A team of experts, after evaluating various reports associated with the periodontal (oral) and other diseases — published in the last 20 years — has noted that systemic inflammation due to pathogens associated with bad teeth and gums cannot only play a role in the initiation but also progression of life-threatening ailments.
“Periodontal infections should therefore be considered as a risk factor for various systemic diseases,” said the experts BC Manjunath, Anondya Bhalla, Kudva Praveen and RM Vatchala Rani from People’s Dental Academy in Bhopal in their study published in the latest edition of the National Journal Medical of India.
Periodontal disease is the result of host inflammatory reaction to infection by bacteria found in dental plaque. About 10 species have been identified as putative pathogens in periodontal disease.
Highlighting the importance of good oral health, the study has come in the background of the rising prevalence of CVD, cerebrovascular accidents, respiratory infections and diabetes worldwide. As it identifies risk factors other than the traditionally recognised ones, the study can help in effectively preventing and managing these maladies.
According to the report, poor dental health has been associated with an increased risk of fatal coronary heart disease (CHD). Thus, maintenance of good oral hygiene is important. A study has shown that infrequent brushing of the teeth was associated with increased concentrations of C — reactive protein (CRP) and fibrinogen — both associated with coronary arterial plaque formation.
The researchers also noticed that various studies have correlated periodontal disease with stroke. “Periodontal infections are associated with systemic inflammation characterised by an increased burden of periodontal pathogens, antigens, endotoxins and liberation of pro-inflammatory cytokines, which may contribute to atherogenesis and thrombo-embolic events culminating in ischaemic stroke.”
Also, low birth-weight and preterm babies are associated with periodontal infections. Many prospective cohort studies, case-control studies and cross-sectional observational studies have correlated poor maternal periodontal health with low birth-weight (LBW) and preterm babies, the report adds.
Similarly, dental plaque may promote oral and oropharyngeal colonisation by respiratory pathogens. Bacteria from oral biofilms may be aspirated into the respiratory tract to initiate and cause progression of conditions such as aspiration pneumonia, chronic obstructive pulmonary disease (COPD) and lower respiratory tract infections, it says.
Also, periodontitis has been described as the sixth complication of diabetes, together with retinopathy, nephropathy, neuropathy, macrovascular disease and altered wound healing. The inflamed gums increase the insulin resistance.
“In this background, there is a need to educate both dentists as well as general healthcare practitioners about this important aspect of oral health. It is also necessary to coordinate with medical institutions where the results of emerging research are translated into practice guidelines,” suggest the experts.
Agreeing with the observations, Dr SK Ojha, General Secretary of Dental Council of India said, “To prevent gum diseases proper oral hygiene is essential. Teeth brushing should occur at least twice a day. The spaces between the teeth should also be cleaned daily with floss or special interdental brushes.”
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