An estimated 60 million Americans have periodontal disease.

Over the past decade, an increasing amount of scientific evidence has shown an association between periodontal disease – along with the bacteria that cause it – and systemic diseases affecting other areas of the body, such as cardiovascular disease, diabetes, stroke and preterm low birth weight babies. Linking what happens in the mouth to what occurs throughout the rest of the body is a similar inflammatory response.

However, it is important to note that the development of gingival inflammation or symptoms of periodontal disease does not mean a person will definitely develop a systemic condition. There are many other factors that contribute to the onset of heart disease, diabetes, stroke, etc.

What Are the Oral-Systemic Associations?

Driving the link between oral disease and systemic conditions is the fact that periodontal bacteria can enter the bloodstream and travel to other parts of the body, where it can initiate new infections, trigger or exacerbate an inflammatory response. It’s important to understand that an infection in the mouth is an infection in the body – and like any infection, it can spread. Additionally, as a result of infection, the body produces certain proteins that circulate in the blood, known as C-Reactive Protein (CRP). These proteins can cause an irritation to blood vessel walls that ultimately leads to artery narrowing. This can subsequently lead to heart attack or stroke. Systemic medical conditions affected by periodontal disease and oral bacteria include the following:

Atherosclerosis. Atherosclerosis is an inflammatory disease. Periodontal disease and atherosclerosis frequently coexist in the same person. Studies have shown that with the treatment of gum disease, both the periodontal inflammation and systemic inflammation may decrease. Since atherosclerosis is an inflammatory disease, periodontal treatment may benefit the cardiovascular system. In fact, scientists have shown that intensive periodontal treatments have led to improvements in arterial health. Just like cholesterol, testing for CRP has become part of blood testing for cardiac risk factors.

Adverse Pregnancy Outcomes. The presence of periodontal disease in pregnant women has been linked to preterm births, gestational diabetes, preeclampsia (a sudden rise in blood pressure late in pregnancy), delivery of low birth weight babies and fetal loss. However, researchers have found a reduction in the number of preterm births among women who received periodontal treatment during pregnancy compared to those who waited until after delivery to receive treatment. Pregnant women suffering from periodontal disease may be seven times more likely to have a baby that is born too early and too small. Women considering pregnancy are advised to undergo a complete periodontal examination.

Pneumonia. Periodontal infections can travel into the neck and chest, as well as lodge in the lungs. In fact, research has shown that periodontal bacteria and pathogens are aspirated (breathed in) into the airway of people with severe gum disease, but that regular tooth and gum cleanings may help prevent pneumonia.

Diabetes. Periodontal inflammation is a complication of diabetes. People with diabetes are more prone to infection and severe periodontal disease, meaning they may need to see their dentist more frequently for routine cleanings. Reducing gum infections with antibiotics has been shown to improve diabetes control.

Heart Disease. People with periodontitis, particularly infections causing a high concentration of pathogens in the blood, are at greater risk of coronary heart disease (CHD). What’s more, the use of antibiotic treatment has long been recommended for patients with certain heart conditions when they undergo periodontal therapy. In addition, research has connected periodontal disease and related bacteria to cardiovascular disease, stroke, infective endocarditis and other heart conditions.

Authored By: Allison DiMatteo / Reviewed by: W. Peter Nordland, DMD