Is your head where your heart is? It may be now. There is scientific evidence linking periodontal disease, specifically Chronic Periodontitis as a risk factor for other systemic diseases, including diabetes, cardiovascular disease and adverse pregnancy outcomes.

Biological Basis for the Link

It is well documented in the literature that gram-negative anaerobic bacteria are the causative agents responsible for Chronic Periodontitis. These bacteria can initiate a series of inflammatory and immunologic host changes that ultimately lead to destructive effects, such as bone and tooth loss.1,2  It is the systemic spread of gram-negative anaerobic bacteria and their components present in subgingival biofilms, as well as inflammatory mediators that reach high levels in the diseased periodontal tissues, that are the basis for the association between oral disease and “several potentially deadly systemic diseases and conditions.”3,4

The Link is Real

For many decades, there has always been a hypothesis that a connection exists between oral and systemic diseases. For example, the American Heart Association has long recommended antibiotic coverage for certain patients with heart defects during periodontal or dental treatment. Currently, there are 3 basic mechanisms or pathways associating oral infections to secondary systemic effects have been proposed, including: metastatic spread of infection from the oral cavity as a result of transient bacteremia;  metastatic injury from the effects of circulating oral microbial toxins; and metastatic inflammation caused by immunological injury induced by oral microorganisms.5

What Do We Know

Periodontal bacteria can enter the bloodstream and travel to major organs, where it can begin new infections. The research suggests that this process may:6

  1. Contribute to the development of heart disease, the nation’s leading cause of death
  2. Increase the risk of stroke
  3. Increase a woman’s risk of having a preterm low birth-weight baby
  4. Pose a serious threat to people whose health is already compromised by diabetes, respiratory diseases, or osteoporosis

As a result of the collective research, we know that people with periodontal disease are almost twice as likely to suffer from coronary artery disease than those without periodontal disease.6Additionally, we know that there is a 2 – way relationship that exists between chronic periodontal disease and diabetes.  Diabetics with uncontrolled periodontal disease have poor glycemic control and vice versa7. Furthermore, the research now suggests that pregnant women who have periodontal disease may be 7 times more likely to have a baby that is born too early and too small.8

The significant findings that Chronic Periodontitis is a risk factor for many systemic diseases reflect a paradigm shift in the management of their patients. The traditional role of a dentist was from a “repair of damage” mode. Now the emphasis will be on “proactive” to prevent the disease from occurring. Dentists will be the first line of defense to work with physicians to best manage their medical needs.  The doctors at Prestipino Dental Group are experienced in recognition of these conditions and are proactive in its management with your physician.

1.Kunzel C, Lalla E, Albert D, et al. On the primary care frontlines: The role of the general practitioner in smoking-cessation activities and diabetes management. JADA. 2005;136:1144-53.

  1. U.S. Department of Health and Human Services. Oral Health in America: A Report of the Surgeon General. Rockville, MD: 2000.
  2. Page R. Introduction to periodontal diseases: Clinical presentations, etiology, and pathogenesis. Public Health Implications of Chronic Periodontal Infections in Adults.
  3. Amar S, Han X. The impact of periodontal infection on systemic diseases. Med Sci Monit. 2003;9(12):RA291-9.
  4. Li X, Kolltveit KM, Tronstad L, et al. Systemic diseases caused by oral infection. Clin Microbiol Rev. 2000;13(4):547-58.
  5. Scannapieco FA, Papandonatos GD, Dunford RG. Associations between oral conditions and respiratory disease in a national sample survey population. Ann. Periodontol. 1998;3: 251-6.
  6. Grossi SG, Genco RJ. Periodontal disease and diabetes mellitus: a two-way relationship. Ann. Periodontol. 1998;3:51-61.
  7. Offenbacher S, Katz V, Fertik G. Periodontal infection as a possible risk factor for preterm low birth weight. J. Periodontol. 1996;67:1103-13.