Periodontal Disease and Overall Health: A Clinician’s Guide, Second Edition provides the latest information and clinical studies pertaining to the oral systemic relationship
A chronic inflammatory disease of the gingiva and periodontiumresults in destruction of gingival connective tissue, periodontal ligament, and alveolar bone. Clinically, inflammation is seen as redness, swelling, and bleeding upon probing.
Diabetes mellitus is a chronic metabolic disorder that has reached epidemic proportions in the United States. The disease affects 18.2 million Americans, yet approximately one-third of these individuals remains undiagnosed. An additional 41 million individuals have prediabetes. It is estimated that one in three that were born in the year 2000 will have diabetes, and that diabetes will increase by 225% between 2000 and 2050.
The bridge between oral and systemic health exists and becomes more concrete as data continue to emerge in support of this relationship. The medical management of diabetes is affected by the presence of chronic infections, such as periodontitis.
The questions that have been raised focusing on the relationship between periodontal diseases and systemic conditions now extend beyond cardiovascular disease and include diabetes, respiratory disease and adverse pregnancy outcomes. Research has demonstrated that the association between oral inflammation and systemic inflammation may be the key to understanding the deleterious effects on multiple organ systems. However, is the relationship so complex that it is like trying to crack the DaVinci Code, or can health care professionals and the public understand the role of inflammation in oral and systemic health?
The World Health Organization (WHO) is an association of ministries of health. Scientific knowledge is used to build public health programs that are evidence-based. The WHO Oral Health Program has interest in oral health/general health relationships as WHO links the continuous improvement of oral health and the control of oral diseases with efforts to control the risk factors of noncommunicable chronic diseases.
Both diabetes and periodontal diseases are common chronic diseases. This article describes the current evidence regarding the relationship between periodontal infections and glycemic control in diabetes. In some individuals, the pathogenesis of diabetes as well as the state of poorer glycemic control appears linked with inflammation and infection. There are important characteristics of periodontal infection that suggest a biologically plausible link to systemic inflammation and adverse effects on glycemic control.
Diabetes is a disease in which the body does not produce or properly use insulin. Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. Of the 20.8 million children and adults in the United States who have diabetes, nearly one-third are unaware that they have the disease.
Cardiovascular disease involves the heart and/or blood vessels. More than 50 million Americans experience cardiovascular problems and cardiovascular disease is the number one cause of death and disability in the United States. By the time heart problems are detected, the underlying cause (atherosclerosis) is usually quite advanced. Therefore, prevention through the modification of risk factors, such as healthy eating, exercise, and not smoking, is key.
Residents of long-term care facilities are often at a greater risk of developing respiratory diseases, such as pneumonia. Poor oral hygiene may be one reason for this development because the bacteria that cause respiratory disease may be present in dental plaque. Previous studies have demonstrated a reduced incidence of respiratory disease development in patients who received daily oral hygiene care while in long-term care facilities.
The objective of this review is to assess the strength of evidence relating periodontal disease and cardiovascular disease. Cardiovascular disease typically encompasses atherosclerosis (including coronary heart disease, peripheral arterial disease, and ischemic stroke), hemorrhagic stroke, congestive heart failure, hypertension, and rheumatic heart disease. This review focuses on atherosclerosis. Periodontal disease and cardiovascular disease may be causally linked or could be explained by common risk factors.
Bone loss is a central, common feature of both periodontal disease and osteoporosis. Osteopenia, or low bone mineral density (BMD), results when bone metabolism becomes unbalanced causing bone resorption to occur at a faster rate than bone production. In periodontal disease, oral inflammation due to chronic infection of the tissue around the teeth results in destruction of oral bone and periodontal ligament, ultimately leading to tooth loss.
Three out of four adults are affected by periodontal disease at some point in their lives and women are particularly susceptible during pregnancy. Pregnant women may find their disease worsening due to hormonal changes that can affect the blood supply to the gums and exaggerate the body’s response to irritation caused by plaque on the teeth.
Many medical professionals consider obesity a chronic disease. Obesity is on the rise in the United States and younger and younger members of our community are becoming obese due to poor nutrition and eating habits. Research demonstrates that obesity increases the risk for hypertension; type 2 diabetes; arthritis; CVD; respiratory problems; and endometrial, breast, prostate, and colon cancers.
Periodontal disease is one of the most common diseases of man and is responsible for most of the tooth loss in adults. Periodontal disease has received considerable attention in the past several decades and a new understanding of the disease is emerging.
The five research articles which appear in this special issue of the Journal of Clinical Dentistry present a series of laboratory and patient-based studies that compare the efficacy of a dentifrice containing 0.3% triclosan, 2.0% PVM/MA copolymer, and 0.243% sodium fluoride (Colgate Total) to a dentifrice containing 0.454% stannous fluoride, sodium hexametaphosphate, and zinc lactate (Crest Pro-Health) for the control of established supragingival plaque and gingivitis.
On behalf of the Colgate-Palmolive Company, I welcome you to the premiere issue of Gingival Health Dialogue -- Investigations and Insights in Gingival Health Research.