Research indicates gum disease may be related to other health problems.
A promising new line of research may one day change the way people think about flossing and the importance of healthy gums. Dentists lecture about flossing as a way to keep teeth clean and to ward off gum disease and, ultimately, that dreaded box of denture cleaner in the medicine cabinet.
But researchers are beginning to think far more is at stake than keeping teeth into old age. Gum disease may also have something to do with the risk of heart attack or stroke, the health of diabetes sufferers–even the likelihood of carrying a baby to term.
It’s too early to know that for sure, but researchers are hinting at intriguing connections between gum disease and medical malfunctions in the rest of the body.
If their theories pan out, doctors and dentists could find much more overlap in their work. The dentist might be the first to discover a patient’s osteoporosis or diabetes. Doctors might warn heart patients to take especially good care of their teeth.
For Dennis Mangan, a microbiologist who directs the infectious-disease program at the National Institute of Dental Research, the implications of the new theories are simple: “The mouth is part of the body,” he said. “Oral medicine has an impact on the rest of the body and vice versa. . . . You can’t be truly healthy if you’ve got bad teeth.”
Given that more than 75 percent of the over-55 population has some form of periodontal disease, those are not comforting words.
So far, the periodontal research has major gaps. Most of what scientists have is circumstantial evidence that gum disease is connected somehow to other diseases: People who have it are more likely to have other things as well. In their studies, the researchers have tried to take into account other risk factors for disease such as smoking or obesity or generally bad health habits.
But they acknowledge the apparent link between sick gums and a sick body might be caused by something they haven’t thought of.
Steven Offenbacher, a University of North Carolina periodontology professor who is studying the connection between gum disease and low birth-weight babies, explained the potential pitfalls of jumping to conclusions this way: “People used to think that drinking coffee gave you lung cancer. Then they realized the people drinking coffee were also smoking cigarettes.”
That’s why researchers are so cautious they even hesitate to call gum disease a “risk factor” for other diseases.
“It’s a promising theory that’s unproven,” said Charles Hennekens, chief of preventive medicine at Brigham and Women’s Hospital in Boston. He has done work showing that heart disease and stroke are related to inflammation within the body. But he also did a study that showed no connection between periodontal disease and cardiovascular problems.
And scientists certainly don’t know whether gum disease “causes” other diseases.
“We need more research,” Hennekens said.
With that in mind, here’s whatis known:
Several studies have found that people who have periodontal disease or other signs of oral infection are more likely to have heart attacks, heart disease or strokes. The increased likelihood of cardiovascular disease ranges from 20 percent to 280 percent, said James Beck, a University of North Carolina epidemiologist who has reviewed all the research.
A study by Beck’s colleague Offenbacher found that women with periodontal disease were seven times as likely to have premature, low birth-weight babies as similar women with healthy gums.
Another found that it was harder to control blood sugars in diabetics with periodontal disease. Yet another found that people with chronic obstructive pulmonary disease, a serious lung problem associated with smoking, had more flareups when they also had gum infections.
There also was a study showing that a bacterium common in plaque, the slimy germ colonies on your teeth, could cause blood clotting and heart irregularities when injected into rabbits. A Temple University team including Eugene Whitaker, associate professor of dentistry, and Thomas Rams, chairman of the department of periodontology, found that a different bacterium associated with gum disease caused blood to clot in a test tube. And another study found a type of gum disease bacteria in diseased arteries.
Sorting out what all this means will take years.
Last year, the National Institute of Dental Research, which is part of the National Institutes of Health, funded about $3 million worth of research into the connection between oral infections and heart, kidney and lung diseases, stroke, and adverse pregnancy outcomes. Mangan expects that funding to grow slowly in coming years. As for evidence of the association between periodontal disease and other health problems, Mangan said, “the evidence is getting stronger every day.”
