More Links Between Periodontal & Systemic Diseases

  Periodontium refers to the bone surrounding our teeth, the ligaments that hold our teeth to the bone, and the soft (gingiva or gums) tissue covering our jaw bone and around our teeth.  Periodontal medicine is the effort and art of treating periodontal disease and maintaining ideal periodontal health. Our periodontium experiences a state of disease when stressors cause destruction of the bone, ligament and gum tissues.  The identified stressors that can cause periodontal disease are broad, but a short list includes specific types of bacteria such as Pneumoniae Gingivalis, activation of the body’s immune system leading to inflammation of the periodontium, biting or occlusal stresses, and poor oral hygiene practices such as failure to adequately brush and smoking tobacco, to list a few. Numerous studies over the years suggest the potential relationship between periodontal health and systemic health.  Periodontitis has been linked to hyperglycemia, type 2 diabetes, and cardiovascular disease.  The following recent studies add high blood pressure and respiratory diseases to the list of potential systemic illnesses with ties to periodontal disease.

High Blood Pressure

In a recent study Vieira et al from the University of Sao Paulo, Brazil, found that patients with severe periodontitis may be at risk for high blood pressure, though additional studies are needed to confirm these findings (Vieria CLZ, Cury PR, Miname MH, et al. J Periodontal 2011: 82:683-688). They tracked a body mass index, blood pressure, total cholesterol, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol, triglycerides, glucose levels, white blood cell counts, C-reactive protein levels (indicating inflammation), and carotid artery thickness.  After analysis, only the association between high diastolic blood pressure and severe periodontitis were significant.  Again, additional follow-up studies are needed to confirm these findings, but so far indicators positively link high blood pressure to periodontal disease. I suspect, in lay-men terms, that the inflammation found in periodontal disease has a systemic effect contributing to the high blood pressure.

Respiratory Disease

In another recent study Sharma from the Center for Dental Studies and Research in India studied hospitalized patients to determine whether an association exists between respiratory disease and periodontal disease. A group of 100 patients diagnosed with acute respiratory disease (pneumonia, acute bronchitis, or a lung abscess) or having chronic bronchitis or emphysema were studied.  Another 100 patients without a past or present history of respiratory disease served as the control.  Researchers measured the gums, plaque levels, an oral hygiene index, and boney attachment levels around the teeth. In this study, 72% of the patients had chronic obstructive pulmonary disease such as bronchitis or emphysema, 17% had pneumonia and 11% had lung abscesses.  All findings were higher in the respiratory disease group than in the control group (Sharma N, Shamsuddin H.  J Periodontal 2011; 82:1155-1160). These two studies listed here suggest an association between poor periodontal health and the risk of developing high blood pressure and pulmonary diseases.  It also suggests that dentists may play a significant role in the prevention of these diseases.  Certainly the importance of good oral hygiene at home, and regular dental evaluations and professional oral cleanings cannot be emphasized enough.