CHICAGO – October 26, 2004 – Research is racing to help healthcare professionals further understand how periodontal diseases are linked to cardiovascular disease. A study published in a recent issue of the Journal of Periodontology explains another reason why people with periodontal diseases are at a significant risk for coronary artery disease (CAD).

The study looked at 108 patients with CAD with a mean age of 59.2 +/- 10.9 years and a group of 62 people without CAD with a similar mean age (57.7 +/- 8.7 years).

“The results of this study showed that periodontitis in cardiac patients was significantly more frequent than in non-cardiac patients.” said Professor E.H. Rompen, Department of Periodontology – Dental Surgery, C.H.U. Liège, Belgium. “We found that 91% of patients with cardiovascular disease suffered from moderate to severe periodontitis, while this proportion was 66% in the non-cardiac patients.”

Periodontitis seems to influence the occurrence and the severity of coronary artery disease and increases the risk of heart attack or stroke, and the study proposes two hypotheses for this occurrence. One hypothesis is that periodontal pathogens could enter the bloodstream, invade the blood vessel walls and ultimately cause atherosclerosis. (Atherosclerosis is a multistage process set in motion when cells lining the arteries are damaged as a result of high blood pressure, smoking, toxic substances, and other agents.)

Another hypothesis is based on several studies that have shown that periodontal infections can be correlated with increased plasma levels of inflammation such as fibrinogen (this creates blood clots), C-reactive protein, or several cytokines (hormone proteins).

“This study supports earlier findings, and even showed a significantly higher prevalence of periodontal diseases in cardiac patients. There is still much research to be done to understand the link between periodontal diseases and systemic diseases, such as cardiovascular, and difficult-to-control diabetes,” said Dr. Michael P. Rethman, DDS, MS, and president of the American Academy of Periodontology. “The data in this study shows the importance of regular dental checkups to ensure a healthy, diseased-free mouth.”

A referral to a periodontist in your area and free brochure samples including one titled Ask Your Periodontist About Periodontal Disease and Heart Disease are available by calling 800-FLOSS-EM or visiting the AAP’s Web site at www.perio.org.

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CHICAGO – May 19, 2005 – Researchers have found evidence that the amount of bacteria in subgingival plaques, the deep plaques in periodontal pockets and around the teeth, may contribute to an individual’s risk of a heart attack, according to two studies appearing in the Journal of Periodontology. These studies further researchers’ understanding that periodontal bacteria may increase the risk for heart disease.

In one study researchers looked at 150 individuals with periodontal diseases and found that the total number of periodontal bacteria in subgingival plaques was higher in individuals that have suffered from an acute myocardial infarction (heart attack). The second study found that the same DNA from different kinds of periodontal bacteria in plaque was also in the patients’ heart arteries. Researchers believe that these findings may help substantiate what they have long known; if there is a sterile pathway, such as a bloodstream, near a periodontally infected area that the bacteria from this infected area cause inflammation in the gums that opens up pores in the surrounding blood vessels, which enables the bacteria to enter the bloodstream and travel to other parts of the body and cause great harm.

“It is like setting up a garbage dump on the edge of a river. You wouldn’t be surprised if the lake downstream ended up polluted with the garbage from the dump,” said Vincent J Iacono DMD and president of the American Academy of Periodontology. “A patient’s bloodstream acts very much like the river in this analogy, in that it carries the bacteria from the periodontal plaques, possibly ‘polluting’ the arteries of the heart with periodontal bacteria, causing inflammation of the arteries which may lead to a heart attack. This potential effect of periodontal bacteria further supports the need for periodic deep cleanings to enhance overall health and wellbeing.”

These studies represent two in a large body of research that investigates the possible link between periodontal diseases and other systemic conditions such as heart disease. “Intervention data is not available to prove a causal relationship between the two. Right now we are currently advising patients that maintaining good periodontal health can only help not hurt,” said Iacono.

Referral to a periodontist in your area and free brochure samples including one titled Ask your Periodontist about Periodontal Disease and Heart Disease are available by calling 800-FLOSS-EM or visiting the AAP’s Web site at www.perio.org.

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CHICAGO – July 18, 2006 – The presence of specific bacteria and combinations of bacteria in periodontal pockets might be an explanation for the relationship between periodontal disease and acute coronary syndrome (ACS), according to a new study published in the Journal of Periodontology. Study Abstract *

The amount of oral bacteria was two times higher in the ACS group for the combination of the bacteria streptococci spp, P. gingivalis, T. forsythia and T. denticola. Specifically, the findings suggest that T. denticola, T. forsythia and streptococci spp are bacteria in a shared infectious etiology for periodontitis and ACS.

