Periodontitis And Systemic Health

Does periodontal disease cause CHD (coronary heart disease), COPD (chronic obstructive pulmonary disease) or adverse pregnancy outcomes?  The answer could be yes. Periodontal disease may increase the risk for many systemic disorders. A significant interrelationship exists between periodontal disease and systemic health. It’s a two way road wherein chronic inflammatory periodontal disease has a significant effect on systemic health conditions such as coronary heart disease, stroke etc. whereas, systemic host factors or systemic health conditions act locally causing periodontal destruction.

Influence of systemic conditions on the Periodontium:

There are many systemic conditions that can modify the host’s susceptibility to periodontitis.

DIABETES MELLITUS:

It is an extremely important disease from a periodontal standby. The most striking feature in poorly controlled diabetes is reduction in defense mechanisms and increased susceptibility to infections. Various numbers of oral changes have been observed in diabetic patients like decreased salivary flow, dry mouth, increased rate of dental caries and destructive periodontal disease. Periodontal findings include periodontal abscesses, greater loss of attachment, increased bleeding on probing and increased tooth mobility.

HEMATOLOGICAL DISORDERS:

Disorders of any blood cells can have a profound effect on the periodontium as blood cells play an essential role in the maintenance of a healthy periodontium may it be the cellular defense against microorganisms or nutrient supply to the periodontal tissues. Oral and periodontal manifestations include bleeding, hemorrhages, oral ulcerations and periodontal and oral infections. Gingival enlargement often occurs in leukemic conditions.

GENETIC DISORDERS:

Some congenital disorders like Down syndrome are characterized by periodontal diseases like increased plaque and calculus retention, deep periodontal pockets, gingival enlargement etc.

MEDICATIONS:

Some medications like bisphosphonates, corticosteroids are proved to have some negative effect on Periodontium.

Some nutritional deficiencies can affect the condition of Periodontium and may accentuate the deleterious effects in susceptible individuals.

HIV:

There may be an increased risk of periodontal disease in HIV positive patients. They exhibit an exaggerated inflammation of gingiva, necrotizing lesions of gums and Periodontium. These patients can be managed with non-surgical periodontal treatment in the dental office in much the same way as normal patients with respect to strict infection control measures.

PREGNANCY:

During pregnancy, due to hormonal imbalance, various oral manifestations are seen like changes in periodontal tissues. It is characterized by erythema, edema and gingival bleeding. Pyogenic granuloma also known as pregnancy tumor (localized swelling) is common manifestation of gums during pregnancy.

Impact of periodontal infection on systemic health:

Periodontal infection is one of many potential risk factors for a number of systemic conditions. Periodontal diseases should be treated not only to maintain oral health but also to reduce the risk of systemic diseases related to active periodontal inflammation. Periodontal infection may exacerbate existing systemic disorders.

Patients with periodontal disease are at greater risk for arteriosclerotic coronary artery disease (CAD) than patients with healthy periodontal tissues. There is also a connection between periodontal disease and thromboembolic events such as stroke.

In patients suffering from periodontal infection, their glycemic control would be more difficult and they are at higher risk for other complications such as cardiovascular and kidney disease. Diabetic patients may have improved diabetic status once their active periodontal disease is treated.

Periodontitis during pregnancy may have adverse outcomes as periodontitis serves as potential source of microorganisms that may enter the circulation and directly or indirectly have potential to influence the health of the fetus. Low birth weight, pre-term birth and pre-eclampsia can be some of the detrimental results of periodontitis in pregnant women.

Our dentists inform the patients of the potential risks and enhance the quality and longevity of life for our patients. Also our doctors communicate with physicians so that susceptible patients are evaluated for periodontal disease and receive appropriate treatment. Proper long term maintenance therapy is also essential after successful periodontal therapy to consolidate the reduction of risk of systemic diseases.