|
Can periodontal disease increase my risk for heart disease?
Over the years research has shown periodontal disease may have an association with the
onset of many systemic diseases including heart disease. Periodontal disease occurs due to
the formation of plaque, which contains bacteria. If the bacteria enter the bloodstream they
may secrete chemicals that cause the immune system to respond the same way as it would to
other illnesses like pneumonia or infected cuts.
The presence of periodontal disease, which is left untreated, may place you at a much greater
risk of cardiovascular disease. Research is finding increasing evidence that the presence of
chronic bacterial infection (periodontal disease) may put a person at increased risk of heart
disease and increase the risk of a fatal heart.
There are several theories to explain how this can happen. One theory is that when bacteria
from the mouth enter the blood stream, they are able to accumulate in the blood vessels and
heart tissues. This thickens the artery walls, which is a characterization of Coronary Artery
Disease. These bacteria also contribute to the formation of blood clots. The combination of the
formation of blood clots and thickening arteries tend to restrict the normal flow of blood which
in turn restricts the oxygen and nutrients required for the heart. Another theory is that
periodontal disease causes inflammation, because of the increased plaque build up, which
may contribute to the swelling of the arteries.
Periodontal disease can also aggravate existing conditions. If a person is at risk of infective
endocarditis, antibiotics may be required prior to dental procedures being done. Your
cardiologist and your periodontist will inform you if your condition requires this antibiotic
pre-medication prior to treatment.
Back to top
Periodontal disease (gum disease) is an infection of the tissues, which surround and support
the teeth. If left untreated periodontal disease will lead to damage of the supporting structures,
bone and tissue, and may lead to tooth loss.
Periodontal disease is caused by plaque, which accumulates at or beneath the gum line.
This plaque contains bacteria, which may damage the gums, by causing swelling and
inflammation. When this occurs the gums separate from the teeth, forming pockets. These
pockets are spaces around the teeth where bacteria and other debris can accumulate, leading
to further inflammation and eventual bone loss. In many cases, periodontal disease is painless
and as such, most people are unaware that the disease may be present in their own mouth.
Periodontal disease is the leading cause of tooth loss in adults. Once the bone has been lost,
it usually cannot be regenerated, however if it is diagnosed early, treatment may help in
preventing the disease process from becoming worse.
Stages of Periodontal Disease:
- Healthy gums - firm and pink
- Gingivitis - inflamed, red, puffy and bleeding gums
- Early periodontal disease - continued inflammation causing the gums to pull away from the
teeth. Formation of pockets around the teeth and the beginning stages of bone loss
- Moderate periodontal disease - continued spread of infection causing further bone loss,
resulting in loose and shifting teeth, and recession of the gum tissue
- Advanced periodontal disease - chronic infection that can result in painful abscesses
around the teeth, destroying bone and tissue. The teeth can no longer be supported and may
be lost.
Periodontal disease progresses at slow rate in most individuals and may be undetected for
months or years. In many cases, due to the lack of pain, individuals are not aware of the
presence of the disease. The best prevention is visiting your dentist for routine check ups and
cleanings. Being aware of the warning signs and symptoms can help you detect the problem
early on and seek treatment.
SIGNS TO BE AWARE OF:
- Bleeding
- Inflamed gums (red, swollen and tender)
- Pus visible around the teeth when you press the gums
- Receding gums making teeth look longer
- Exposed roots causing sensitivity to hot and cold
- Teeth that feel loose when touched with tongue or finger
- Open space between teeth that was not there before
- Persistent bad taste or breath
- Changes in your bite
- Changes in how your partial dentures fit
If you suspect that you have periodontal disease, see your dentist. Maintaining regular dental
visits can help detect problems early on and keep your mouth healthy and disease free.
Back to top
There are two types of tissue around teeth - attached tissue and mucosal tissue. The attached
tissue is the firm, pink tissue close to the teeth, and is vital in maintaining health around the
teeth. The mucosal tissue is loose, thin and located further away from the teeth. When the
gums recede, there is loss of the attached tissue. This can compromise the health of the
tissue and lead to bone problems around the teeth.