“This might be one of several explanations as to why elevated bacteria and the combination of specific pathogens in periodontal pockets can be linked to a history of ACS,” said Stefan Renvert, DDS, PhD and Department of Health Sciences, Kristianstad University. “We also found that the amount of periodontal bacteria results in an inflammatory response that elevates the white blood cell counts and high sensitivity C-reactive protein levels, which has also been linked in past studies to heart disease.”

It was also found that the extent of alveolar bone loss was significantly greater among subjects with ACS. Seventy-seven percent of the participants in the ACS group and 42 percent in the control group demonstrated evidence of periodontitis. The extent of bone loss was more severe in the ACS group than in the non-ACS group.

Another reason people diagnosed with ACS may have higher oral bacteria could be due to their infectious susceptibility and lack of an adequate host inflammatory response, which may induce other systemic vascular effects participating in the onset of ACS.

“Although this study supports past findings, further research is needed to evaluate the effects of reducing specific bacteria such as T. forsythia and T. denticola on reducing the risk for ACS,” said Kenneth A. Krebs, DMD and AAP president. “This data highlights the importance of routine periodontal examinations and at-home dental care.”

Background Information

Researchers evaluated 161 subjects diagnosed with ACS and a control group of 161 participants of not having ACS. Diagnosis of the ACS group was based on chest pain associated with electrocardiogram changes that were combined with typical patterns of cardiac markers (such as creatine kinase). The control group included people without cardiovascular disease. This included the absence of elevated blood pressure, or the use of statins and beta-blockers.

A referral to a periodontist in your area and free brochure samples including one titled Periodontal Diseases: What You Need to Know are available by calling 800-FLOSS-EM or visiting the AAP’s Web site at www.perio.org.

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CHICAGO—September 26 2006—Researchers found an increased risk of coronary heart disease for people below the age of 60 who have more than four millimeters of alveolar bone loss (the bone that holds the teeth in the mouth) from periodontal disease, according to a new study that is printed in the Journal of Periodontology. Study Abstract *

It was found that participants with coronary heart disease had an increase of periodontal disease indicators, including alveolar bone loss, clinical attachment loss and bleeding compared to the group without coronary heart disease.

“This study is distinctive because to our knowledge, it is the first to include both the alveolar bone loss and full mouth recording of clinical attachment loss as measurements of periodontal disease,” explains Dr. Karen Geismar, Department of Periodontology, School of Dentistry, Faculty of Health Science, University of Copenhagen, Denmark. “Alveolar bone loss was recently found to be the periodontal variable that had the strongest association to coronary heart disease.”

The association between periodontal disease and coronary heart disease has been that chronic infections and the inflammatory response from diseases such as periodontal disease may be involved in the initiation and progression of atherosclerosis.

“A number of pathways are suspected to be involved,” said Geismar. “One way is that periodontal bacteria directly invade the arterial wall and another way is that bacterial products from the periodontal pocket exert a systemic effect on atherosclerosis development based on the immune system.”

“This is one of many studies suggesting that the spread of bacteria and bacterial products from the periodontal lesion to the bloodstream may contribute to coronary heart disease,” said Preston D. Miller, DDS and AAP President. “However, it is still uncertain whether or not the association between periodontal disease and coronary heart disease is causal. Until we know more, it is very important that people talk to their dentist or periodontist about their periodontal health.”

Background Information

This study included 110 patients with coronary heart disease and 140 people without coronary heart disease. The mean age was 65 years and 70 percent of the participants were male. All 250 participants received a medical and dental examination. Researchers found a significantly higher odds ratio of 6.6 for individuals below age 60 having being a patient with coronary heart disease when having a mean alveolar bone loss of more than four millimeters.

A referral to a periodontist in your area and free brochure samples including one titled Ask Your Periodontist About Periodontal Disease and Heart Disease are available by calling 800-FLOSS-EM or visiting the AAP’s Web site at www.perio.org.

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CHICAGO – October 10, 2006 – People missing some or all of their teeth or who have significant loss of bone and tissue surrounding their teeth may be at an increased risk for having a stroke, according to a new study that appeared in the October issue of the Journal of Periodontology (JOP). Study Abstract *

Researchers from Boston University investigated the relationship between periodontal disease and history of stroke in patients 60 years of age and older by examining the data of the Third National Health and Nutrition Examination Survey (NHANES III).

“We found that patients 60 years and older who were edentulous, partially edentulous and/or had significant clinical attachment loss were more likely to have a history of stroke compared to dentate adults without significant clinical attachment loss,” said Dr. Martha E. Nunn, Goldman School of Dental Medicine, Boston University. “However, based on the results of this study, it is unclear whether periodontal disease is an independent risk factor for stroke or simply a risk marker that reflects negative effects of risk factors common to both periodontal disease and stroke.”

