Healthy
Gums and a Healthy Heart: The Perio-Cardio Connection
[Submitted by Dr. Andreas Siebold on 21
September, 2009]
Newly
released clinical recommendations encourage cardiologists to examine the
mouth and periodontists to ask questions about heart health
CHICAGO
– Cardiovascular disease, the leading killer of men and women in the
United States, is a major public health issue contributing to 2,400
deaths each day. Periodontal disease, a chronic inflammatory disease
that destroys bone and gum tissues that support the teeth affects
nearly 75 percent of Americans and is the major cause of adult tooth
loss. And while the prevalence rates of these disease states seems
grim, research suggests that managing one disease may reduce the risk
for the other.
A
consensus paper on the relationship between heart disease and gum
disease was recently published concurrently in the online versions of
two leading publications, the American Journal of Cardiology (AJC),
a publication circulated to 30,000 cardiologists, and the Journal
of Periodontology (JOP), the official publication of the American
Academy of Periodontology (AAP). Developed in concert by
cardiologists, the physicians specialized in treating diseases of the
heart, and periodontists, the dentists with advanced training in the
treatment and prevention of periodontal disease, the paper contains
clinical recommendations for both medical and dental professionals to
use in managing patients living with, or who are at risk for, either
disease. As a result of the paper, cardiologists may now examine a
patient’s mouth, and periodontists may begin asking questions about
heart health and family history of heart disease.
The
clinical recommendations were developed at a meeting held earlier this
year of top opinion-leaders in both cardiology and periodontology. In
addition to the clinical recommendations, the consensus paper
summarizes the scientific evidence that links periodontal disease and
cardiovascular disease and explains the underlying biologic and
inflammatory mechanisms that may be the basis for the connection.
According
to Kenneth Kornman, DDS, PhD, Editor of the Journal of
Periodontology and a co-author of the consensus report, the
cooperation between the cardiology and periodontal communities is an
important first step in helping patients reduce their risk of these
associated diseases. “Inflammation is a major risk factor for heart
disease, and periodontal disease may increase the inflammation level
throughout the body. Since several studies have shown that patients
with periodontal disease have an increased risk for cardiovascular
disease, we felt it was important to develop clinical recommendations
for our respective specialties. Therefore, you will now see
cardiologists and periodontists joining forces to help our
patients.”
For
patients, this may mean receiving some unconventional advice from
their periodontist or cardiologist. The clinical recommendations
outlined in the consensus paper advise that periodontists not only
inform their patients of the increased risk of cardiovascular disease
associated with periodontal disease, but also assess their risk for
future cardiovascular disease and guide them to be evaluated for the
major risk factors. The paper also recommends that physicians managing
patients with cardiovascular disease evaluate the mouth for the basic
signs of periodontal disease such as significant tooth loss, visual
signs of oral inflammation, and receding gums.
While
additional research will help identify the precise relationship
between periodontal disease and cardiovascular disease, recent
emphasis has been placed on the role of inflammation - the body’s
reaction to fight off infection, guard against injury or shield
against irritation. While inflammation initially intends to have a
protective effect, untreated chronic inflammation can lead to
dysfunction of the affected tissues, and therefore to more severe
health complications.
“Both
periodontal disease and cardiovascular disease are inflammatory
diseases, and inflammation is the common mechanism that connects
them,” says Dr. David Cochran, DDS, PhD, President of the AAP and
Chair of the Department of Periodontics at the University of Texas
Health Science Center at San Antonio. “The clinical recommendations
included in the consensus paper will help periodontists and
cardiologists control the inflammatory burden in the body as a result
of gum disease or heart disease, thereby helping to reduce further
disease progression, and ultimately to improve our patients’ overall
health. That is our common goal.”
To
learn more about gum disease, locate a periodontist, or to find out if
you are at risk for periodontal disease, visit perio.org or call (800)
FLOSS-EM (800/356-7736).
About
the American Academy of Periodontology
The
American Academy of Periodontology (AAP) is the professional
organization for periodontists, specialists in the prevention,
diagnosis, and treatment of diseases affecting the gums and
supporting structures of the teeth, and in the placement of dental
implants. Periodontists are also dentistry’s experts in the
treatment of oral inflammation. They receive three additional years of
specialized training following dental school, and periodontics is one
of the nine dental specialties recognized by the American Dental
Association. The AAP has 8,000 members world-wide.
