Researchers Highlight Link Between Oral Health and Overall Health
February 24, 2006

By Nancy Volkers
InteliHealth News Service

INTELIHEALTH -- Medical conditions as different as stroke and preterm birth can be affected by the health of your mouth and teeth, researchers said at a special briefing in New York held Feb 23. The briefing was sponsored by the American Medical Assocation (AMA) and the American Dental Association (ADA).

"Having the AMA and ADA have a joint press conference and focus on this issue stresses the growing body of research that shows associations between periodontal disease and systemic health," said David Albert, D.D.S., M.P.H., associate professor of clinical dentistry at the Columbia University College of Dental Medicine, who attended the briefing. "What this conference was trying to do was inform the public about what's going on with these studies."

Five speakers took the microphone to discuss the relationship between oral health and general medical health, a connection that has received increased attention over the past decade.

Robert J. Genco, D.D.S, Ph.D., of the State University of New York at Buffalo, said that periodontal disease — a bacterial infection of the gums and other supporting structures of the teeth — can affect the rest of the body. The infection can travel to other areas, lodging in the heart, lungs and other organs. In pregnant women, periodontal disease also can increase the risk of preterm birth, he said.

According to Dr. Genco, studies show that treating periodontal disease improves blood-sugar control in diabetics, reduces the frequency of pneumonia in people in intensive care and reduces the frequency of preterm birth in pregnant women.

Most research on the systemic effects of periodontal disease has been on diabetes. Louis Rose, D.D.S., M.D., said, "The relationship is cyclical. Periodontal disease, if left untreated, will affect a patient's diabetes, and vice versa." Rose urged physicians and dentists who treat diabetic patients to work together closely to optimize their patients' health.

Rose, who is both a physician (affiliated with Drexel University) and a dentist (affiliated with the University of Pennsylvania School of Dental Medicine), explained that periodontal disease throws off the body's immune system and chemical balance, making it harder for diabetics to manage their blood sugar. Similarly, diabetics who do not control their blood sugar are more prone to infections, including periodontal disease.

Periodontal disease has also been linked with cardiovascular disease (stroke, heart disease, and atherosclerosis), though the link is still tenuous. Moise Desvarieux, M.D., Ph.D., of Columbia University's Mailman School of Public Health, said there appears to be a relationship between periodontal disease and atherosclerosis (hardening of the arteries), but researchers aren't yet sure what the nature of the relationship is.

Therefore, he said, "we can't make recommendations for people with periodontal disease with respect to cardiovascular disease."

Dr. Desvarieux recommended that people reduce as many risk factors as they can by not only having their periodontal disease treated, but also by eating a healthy diet, exercising, losing weight if necessary, quitting smoking and managing their blood sugar if they have diabetes.

Steven Offenbacher, D.D.S., Ph.D., of the University of North Carolina, Chapel Hill, presented research showing that periodontal disease that worsens during a pregnancy can put the fetus at risk of very premature birth (prior to 32 weeks gestation). The costs of neonatal intensive care for premature births run into the billions each year, and costs are also high for treating infants with neurodevelopmental disabilities linked to prematurity. Multi-center clinical trials currently are under way to see if treating periodontal disease during pregnancy will reduce the risk of preterm birth.

"Periodontal disease represents a new risk factor (for preterm birth) that we may be able to control," he said. "Studies are now under way to determine whether treating gum disease can also reduce the number of preterm, low birthweight deliveries each year and avoid the associated complications."

Dr. Offenbacher recommended that pregnant women be treated for periodontal disease.

Elizabeth Krall Kaye, Ph.D., M.P.H., presented new research showing that smokers have a higher risk of needing root canal treatment, compared with nonsmokers. The study, based on about 800 men who initially were root-canal free, found that smoking increased a man's risk of needing a root canal by 70%. If a man stopped smoking, his risk fell to that of a nonsmoker after nine years.

Root canal treatment is recommended when a tooth's pulp or center, which contains the nerves and blood vessels, becomes inflamed, infected or traumatized. Severe tooth decay leads to the need for most root canal treatments. Past research has shown that smokers are at a higher risk for tooth decay.

Dr. Kaye suggested that smoking reduces the body's ability to fight infections, which can lead to tooth decay and ultimately to root canal treatment.

Dr. Albert said, "The researchers emphasize the need for prospective, randomized clinical trials to give us more answers. They also stressed the importance of good communication between physicians and dentists," particularly with diabetic patients, he said.

Ultimately, Dr. Albert said, "I think what will happen over time is that the link between oral health and systemic health will become more robust, and dentistry will change because of that."

Read more about the link between oral health and general health.