Age, tobacco use, hypertension, diabetes, serum glucose, C-Reactive protein (CRP) and alcohol intake were also included as additional risk factors in this study. These confounders are independent risk factors for cardiovascular disease and if left untreated, periodontitis has been shown to have harmful effects on the control of diabetes, serum glucose levels and increases CRP levels.

Evidence continues to accumulate associating severe periodontitis with an increased risk of forming atherosclerotic plaques, which are responsible for myocardial infarction and ischemic stroke. According to past JOP studies, this relationship could be due to elevated CRP levels in patients with chronic periodontal disease.

Further investigation is needed to support periodontal treatment intervention as a means of controlling systemic inflammation. Based on findings from another study in the same issue of the Journal, CRP levels may now be reduced by periodontal treatment such as scaling and root planing in patients with severe periodontal disease. Study Abstract *

“Studies evaluating additional treatment methods such as repeated scaling and root planing or surgical treatment are needed to conclusively demonstrate that CRP can be improved by periodontal treatment,” said Preston D. Miller, DDS and AAP president. “Until science presents a definitive direction, the periodontists ultimate goal is to lead patients to the right side of health. What we do know is that eliminating periodontal infection saves teeth.”

A referral to a periodontist in your area and free brochure samples including one titled Periodontal Diseases: What You Need to Know are available by calling 800-FLOSS-EM or visiting the AAP’s Web site at www.perio.org.

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CHICAGO—March 1, 2007—Research presented in a recent paper by Tonetti et al published in the New England Journal of Medicine (NEJM) suggests that intensive periodontal treatment may reverse atherosclerosis by improving elasticity of the arteries, or endothelial function. Findings from previous studies have suggested a link between periodontal disease and atherosclerosis and proposed that periodontal treatment may reduce cardiovascular risk. This study is important because it furthers the understanding of the potential relationship between periodontal disease and cardiovascular disease.

The study examined two groups: a control treatment group and a periodontal treatment group. The control treatment group received supragingival mechanical scaling and polishing, also known as a prophylaxis. According to the study author, the periodontal treatment group underwent four to six hours of scaling and root planing performed by a periodontist, local delivery antimicrobials, and the extraction of hopeless teeth. It is well documented that meticulous scaling and root planing is an essential form of periodontal treatment when compared to supragingival scaling and polishing because the latter is not used to treat periodontitis. This study did not examine the effects of scaling and root planing without local delivery antimicrobials, so the potential added value of local delivery antimicrobials remains unclear. It will be important for future research to examine the cost-benefit analysis of scaling and root planing compared to scaling and root planing and local delivery antimicrobials. In addition, research is necessary to identify how the results of this study would translate when treatment is provided by dental professionals other than periodontists.

According to the American Heart Association, it is estimated that nearly 80 million Americans had one or more forms of cardiovascular disease in 2004. Cardiovascular disease involves a complex interplay of many risk factors. The interesting findings of the Tonetti study support the need for additional research to determine whether the treatment of severe periodontitis could reduce the risk of developing atherosclerosis and cardiovasular events in adults.

Knowledge of the risk factors and possible links to coronary heart disease, such as periodontal disease is the first step towards preventing it. To find out if you are at risk for periodontal disease, please visit the AAP’s Web site at www.perio.org and take a free risk assessment test. To find out if you are at risk for heart disease, visit www.americanheart.org.

NOTE: An article abstract and pay-per-view copy of the New England Journal of Medicine study are available at www.nejm.org.

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CHICAGO—January 08, 2008—Each year, cardiovascular disease kills more Americans than cancer. And while most people are aware that lifestyle choices such as eating right, getting enough exercise and quitting smoking can help prevent cardiovascular disease, they may not know that by just brushing and flossing their teeth each day, they might also be avoiding this potentially lethal condition.

An article published in the December issue of the Journal of Periodontology (JOP), the official publication of the American Academy of Periodontology (AAP), suggests that periodontal patients whose bodies show evidence of a reaction to the bacteria associated with periodontitis may have an increased risk of developing cardiovascular disease. Study Abstract

“Although there have been many studies associating gum disease with heart disease, what we have not known is exactly why this happens and under what circumstances,” said JOP editor Kenneth Kornman, DDS, PhD. “The findings of this new analysis of previously published studies suggest that the long-term effect of chronic periodontitis, such as extended bacterial exposure, may be what ultimately leads to cardiovascular disease.”

Researchers at Howard University identified 11 studies that had previously examined clinically-diagnosed periodontal disease and cardiovascular disease. The team then analyzed the participants’ level of systemic bacterial exposure, specifically looking for the presence of the bacteria associated with periodontal disease, as well as measuring various biological indicators of bacterial exposure. They found that individuals with periodontal disease whose biomarkers showed increased bacterial exposure were more likely to develop coronary heart disease or atherogenesis (plaque formation in the arteries).

