In recent years there has been intense research interest around the connection between gum disease (periodontitis) and systemic diseases. Statistics showed that patients with periodontitis were more likely to have other systemic and more serious health problems, such as problems with pregnancy, problems of the cardiovascular system , diabetes , kidney disease and even chronic obstructive pulmonary disease.
What is the evidence?
Apart from the statistical correlation of the above, there is verification based on scientific data and studies that link periodontal disease with systemic diseases through a mechanism of remote attack to various organs. Periodontitis, as an inflammatory disease, has the ability through toxic products of microbes ( toxins) to affect the function of other organs such as the heart, blood vessels, kidneys, pancreas and even the lungs. Meanwhile, even through the bloodstream, these pathogenetic bacteria can speard throught the body and infect distant organs with dire consequences.
The relationship between periodontitis and pregnancy has been studied extensively. Studies have shown that women that have periodontitis, which is not under control during pregnancy, may experience a rapid deterioration of their condition. This can cause much destruction of tissues from disease progression, which has very negative consequences for the future of their teeth. But there is another side of the coin, also very important. Research has shown that pregnant women are more likely to have children with low birth weight (less than 2.2Kg) or to have a preterm birth (before 36 weeks of gestation). Furthermore, the risk of preterm birth appears to correlate directly with the degree of disease progression.
Another group of diseases associated with periodontitis are cardiovascular diseases. Patients who have periodontitis have increased risk for development of cardiovascular problems, compared to patients that have healthy gums. Here the mechanism connecting the two diseases has been studied in depth and confirmed by multiple independent studies. This connection has to do with atherogenesis. The arteries are reduced in diameter and the blood flow through them is reduced. This is particularly important for small arteries that supply the heart, kidney, retina and brain. At the same time, small emboli (small pieces of fatty tissue or clots) can be detached from the plaque on the arterial wall and thus completely block the lumen of the vessel. It is therefore obvious that the existence of Periodontal disease increases the risk of heart attack and stroke, with all the adverse health effects but also for the survival of the patient.
The effects of periodontitis do not stop here though. Patients suffering from diabetes are more predisposed to developing periodontitis. This correlation is so strong that often periodontitis is called the sixth complication of diabetes mellitus. But here we have an interactive relationship. Proper control of periodontitis and good gingival health, improves control of diabetes. Blood glycose levels fall and long-term control becomes easier.
Patients with chronic kidney disease or patients that undergo dialysis are siad to benefit from the periodontal treatment. It has been found that this leads to a reduction in markers of systemic inflammation circulating in the blood. Even patients who have received kidney transplant benefit as studies suggest that there is better tolerance and durability of the transplant into the body of the patient.
Prevention and Treatment
From the above it is clear that the control of periodontitis can only benefit the patient. Treatment is proven and safe and effective, even for patients with systemic diseases. Already in many European countries there are awareness campaigns on the benefits of such treatment, since it is obvious that such a simple intervention can reduce the relative risk of the patient to develop very serious systemic diseases such as diabetes, the risk of a heart attack or a stroke episode .
The only reasonable recommendation we can make is to frequently monitor gingival health and if any problem is detected then the appropriate treatment can be applied. Judging only by the fact that research suggests that periodontal therapy may help reduce the risk of a multitude of systemic diseases, is a valid reason for the patient to seek periodontal treatment.