Treatment of loss of attached tissue is most commonly done using a tissue graft. Soft tissue
grafts can be used to cover roots or develop gum tissue where it has been lost due to
excessive gingival recession. This procedure involves taking attached tissue from another part
of the mouth (most commonly the roof of the mouth), and moving it to the area where the
tissue defect exists. The area which donates the tissue will heal and fill back in with more
attached tissue. This procedure helps rebuild some of the lost tissue to maintain health of the
gums and teeth.
A soft tissue graft can reduce further recession and bone loss. In some cases, it can cover
exposed roots to protect them from decay. This may reduce tooth sensitivity and improve the
esthetics of your smile.
Bone Grafting
Bone grafting is generally required in areas where bone has been lost, in an attempt to
generate enough bone for the placement of implants or to recontour bone in areas where
bone has been lost during dental extractions. Bone grafting may also be performed around
teeth that have localized bone defects caused by periodontal disease.
The amount of bone required will determine the type of grafting materials to be used. If the
area to be grafted is relatively small, biocompatible bone products can be used (called an
Allograft). If the area to be grafted is larger, bone from the patient is used (called an Autograft).
Bone grafting is a routine procedure that can be used in a variety of treatment situations, and
may help rebuild lost bone and improve the appearance of your smile.
Back to top
Periodontal (gum) disease is one of the leading causes of tooth loss. Plaque and tartar that
build up on the teeth contain bacteria, which cause tissue inflammation and destroy the
supporting bone around the roots of the teeth. Periodontal disease can be treated by either a
surgical or non-surgical approach, depending on how advanced the disease process is.
Initial Phase
In most cases removal of this bacteria using a non-surgical approach is the initial step in
treatment. This initial phase in the treatment of periodontal disease is scaling and root planing.
Scaling involves removal of the bacteria and other debris from the crown and root surfaces of
the teeth. Root planing involves smoothing the root surfaces of the teeth, in areas where they
have become rough due to tartar. Antibiotics are sometimes used in addition to this
non-surgical therapy and may be given in oral systemic doses or can be placed directly into
the gum pocket.
Depending on the severity of the disease process, some individuals require local anesthetic
for the scaling and root planing appointment. This treatment involves a deep and thorough
cleaning around the roots of the teeth, and although this deep cleaning cannot restore the lost
bone and tissue, it can prevent the disease process from advancing and help to prevent tooth
loss. Once the teeth have been thoroughly cleaned, the disease process is slowed, however,
proper home care is a vital component of successful treatment.
Surgical Phase
If advanced bone and tissue destruction has occurred from periodontal disease, or if the initial
scaling and root planning have not adequately removed all the bacteria, plaque and tartar
from the tissue pockets around the teeth, periodontal surgery may be required.
Flap surgery is performed to further clean the roots of the teeth and to reduce the depth of the
tissue pockets that may exist around the teeth with advanced bone loss. Flap surgery involves
pushing back the gum tissue away from the supporting bone and teeth, to allow the dentist to
gain access to the root of the tooth for the removal of plaque, calculus and diseased tissue.
The gum is then carefully sutured back into place. This is done with local anesthetic.
Guided tissue regeneration (GTR) may be performed to help rebuild tissue that has been lost.
This is usually performed in conjunction with flap surgery, and may be performed in an
attempt to restore or regenerate missing bone and tissue around teeth subjected to longstanding
gum disease.
GTR refers to procedures that attempt to regenerate lost bone, periodontal ligament and
connective tissue that support our teeth. This is accomplished using biocompatible membranes, often in combination with bone grafts and/or tissue stimulating proteins.
Back to top
A periodontist is a dentist who specializes in the diagnosis, prevention and treatment of
periodontal gum disease. In addition to the latest techniques for diagnosing and treating gum
disease, a periodontist can perform the surgical placement of dental implants, tissue grafting
procedures and cosmetic gum procedures.
Periodontists receive three additional years of extensive training beyond dental school in a
graduate program. General dentists often refer patients to a periodontist for the treatment of
periodontal disease or for tissue related procedures. Some individuals who have advanced or
uncontrolled periodontal disease may require the advanced knowledge and training that a
periodontist has, to provide the necessary treatment.
Periodontal disease is one of the leading causes of tooth loss. If you suffer from periodontal
disease, a periodontist may be able to help you save your teeth.
Back to top
|