“While more research is needed to better understand the connection between periodontal disease and cardiovascular disease, this study suggests the importance of taking of your teeth and gums and how that can help you take care of your heart,” said Susan Karabin, DDS, President of the AAP. “With the number of people with heart disease continuing to increase, it is important to understand that simple activities like brushing and flossing twice a day, and regular visits to your dental professional can help lower your risk of other health conditions.”

EDITOR’S NOTE: Representatives of the media may contact the AAP Public Affairs Department to receive a copy of the articles Markers of systemic bacterial exposure in periodontal disease and cardiovascular disease risk. Abstracts of Journal of Periodontology articles are available to the public online. Full-text of studies may be accessed by AAP members and Journal subscribers or purchased online for $20.

To find out if you are at risk for periodontal diseases, take the Academy’s risk assessment test. Referral to a periodontist in your area and free brochure samples including one titled Ask Your Periodontist about Periodontal Disease and Heart Disease are available by calling 800-FLOSS-EM or visiting the AAP’s Web site at www.perio.org.

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CHICAGO—June 1, 2009—Cardiovascular disease, the leading killer of men and women in the United States, is a major public health issue contributing to 2,400 deaths each day. Periodontal disease, a chronic inflammatory disease that destroys bone and gum tissues that support the teeth affects nearly 75 percent of Americans and is the major cause of adult tooth loss. And while the prevalence rates of these disease states seems grim, research suggests that managing one disease may reduce the risk for the other.

A consensus paper on the relationship between heart disease and gum disease was recently published concurrently in the online versions of two leading publications, the American Journal of Cardiology (AJC), a publication circulated to 30,000 cardiologists, and the Journal of Periodontology (JOP), the official publication of the American Academy or Periodontology (AAP). Developed in concert by cardiologists, the physicians specialized in treating diseases of the heart, and periodontists, the dentists with advanced training in the treatment and prevention of periodontal disease, the paper contains clinical recommendations for both medical and dental professionals to use in managing patients living with, or who are at risk for, either disease. As a result of the paper, cardiologists may now examine a patient’s mouth, and periodontists may begin asking questions about heart health and family history of heart disease.

The clinical recommendations were developed at a meeting held earlier this year of top opinion-leaders in both cardiology and periodontology. In addition to the clinical recommendations, the consensus paper summarizes the scientific evidence that links periodontal disease and cardiovascular disease and explains the underlying biologic and inflammatory mechanisms that may be the basis for the connection.

According to Kenneth Kornman, DDS, PhD, Editor of the Journal of Periodontology and a co-author of the consensus report, the cooperation between the cardiology and periodontal communities is an important first step in helping patients reduce their risk of these associated diseases. “Inflammation is a major risk factor for heart disease, and periodontal disease may increase the inflammation level throughout the body. Since several studies have shown that patients with periodontal disease have an increased risk for cardiovascular disease, we felt it was important to develop clinical recommendations for our respective specialties. Therefore, you will now see cardiologists and periodontists joining forces to help our patients.”

For patients, this may mean receiving some unconventional advice from their periodontist or cardiologist. The clinical recommendations outlined in the consensus paper advise that periodontists not only inform their patients of the increased risk of cardiovascular disease associated with periodontal disease, but also assess their risk for future cardiovascular disease and guide them to be evaluated for the major risk factors. The paper also recommends that physicians managing patients with cardiovascular disease evaluate the mouth for the basic signs of periodontal disease such as significant tooth loss, visual signs of oral inflammation, and receding gums.

While additional research will help identify the precise relationship between periodontal disease and cardiovascular disease, recent emphasis has been placed on the role of inflammation – the body’s reaction to fight off infection, guard against injury or shield against irritation. While inflammation initially intends to have a protective effect, untreated chronic inflammation can lead to dysfunction of the affected tissues, and therefore to more severe health complications.

“Both periodontal disease and cardiovascular disease are inflammatory diseases, and inflammation is the common mechanism that connects them,” says Dr. David Cochran, DDS, PhD, President of the AAP and Chair of the Department of Periodontics at the University of Texas Health Science Center at San Antonio. “The clinical recommendations included in the consensus paper will help periodontists and cardiologists control the inflammatory burden in the body as a result of gum disease or heart disease, thereby helping to reduce further disease progression, and ultimately to improve our patients’ overall health. That is our common goal.”

NOTE: A copy of The American Journal of Cardiology and Journal of Periodontology Editors’ Consensus: Periodontitis and Atherosclerotic Cardiovascular Disease can be viewed online.

