a history of stroke and heart attack) the detection, treatment and prevention of periodontal diseases are more important.