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The Relationship Between Periodontal Health And Cardiac Health

You might ask, is there a connection between our mouth and our heart? Apparently, there is, and it is a connection that should not be ignored or trivialized. There is growing evidence that periodontal health is related to cardiovascular health.

Chronic bacterial infections of the gums lead to gingivitis, which in turn promotes inflammation of blood vessels, a risk factor for atherosclerosis. Experts believe that bacteria, particularly Porphyromonas gingivalis, which is associated with the development of atherosclerotic plaques, enter the bloodstream through the gums, and these same bacteria have been found in artery plaques.

Moreover, in an analysis of 421 participants in the National Heart, Lung, and Blood Institute's Family Intervention Trial for Heart Health, Mochari et al. noted elevated levels of C-reactive protein, a marker of inflammation that is also associated with an increased risk of coronary artery disease, have been noted in people with periodontal diseases. Phospholipase A2, a lipoprotein-associated enzyme and another marker of inflammation associated with cardiac disease, was also shown to be increased with people with periodontal disease. They concluded that self-reported periodontal disease is independently associated with inflammation and common in individuals without traditional CVD risk factors.

National Health and Nutrition Examination Survey (NHANES) found that gum disease is an important risk factor for diseases of the blood vessels and the arteries that supply the brain, especially strokes involving insufficient blood or oxygen to the brain. This is further bolstered by the findings of the American Academy of Periodontology that people with periodontal disease are almost twice as likely to have coronary artery disease. Common oral problems such gingivitis, cavities, and missing teeth are as accurate a predictor of heart disease as cholesterol levels. There is also evidence that the vascular function of people with periodontal disease improves when they undergo good dental care and improve their oral hygiene.

Piconi et al. showed that periodontal treatment resulted in a significant reduction of the total oral bacterial load, which was associated with a significant decrease of inflammation biomarkers and adhesion and activation proteins. They also noted that the thickness of the intima-media thickness significantly decreased after periodontal treatment. The results of their studies shed light on the possible correlation of oral health and the pathogenesis of atherosclerosis.

In the study of a cardiovascular-related disease, diabetes, by Leite et al., there is a strong body of evidence that supports the relationship between oral health and type 2 diabetes mellitus, and this established link between periodontitis and diabetes calls for more studies on how to control both diseases, particularly among populations with limited access to oral and health care.

Note, however, that there are still no extensive, long-term randomized trials that can definitely prove a connection. And although current evidence points to the relationship between oral health and cardiovascular health, cardiologists and periodontists are still debating the link between dental health and heart disease, with Robert Bonow, MD, past president of the American Heart Association and chief of cardiology at Northwestern University's Feinberg School of Medicine, contending that if people with poor oral health have more heart attacks, it does not mean that poor oral health leads to poor cardiac health, but that people with good oral hygiene may be taking care of themselves better. Gordon Douglass, DDS, past president of the American Academy of Periodontology, however, noted that although exact relationship between cardiovascular disease and periodontal disease is not yet clear, there is no question that there appears to be a connection between periodontal health and cardiac health. Sally Cram, DDS, a periodontist and a spokeswoman for the American Dental Association, adds that everyone should make a special effort to prevent oral health problems, and that it especially true for those who are at risk for developing cardiac diseases.

Inconclusive studies regarding its relationship with cardiac notwithstanding, considering the benefits of good oral hygiene such as reduction of cavities, plaque, and halitosis and preservation and protection of the teeth, consistent and meticulous brushing, flossing, and periodic oral prophylaxis are highly recommended. And as Douglass noted, the connection between oral health and cardiac health might not be clear, but obviously, there is one. Besides, knowing that having healthy teeth might mean having a healthier heart will surely make our smiles all the more radiant.

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