To find out if you are at risk for periodontal diseases, take the Academy’s risk assessment test. Referral to a periodontist in your area and online brochure samples including one titled Ask Your Periodontist about Periodontal Disease and Heart Disease are available by calling 800-FLOSS-EM or visiting the AAP’s Web site.

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CHICAGO – April 11, 2006 – The patient of a periodontist in private practice in New Orleans, LA, developed osteonecrosis of the jaw (ONJ), a condition that can cause severe, often irreversible and debilitating damage to the jaw, following periodontal surgical therapy. Two years prior to surgery, the patient had started receiving IV bisphosphonate therapy, or bone-sparing drugs commonly used in the treatment of osteoporosis and metastatic bone cancer to help decrease associated pain and fractures, following treatment for breast carcinoma. When the patient presented to the periodontist, no reports of ONJ had been reported in the literature. This case report is published in the April issue of the Journal of Periodontology (JOP). Study Abstract *

“It is counter-intuitive to believe that bone-sparing drugs such as IV bisphosphonates can have the opposite affect and actually necrotize the jaw bone,” said Kristi M. Soileau, DDS, case report author and member of the American Academy of Periodontology (AAP). “While we’re not sure exactly why this happens, one possibility is that the drug compromises the vascular supply, which contributes to non-healing or the development of a diseased wound once the bone is exposed such as with extractions or with oral surgery.”

“It is important that our colleagues in dentistry and medicine are aware of this potential complication in this large and growing population of patients for whom IV bisphosphonates are being prescribed,” explained Kenneth A. Krebs, DMD and AAP president.

“A complete dental examination, including a periodontal evaluation, should be performed before a patient begins IV bisphosphonate therapy to identify and address any oral conditions, as recommended with preradiation patients,” added Soileau.

The case report did not include information related to patients taking oral bisphosphonates, which are more relevant to osteoporotic concerns.

A referral to a periodontist in your area and free brochure samples including one titled Periodontal Diseases: What You Need to Know are available by calling 800-FLOSS-EM or visiting the AAP’s Web site at www.perio.org.

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CHICAGO – May 31, 2006 – Caregivers of people under psychological or physical stress, as well as those with the conditions themselves, should not overlook their oral health, according to a new study printed in the Journal of Periodontology. Study Abstract *

The results from the study suggest that being a caregiver to relatives with dementia, hypercortisolemia (overproduction of cortisol) or stress was associated with elevated plaque levels and increased gingival bleeding in adults aged 50 years and older.

“We found that short-term psychological stress was a risk indicator to elevated plaque levels and long-term physical stress was a risk indicator to gingivitis,” said Fernando N. Hugo, DDS and Faculty of Dentistry of Piracicaba, Brazil. “These findings support the health impact of psychosocial risk factors from chronic stress, which may lead to malfunction of some biological functions.”

The study indicates that the demanding task of caregiving, usually associated with increased stress, may also be a risk factor for poor oral hygiene. These findings point out that stress may contribute to a disinterest in performing oral hygiene.

“Flossing and brushing the teeth and gums had a protective effect against plaque and gingivitis,” said Kenneth A. Krebs, DMD and AAP president. “That said, future research is needed to explore the relationship between stress and oral hygiene negligence.”

In this study, 230 individuals were evaluated, and almost 52 percent were caregivers. Caregivers of patients with dementia were examined because they represent a well-known group suffering from the impacts of chronic stress on human health and immune functions. The results are among the first in literature to suggest that caregivers of relatives with dementia are at risk of having more plaque and gingivitis than non-caregivers.

A referral to a periodontist in your area and free brochure samples including one titled Periodontal Diseases: What You Need to Know are available by calling 800-FLOSS-EM or visiting the AAP’s Web site at www.perio.org.

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CHICAGO – July 5, 2006 – Researchers found that prolonged use of anabolic androgenic steroids (AAS) is closely associated with significant levels of gingival enlargement, according to a new study published in the Journal of Periodontology. Study Abstract *

Gingival overgrowth is a condition in which the gingival tissues become swollen and grow over the teeth. Overgrown gums make it easier for bacteria found in plaque to accumulate and attack supporting structures of the teeth, potentially leading to severe periodontal infection.

“It was found that AAS abusers had statistically significant levels of gingival enlargement compared to non-users, requiring a gingivectomy (removal of excess or diseased gum tissue) for many cases,” explains Onur Ozcelik, DDS, PhD, Faculty of Dentistry, Department of Periodontology, Cukurova University, Adana, Turkey. “Although it has been reported that many of the adverse effects of AAS abuse are fully reversible within several months after the cessation of the drug, it is not known if gingival enlargement would also regress after the withdrawal of AAS.”

