Cardiovascular

The evidence suggests an association—but not a causal relationship—between periodontal disease and heart disease. Results of case-control studies indicate that periodontal bacterial infection may be associated with myocardial infarction. Oral bacteria have been found in carotid atheromas and some oral bacteria may be associated with platelet aggregation, an event important for thrombosis. These studies suggest that periodontal infection may be a contributing risk factor for heart disease. However, these are early investigations and since even a small elevated risk of heart attack due to periodontal infection could have disastrous results, it is prudent to have all infections treated in a timely manner.

Stroke

Additional studies have pointed to a relationship between periodontal disease and stroke. In one study that looked at the causal relationship of oral infection as a risk factor for stroke, people diagnosed with acute cerebrovascular ischemia were found more likely to have an oral infection when compared to those in the control group.

Pregnancy Complications

For a long time it has been known that risk factors such as smoking, alcohol use, and drug use contribute to mothers having babies that are born prematurely at a low birth weight. Now evidence is mounting that suggests a new risk factor – periodontal disease. In a study co-authored by Dr. Collins, it was shown that pregnant women who have periodontal disease are seven times more likely to have a baby that is born too early and too small. Oral infections such as periodontal disease should be treated before pregnancy and now due to these studies, patients are even being treated during pregnancy to reduce the likelihood of adverse pregnancy outcomes.

Obesity

Adult participants in the National Health and Nutrition Examination Survey (NHANES III) had a periodontal examination and were selected for the analysis. Body mass index (BMI) and waist circumference (WC) were used as measures of overall and abdominal fat content. Statistical models were used to estimate the association between increased body weight and periodontal disease. Patients were also stratified by age: younger age (18 to 34 years old), middle-aged (35 to 59 years old), and older (60 to 90 years old) adults.

Results: A significant association between the measures of body fat and periodontal disease was found among the younger adults, but not middle or older adults. Young subjects with high WC (larger waistlines)were 2.5 times more likely to have periodontal disease.

Conclusions: In a younger population, overall and abdominal obesity is associated with increased prevalence of periodontal disease. Obesity could be a potential risk factor for periodontal disease especially among younger individuals. Promotion of healthy nutrition and adequate physical activity may be additional factors to prevent or halt the rate of progression of periodontal disease.

Osteoporosis

There is increasing evidence that osteoporosis, and the underlying loss of bone mass characteristic of this disease, is associated with periodontal disease and tooth loss. Periodontitis has long been defined as an infection-mediated destruction of the alveolar bone and soft tissue attachment to the tooth, responsible for most tooth loss in adult populations. However studies that focus on the relation of gum loss and osteoporosis are less consistent. Systemic loss of bone density in osteoporosis, including that of the oral cavity, may render a patient more susceptible to infectious destruction of periodontal tissue. Studies have provided evidence that hormones, heredity, and other host factors influence periodontal disease incidence and severity. Both periodontal disease and osteoporosis are serious public-health concerns in the United States. Prevalence of both osteoporosis and tooth loss increase with advancing age in both women and men. Understanding the association between these common diseases and the mechanisms underlying those associations will aid health professionals to provide improved means to prevent, diagnose, and treat these very common diseases.