"Gum Disease Can Harm Much More Than Your Teeth", Forbes, June 15,
2006,
Link:
http://www.forbes.com/forbeslife/health/feeds/hscout/2006/06/15/hscout532224.html

Proper oral hygiene may do a lot more than keep your teeth bright and
cavity-free -- it could be a boon to your overall health.

A growing body of research suggests that periodontal disease may
exacerbate a variety of health problems as wide-ranging as diabetes,
heart disease, respiratory disease -- even premature births, experts
say.

For instance, several promising studies have found that blood-sugar
levels in diabetics with periodontal disease were reduced to normal
when the patients' gum disease was treated. Other research revealed
that the incidence of respiratory diseases among nursing-home residents
was cut when they were treated for gum disease, said Dr. Robert Genco,
distinguished professor of oral biology at the School of Dental
Medicine at the State University of New York at Buffalo.

"All of these are pilot studies, and whether [the periodontal disease]
is causal, we cannot say, but we can't ignore these associations,"
Genco said. "Further, from a practical standpoint, there is no harm in
treating periodontal disease in these patients."

Gum disease is very common, Genco explained. Approximately 80 percent
of Americans have some form of the condition, which is a bacterial
infection of the gums surrounding the teeth.

Gingivitis is the mildest and most common form of gum disease, causing
inflammation of the tissues around the teeth. More serious is
periodontitis, when the inflammation affects the connective tissue
supporting the teeth and, eventually, the bone. An estimated 20 percent
of Americans have periodontitis, making it the primary cause of tooth
loss in adults.

Because periodontal disease is so common, Genco said, treating the
condition successfully could have a significant impact on public
health, even if it's associated with only a small portion of other
ailments.

One reason gum disease could contribute to other ailments, researchers
say, may be that oral bacteria get into the bloodstream and cause
inflammation of other body tissues. Another possibility is that an oral
infection could trigger inflammatory responses from the immune system,
adversely affecting the rest of the body.

Dr. Steven Offenbacher, distinguished professor at the Department of
Periodontics at the University of North Carolina School of Dentistry,
is studying the link between periodontal disease and preterm birth, and
thinks inflammation could play an important part in the connection.

"Organisms are capable of invading the bloodstream and challenging the
fetus by inflammation of the fetal and placenta unit, thus promoting
premature birth," he said.

In monitoring the dental health of 1,020 pregnant women, Offenbacher
and his colleagues found that those who suffered moderate-to-serious
periodontal disease (14 percent of the women) were twice as likely to
give birth to premature babies, than women with healthy gums. This
difference held up even when the results were adjusted to reflect
factors such age of the mother, prior preterm births and socioeconomic
differences.

Offenbacher is now the lead investigator of a five-year, multi-center
study that's enrolling 1,800 pregnant women and treating their
periodontal disease, to see if the treatment reduces the risk of
premature delivery. Within three years, he said, there will be good
data showing whether or not treating gum disease can reduce preterm
birth risk.

"We have not yet proven [a link] but the data suggests that treating
the mother is safe and can improve dental health," he said.

Meanwhile, growing interest in the possible links between periodontal
disease and other illnesses has prompted study into more aggressive
treatment of gum disease.

"Periodontal disease is a silent disease. The signs are not that
obvious, and people really don't know they have problem," Genco said.

Doctors with patients with diabetes, respiratory illnesses, heart
disease as well as pregnant women would all benefit from awareness of
the possible effects of periodontal disease on the conditions they're
treating, he said.

To help them and their patients recognize the signs of periodontal
disease, Genco is one of several health professionals working with the
U.S. Centers for Disease Control and Prevention. The goal: To develop a
simple questionnaire for doctors to give their patients that would
suggest when a patient should be seen by a dentist.

Answering "yes" to questions like whether their gums bleed or if their
teeth look different could indicate which patients might have gum
disease and should be referred to a dentist.

"People know when their gums recede -- there can be discoloration. Or
if there is a difference in the spacing of their teeth or if their
teeth look different," he said.