Researchers also found that gingival inflammation was higher in the AAS user group compared to the non-AAS users. “Further studies are required to find out if increased gingival scores in the user group are a direct effect of AAS or if the inflammation is a result of compromised oral hygiene due to gingival enlargement,” said Ozcelik.

“It is not surprising that gingival tissue is a target for the actions of steroid hormones,” said Kenneth A. Krebs, DMD and AAP president. “Clinical changes in tissues of the periodontium have been identified during periods of hormonal fluctuations such as puberty, the menstrual cycle, pregnancy, menopause, contraceptives and ovulation induction drugs in women.”

People taking AAS without medical supervision, should be informed of the adverse effects and strongly encouraged to begin a cessation program. Since periodontal infection may be a risk factor for more serious conditions, such as cardiovascular disease, respiratory disease and pre-term, low birth weight babies it is important for patients to take care of their periodontal health.

Background Information

Researchers examined 24 athletes between the ages of 17 and 29 who had been using AAS for more than one year. All subjects were examined for plaque levels, gingival inflammation and gingival enlargement. The results were then compared with a control group of 20 bodybuilders who had never used AAS drugs and matched for age, educational level and oral habits according to the data obtained from the AAS user group.

A referral to a periodontist in your area and free brochure samples including one titled Periodontal Diseases: What You Need to Know are available by calling 800-FLOSS-EM or visiting the AAP’s Web site at www.perio.org.

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The American Academy of Periodontology (AAP) is the professional organization for

CHICAGO – September 12, 2006 – Salivary melatonin may play an important role in maintaining periodontal health, according to a new study published in the Journal of Periodontology. This is one of the first attempts to examine the influence of salivary melatonin upon periodontal disease, an inflammation that destroys the tissues and bone that support the teeth. Study Abstract *

Researchers found that melatonin, a hormone created by the pineal gland, may be able to protect the oral cavity against free radicals produced by inflammatory diseases. Melatonin has strong antioxidant effects that can protect cells against inflammatory processes and oxidative damage. Melatonin supplements are commonly promoted to ease jet lag and hasten sleep.

“Patients with higher salivary and melatonin ratios had lower community periodontal index (CPI). CPI is the score used to assess periodontal status,” said Pablo Galindo, DDS, Department of Oral Surgery, School of Dentistry, University of Granada, Spain. “This finding suggests that the melatonin may fight against infection and inflammation possibly due to its antioxidant, anti-aging and immunoenhancing ability.”

It was also observed that older patients had lower saliva volumes and melatonin ratios and higher CPI scores compared to younger patients with increased salivary and melatonin levels and decreased CPI scores.

“Further research is required to fully explain the relationship between melatonin and its influence on periodontal health,” said

CHICAGO – November 14, 2006 – Researchers from the University of Connecticut Health Center report an interrelationship between periodontal and systemic inflammation in solid-organ-transplant recipients. This study appears in this month’s issue of the Journal of Periodontology. Study Abstract *

For a long time researchers have known that inflammation plays a pivotal role in organ transplant rejection and that levels of serum interleukin-6 (IL-6) can identify individuals who are at greater risk for transplant rejection. IL-6 is a protein that is secreted to stimulate the immune response to trauma, foreign antigens, or infections, such as periodontal infection. Once secreted, IL-6 can enter the bloodstream and circulate in an active form long enough to mediate distal effects in other tissues and organs.

“Our goal was to assess the periodontal status of solid organ transplant patients to quantify the IL-6 levels in bloodstream and gingival tissues and explore their possible association with chronic periodontitis,” explains Principal Investigator Anna Dongari-Bagtzoglou, DDS, MS, PhD, Associate Professor and Chair of the Division of Periodontology at University of Connecticut Health Center. “We found that in transplant patients with chronic periodontitis, bloodstream IL-6 levels were elevated compared to those with no periodontitis, and were positively association with locally synthesized levels of IL-6 within periodontal tissue. This suggests that periodontal infections have the potential to affect systemic levels of IL-6 in this population.”

In support of this, it was also found that clinical periodontal parameters such as probing depth and clinical attachment loss were independent predictors of the body’s IL-6 levels.

“With research and science advancing every day, the life expectancy after organ transplantation is on a steady rise,” said Preston D. Miller, DDS and AAP president. “Further studies monitoring periodontal disease, IL-6 and transplant tissues are needed to provide conclusive evidence that periodontal inflammation may have negative effects on long-term transplant survival.”

Background Information

Forty-seven kidney and cardiac transplant patients were recruited for this study. Patients had to be clinically stable, at least one-year post transplant, absent of additional systemic conditions that might elevate the systemic inflammatory status and no history of periodontal treatment within the last year. A group of 18 systemically healthy individuals that matched the age and sex were also recruited.

