The Gum Disease - Heart Disease Project

The Gum Disease - Heart Disease Project

www.perioheart.com

THE PROBLEM

Scientific studies have been done which have established an association between gum disease(periodontitis) and cardiovascular disease. While the exact mechanism which links gum disease and cardiovascular disease has not been firmly established, the association between the two disease entities is cause for concern. In our health-conscious society, it is being recommended that patients with cardiovascular disease and especially those with heart valve deficiencies and/or replacements be monitored more thorougly regarding their periodontal status.

THE RESEARCH

Initial research was done in Finland which presented evidence in 1989 that even when conventional risk factors for strokes and heart attacks were taken into account, dental infections were associated with strokes (reference #1) and heart attacks (reference #2). Another study examining 9,760 men during a period spanning 1971-1987, confirmed the conclusions of the Finnish study which linked coronary artery disease and gum disease (reference #3). The most noteworthy finding ws that gum disease and poor oral hygiene are stronger indicators of risk of total mortality than were coronary artery disease. Other research has shown a strong association between bone loss from gum disease and both fatal coronary heart disease and strokes (reference #4).

References:

1.	Syrjanen J. et al: Dental infection in association with cerebral infarction in young and middle-aged men.J Intern Med 225:179-184,1989.
2.	Mattila KJ, et al: Association between dental health and acute myocardial infarction. Brit Med J 298:779-782,1989.
3.	DeStefano F, et al:Dental disease and risk of coronary heart disease and mortality. Brit Med J 306:688-691, 1993.
4.	Beck J, et al: Periodontal disease and cardiovascular disease. J Periodontal 67 (suppl): 1123-1137,1996.

THE MECHANISM OF ACTION

Some of the proposed mechanisms of the gum disease (periodontitis) and heart disease association are:
A. The primary association between heart disease and strokes and periodontal disease appears to be the relationship between inflammation (infection) and the production of C-reactive protein.Any inflammation in the body produces C-reactive protein. In studies at Harvard University, C-reactive protein has had a stronger relationship between heart attacks and strokes than high cholesterol levels - the predictability of heart attacks and strokes was twice as great as it related to C-reactive protein than was the association with cholesterol levels. (reference #5).
B. Patients with periodontitis have significantly higher levels of inflammatory products (fibrinogen and white blood cells) which are well known risk factors for acute heart attacks.
C. Dental bacterial components affect the body's response to infection and can play a role in the development of atherosclerosis.
D. New development in medical research is further raising concerns that bacteria can cause heart attacks. One bacteria, Chlamydia pneumoniae has been found in the walls of the blood vessel of patients who have had heart attacks (reference #6).

5.	Ridker P. et al: Comparison of C-reactive protein and low-density lipoprotein cholesterol levels in the prediction of first cardiovascular events. N Eng J Med, Vol 347 No. 20:1557, 2002
6.	Shor A and Phillips J. Chlamydia pneumoniae and Atherosclerosis. JAMA 262;2071-2073, 1999.

THE SIGNIFICANCE

While the exact mechanism between gum disease and heart disease and strokes is not completely understood, the Gum Disease - Heart Disease Project and this website, www.perioheart.com are designed to:

A.	Increase the monitoring of the gum health status on those patients who have had heart attacks, have a family history of heart attacks or have a tendency toward strokes.
B.	Increase the monitoring of the gum health status of patients who have had heart valve problems or have had heart valve replacements.
C.	Increase the awareness regarding how any patients who need antibiotic pre-medication before dental treatment may need a closer monitoring of the health of their gums.

This website, www.perioheart.com
will further address:

1. Questions about Heart Disease and Gum Disease
2. The Treatment of Gum Disease
    A. The signs
    B. The causes
    C. The risk factors
    D. The treatments
3. The www.perioheart.com Periodontists