America’s number one killer…
Although it’s a bit early to shout it from the rooftops, scientific research shows that good dental care might reduce the number of deaths caused by America’s number one killer.
Periodontal disease, the end result of poor oral hygiene, has been implicated as a risk factor for cardiovascular disease.
High blood pressure, strokes, coronary heart disease, and congestive heart failure – collectively known as cardiovascular disease (CVD) – account for one of every three deaths in the United States each year. According to the American Heart Association, CVD claimed over 830,000 lives in 2006; over half of these were attributable to coronary heart disease (heart attacks) alone. (1)
Among some populations, the statistics are even grimmer: 65% of all deaths in people who have type 2 diabetes are caused by CVD. (2)
Although a great deal of research and a large portion of our healthcare dollars are devoted to ameliorating the impact of CVD, it is incumbent upon every person to adopt a lifestyle that minimizes the risk for succumbing to this devastating condition.
That’s where a daily dental care regimen of tooth brushing and flossing – along with regular visits to a best dentist and hygienist – enters the picture.
Inflammation Is at the Heart of Cardiovascular Disease
Clinical studies have confirmed that inflammation plays a key role in the genesis of atherosclerosis, or hardening of the arteries. Inflammation, of course, is our immune system’s natural response to injury and foreign invaders. Any time an unfamiliar entity – a bacterium, fungus, virus, allergen, or parasite – breaches our immune defenses, it triggers a cascade of physiologic events that are designed to eliminate the intruder. Inflammation is the initial “all-or-none” phase of this cascade.
Unfortunately, uncontrolled inflammation can harm our tissues and organs. This is why inflammation is normally “down-regulated” after a threat has been addressed. If our immune defenses are constantly being challenged, however, inflammation persists and our tissues are subjected to chronic, low-grade injury.
This seems to be the situation for many people who already suffer from cardiovascular disease…and for many others who are at risk. Scientists have learned that they can detect inflammation in the tissues of these individuals by measuring certain chemicals in their blood. Indeed, physicians now routinely measure levels of a specific protein – called C-reactive protein, or CRP – to assess patients’ risk for CVD or to evaluate their response to medical treatment.
Periodontal Disease Raises the Risk for Cardiovascular Disease by Increasing Inflammation
For more than two decades, scientists have speculated that periodontal disease and cardiovascular disease are linked. For example, in 1996 Dr. James Beck demonstrated that men who had periodontal disease were nearly twice as likely to die from heart attacks as men who had healthy oral tissues. Furthermore, the risk of developing CVD was proportional to the severity of periodontal involvement. Beck suggested that periodontal disease provided an ongoing source of bacterial toxins and inflammatory mediators that both initiated and aggravated atherosclerosis. (3)
Although several investigators have drawn the same conclusions that Dr. Beck and his colleagues did, not all studies support an association between periodontal dental disease and CVD. However, one 2003 meta-analysis of all relevant data dating back nearly 25 years showed that periodontal disease did, indeed, increase a person’s risk of CVD by about 20%, and for individuals younger than 65 years the risk was increased by over 40%. (4)
More recently, in an elegant experiment designed to evaluate how the treatment of mild to moderate periodontal disease in human volunteers might reduce their risk for CVD, Dr. Stefania Piconi and a team of scientists demonstrated a decrease in the number of bacteria in test subjects’ mouths, a reduction in inflammatory mediators in their bloodstreams, and improvement in the appearance of their major arteries following treatment. (5)
Such results offer compelling evidence that periodontal disease – even when it is mild – is a “modifiable” risk factor for CVD.
How many heart attacks and strokes could be prevented if periodontal disease was virtually eliminated? It’s hard to say. But, with 40% of the American population suffering from periodontal disease, and with over 80 million of us also having some form of cardiovascular disease, it seems clear that good oral hygiene is another “heart healthy” habit we should all acquire.
1. American Heart Association. Cardiovascular Disease Statistics. March 19, 2010
2. Gavin J, Peterson K, Warren-Boulton E. Reducing Cardiovascular Disease Risk in Patients with Type 2 Diabetes: A Message from the National Diabetes Education Program. Am Fam Phys. 2003;68(8):1569-74
3. Beck J, Garcia R, et al. Periodontal disease and cardiovascular disease. J Periodontol. 1996;67(10 suppl):1123-37
4. Janket S, Baird A, et al. Meta-analysis of periodontal disease and risk of coronary heart disease and stroke. Oral Surg, Oral Med, Oral Path, Oral Radiol, Endod. 2003;95(5):559-695
5. Piconi S, Trabattoni D, et al. Treatment of periodontal disease results in improvements in endothelial dysfunction and reduction of the carotid intima-media thickness. FASEB J. 2009;23:1196-1204