All individuals received a complete clinical periodontal examination, medical records of the transplant subjects were reviewed and a blood and gingival sample were taken to quantify levels of IL-6. This study was supported by the National Institute of Dental and Craniofacial Research (NIH).

A referral to a periodontist in your area and free brochure samples including one titled Periodontal Diseases: What You Need to Know are available by calling 800-FLOSS-EM or visiting the AAP’s Web site at www.perio.org.

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CHICAGO—June 12, 2007—Two new studies in the June issue of the Journal of Periodontology (JOP) suggest that periodontal diseases are a threat to women of all ages due to hormonal fluctuations that occur at various stages of their lives.

One study looked at 50 women who were between the ages of 20 to 35 with varying forms of periodontitis. The study found that women who currently were taking oral contraceptive pills had more gingival bleeding upon probing and deeper periodontal pockets (signs of periodontitis) than those who were not taking oral contraceptive pills. Study Abstract *

“Younger women often think that periodontal disease is a condition associated with old age,” explained study author Brian Mullally, PhD. “Our study shows that it is very possible for younger women to experience periodontal disease. It is important for women to alert their dental practitioners about any medications they are taking, such as oral contraceptive pills, because it is possible that their oral health may be affected. It might also be prudent where possible for young women to ensure that their periodontal health has been checked before commencing oral contraceptive therapy.”

Another study in this month’s issue of the JOP examined 1,256 postmenopausal women and looked for a potential association between periodontal bacteria and bone loss in the oral cavity. The study results showed that women with periodontal bacteria in their mouths were also more likely to have bone loss in the oral cavity, which can lead to tooth loss if not treated. Study Abstract *

“Our study’s findings are important for postmenopausal women because they suggest that good periodontal health is extremely important in the postmenopausal years,” said study author Renee Brennan, PhD. “We found that oral bone loss was associated with presence of oral bacteria. In fact, 62% of the women in our study had at least one species of subgingival bacteria present, and the women with these bacteria had more evidence of oral bone loss. Interestingly, women who had a Body Mass Index in the overweight range were much more likely to have oral bone loss associated with presence of oral bacteria. Oral bone loss has been associated with osteoporosis in this group as well. This association has been difficult to study because many risk factors for periodontal disease and osteoporosis—including smoking, age, medications, and overall general health—are similar. It should be noted that our study was limited in that it included a relatively healthy group of mostly Caucasian women and that future studies are needed to determine the effects of periodontal bacteria on bone loss in other groups of postmenopausal women.”

“Taking care of your teeth and gums is a lifelong commitment,” explained Preston D. Miller, DDS and AAP president. “Women should pay special attention to their oral health as they enter different stages of their lives because additional periodontal care may be needed during different points such as the reproductive years or menopause. Knowing your ‘pocket size’ depth can be a good way for women to keep track of their periodontal health; periodontal pockets of one to two millimeters with no bleeding are not a concern but pockets of three and four millimeters may need a more in depth cleaning called scaling and root planing.”

To find out if you are at risk for periodontal diseases take the Academy’s test to assess your gum disease risk. A referral to a periodontist in your area and free brochure samples including one titled Women and Periodontal Disease are available by calling 800-FLOSS-EM or visiting the AAP’s Web site at www.perio.org.

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CHICAGO—August 8, 2007—A literature review published in the August issue of the Journal of Periodontology (JOP) saw a strong relationship between stress and periodontal diseases; 57% of the studies included in the review showed a positive relationship between periodontal diseases and psychological factors such as stress, distress, anxiety, depression and loneliness. Literature Review Abstract *

“More research is needed to determine the definitive relationship between stress and periodontal diseases” said study author Daiane Peruzzo, PhD. “However, patients who minimize stress may be at less risk for periodontal disease.”

Researchers speculate that the hormone cortisol may play a role in the possible connection between stress and periodontal diseases. A study in the July issue of the JOP found that increased levels of cortisol can lead to more destruction of the gums and bone due to periodontal diseases. It is well known that periodontal diseases left untreated can ultimately lead to bone loss or tooth loss.

“Individuals with high stress levels tend to increase their bad habits, which can be harmful to periodontal health. They are less attentive to their oral hygiene and may increase their use of nicotine, alcohol or drugs,” explained Preston D. Miller, DDS and AAP president. “Patients should seek healthy ways to relieve stress through exercise, balanced eating, plenty of sleep and maintaining a positive mental attitude.”

Patients should to also keep in mind their “pocket size guide” to periodontal health; periodontal probing depths of one to two millimeters with no bleeding are not a concern but probing depths of three and four millimeters may need a more in depth cleaning called scaling and root planing. Probing depths in excess of 5mm may require more advanced treatment and patients should talk to their dental specialist.

