Periodontal disease is a serious communicable infection which, if left untreated, has potential “life threatening” consequences. The objective of this article is for you and your loved ones to better understand the impact of periodontal disease and overall health. Key words are Biofilm, Perio Disease Development, C-Reactive Protein, Perio-Systemic Links, Medical Manifestations, Clinical Significance and the Future.
Biofilm, or plaque, is a layer of bacteria enveloped by a dense, slimy matrix that is attached to the tooth or gum. The early colonizers of this biofilm are beneficial bacteria, later colonizers are pathogenic. It is these later pathogens that disturb the gingival epithelium allowing bacteria to invade - this causes cell death and infection. Peridodontal Disease is therefore an ‘infection’. The infection causes an inflammatory response, increased blood flow, gaps in blood vessel walls and further infection. The immune system attacks the infection and in so doing, causes resorption of bone and the inflammatory response causes tissue destruction.
Periodontal disease causes a significant increase in the C-Reactive Protein (CRP) which is a sign of infection and inflamation. CRP can cause the development of clots and plaque resulting in Coronary Artery Disease. The sequence is as follows:
Biofilm, Bacteremia, Inflammatory Response, CRP Increase, Vascular Effects
Women with periodontitis are 4-8 times more likely to have a premature, low-birth weight baby - oral microbes cross the placenta and expose the fetus to infection. Scaling and Root Planing Treatment (SRP) during the 2nd trimester results in a 3.8 fold reduction of pre-term delivery.
82% of diabetic patients with severe periodontitis experienced the onset of cardiovascular events compared to only 21% of diabetics without periodontitis. The treatment of periodontal disease must be considered as integral to diabetic management - it is not an elective treatment.
There is a clear link between endocarditis and periodontal disease where oral bacteria effect the mitral valve and create infection of the innermost layers of the heart.
Conclusions and Recommendations:
· Periodontal disease is directly linked to heart attacks, strokes, coronary artery disease, diabetic side effects, premature low-birth weight babies and endocarditis.
· Use of Arestin or other antimicrobial treatments is highly effective, at both the root planing and scaling appointments and perio maintenance appointments.
· 30-40% of adult patients have periodontitis.
· After 90 days, the biofilm is firmly reestablished, therefore continuing care visits will be recommended at 3 month intervals.
· Never allow your insurance company to dictate your treatment.
· Check your C-Reactive Protein routinely through your family physician.
· Set up an improvement plan of continuing care visits with your dentist and hygienist.