ask dr. dyer

Periodontal – Gum Disease and Heart Disease

The Health Threat in Your Mouth

“When we examined Lauralee’s mouth, we discovered a very surprising—and rather ironic—red flag for heart attack and stroke risk: the young dentist had periodontal disease, the very condition that she specialized in treating at her clinic. People with periodontal disease—a bacterial infection of the gums, connective tissue, and bone supporting the teeth—have double or even triple the risk of a heart attack or stroke, recent research suggests.” “I was so busy taking care of other people that I wasn’t very good about taking care of myself,” admits Lauralee. “I probably flossed twice a week, if I remembered, and got my teeth cleaned every year or two. In hindsight, I recall my hygienist asking me if I was pregnant, because my gums looked completely inflamed. I thought that was a silly question, but it turned out to be a red flag that I wasn’t savvy enough to recognize at the time.” From “Beat the Heart Attack Gene: The Revolutionary Plan to Prevent Heart Disease, Stroke, and Diabetes” by Bradley Bale, Amy Doneen.

Almost 75 percent of Americans have some degree of gum disease, the most common chronic infection in the United States, many of whom don’t know they have it, because in the early stages, the disease is painless. When the infection is relatively mild, it’s called gingivitis and when it’s more severe, it’s known as periodontal disease (PD). At age 30, there’s a 50 percent probability that you have periodontal disease and by the time you’re 65, risk rises to 70 percent. The leading warning sign of PD is bleeding gums. Contrary to what many patients assume, it is not normal to experience any bleeding, even slight amounts, when you brush or floss. Other symptoms of periodontal disease include bad breath, puffy or receding gums, teeth that look longer (due to receding gums), loose teeth, pockets of pus between your gums and teeth, or a change in your bite. Risk factors for developing periodontal disease include poor oral hygiene, smoking, diabetes, and the hormonal upheavals of pregnancy.

Periodontal disease is more likely to strike men than women and disproportionately affects people of certain ethnicities, such as Mexican-Americans. If you have any of these warning signs, alert your dentist or dental hygienist and ask to be screened for PD. Screening is painless and typically involves: A visual inspection and exam of your gums, using a mirror and periodontal probe, to check for redness, puffiness, or other signs of oral infection. Positioning the probe at six specific points of each tooth where it’s attached to the gum, to measure pocket depth.

Pockets measuring three millimeters or more indicate disease. Checking for tooth movement. Loose teeth are another sign of gum disease and loss of bone support for the teeth. When the first studies linking oral infections to higher risk for cardiovascular disease appeared nearly a decade ago, the Bale/Doneen Method immediately began advising healthcare providers to check patients for periodontal disease.

Today, scientific evidence that healthy gums help prevent heart attacks and strokes is so powerful that the editors of The American Journal of Cardiology and the Journal of Periodontology issued a consensus statement recommending that: Doctors and dentists warn patients with moderate to severe gum disease of their potential cardiovascular danger. Patients with gum disease should get a complete physical exam and blood pressure measurement annually. These patients should also be checked for diabetes, high cholesterol, and a family history of early deaths from cardiovascular disease (CVD). People with gum disease and one or more other CVD risk factors, such as blood pressure or high cholesterol, should be treated with lifestyle changes and if necessary, medications.