A referral to a periodontist in your area, additional information, and free brochure samples including one titled Periodontal Diseases: What You Need to Know are available by calling 800-FLOSS-EM or visiting the AAP’s Web site at www.perio.org.

About the AAP

The American Academy of Periodontology (AAP) is the professional organization for

CHICAGO—June 4, 2008—Most people already know that maintaining oral health is a vital component of achieving overall health, but a recent study reveals why it is especially crucial that men pay close attention to their teeth and gums. Research published in the June issue of The Lancet Oncology found that men with a history of gum disease are 14 percent more likely to develop cancer than men with healthy gums. In fact, researchers uncovered that men with periodontal disease may be:

• 49 percent more likely to develop kidney cancer
• 54 percent more likely to develop pancreatic cancer
• 30 percent more likely to develop blood cancers

“Previous research has suggested a potential link between gum disease and other conditions such as heart disease, diabetes and rheumatoid arthritis,” says Dr. Susan Karabin, President of the AAP. “This study should prompt men to be particularly mindful of their teeth and gums now that gum disease may play a role in the onset of cancer.”

Gum disease can be managed with daily brushing and flossing, and routine visits to a dental health professional. Men who develop gum disease should consider consulting with a periodontist, the dentist specially trained in the prevention and treatment of periodontal disease. A periodontist can help develop an effective treatment plan to best manage the disease.

To learn more about gum disease, locate a periodontist, or to find out if you are at risk for periodontal diseases, visit perio.org or call (800) FLOSS-EM (800/356-7736).

About the AAP

The American Academy of Periodontology (AAP) is the professional organization for

CHICAGO—June 5, 2008—Over 1.3 million Americans suffer from rheumatoid arthritis (RA), a chronic, inflammatory disease of the joints. RA is a disabling condition, and can lead to long-term joint damage resulting in persistent pain and loss of function in affected areas. A recent study published in the June issue of the Journal of Periodontology, the official publication of the American Academy of Periodontology (AAP), uncovered yet another potential side effect of RA. Researchers in Berlin, Germany discovered that patients with RA have a higher incidence of periodontal disease compared to healthy controls. Study Abstract *

For some patients, adverse RA symptoms may affect manual dexterity, which can make one’s daily routine quite difficult. One area that may be affected is oral hygiene which can ultimately lead to periodontal disease. However, these research findings indicate that poor oral hygiene alone did not account for the association between RA and gum disease, suggesting that other factors may play a role as well.

The study examined the oral health of 57 RA patients and 52 healthy controls. To determine oral hygiene status, each participant underwent a comprehensive oral examination including an assessment of plaque accumulation and gingival inflammation, both indicators of oral hygiene. Probing pocket depth and clinical attachment loss, two markers of periodontal disease, were also measured. Researchers used questionnaires to gauge the subjects’ risk factors for periodontal disease.

The study findings indicated that RA patients were nearly eight times more likely to have periodontal disease compared to the control subjects. These findings accounted for demographic and lifestyle characteristics such as age, gender, education and tobacco use. Researchers then examined the extent to which poor oral hygiene was connected to the increased occurrence of gum disease in RA patients. The results showed that while oral hygiene was markedly a factor, it did not fully explain the association between the two diseases, suggesting that there may be other parameters responsible for the increased prevalence of gum disease in RA sufferers.

“With results suggesting that rheumatoid arthritis is associated with periodontal disease, it is easy to assume that an RA sufferer is perhaps unable to properly care for his or her teeth and gums due to the debilitating nature of the disease,” says Dr. Kenneth Kornman, editor of the Journal of the Periodontology. “However, this study implies that there are other potential factors involved. For instance, both RA and gum disease are systemic inflammatory disorders which may explain the connection between the two. Inflammation is already thought to link periodontal disease with other conditions such as cardiovascular disease and diabetes. We look forward to future research that may reveal the biological mechanisms that link these two important diseases.”

In an effort to best maintain oral health, RA patients are encouraged to brush and floss on a regular basis and see a dental professional twice a year. If gum disease develops, consulting a periodontist is an effective way to determine the most appropriate course of treatment.

According to Dr. Susan Karabin, President of the AAP, maintaining the complete health of RA patients should be a collaborative effort. “It is critical that dental professionals and medical professionals work together when treating a patient living with rheumatoid arthritis. This partnership will assure that both the oral and overall health of these patients is paramount.”

To learn more about gum disease, locate a periodontist, or to find out if you are at risk for periodontal diseases, visit perio.org or call (800) FLOSS-EM (800/356-7736).

About the AAP

The American Academy of Periodontology (AAP) is the professional organization for