Patients often ask me if there are any connections between what happens in the mouth and the rest of the body. Many do not realize that bleeding gums, mouth infections, bad breath, plaque build-up, not brushing and flossing adequately, color changes in oral tissues, and irregular dental visits can all strongly affect your overall health.

In the last few years, scientific studies have shown connections and strong links between gum disease and the risk of heart disease or stroke. Other medical conditions that have been linked to gum disease include obesity, diabetes, kidney disease, lung disease, and other systemic illnesses. A connection that might surprise you — even premature births have been linked to untreated gum disease.

Besides gum disease, there are other oral health conditions that can affect your overall health. Tooth decay, if not treated promptly, can lead to infections in the nerves of the teeth. Neglected and infected teeth — or wisdom teeth that need to be extracted — can also cause severe infections in the mouth. These infections can then spread into the bones and the bloodstream, and potentially cause a variety of harmful medical conditions.

Your oral health can also have an effect on your partner. Dental studies have shown that the “bad bacteria” that cause gum disease can potentially be spread from one partner to another, by kissing and sharing saliva.

So be sure to keep up with your oral health routines and visit your dentist or periodontist regularly. You’re doing more than just maintaining a nice smile. You’re defending your health, by and large.

Are you surprised to hear some of the connections I mentioned? Have poor oral conditions affected your greater health in any way?

CHICAGO—February 13, 2007—Eliminating dental plaque may be an important step in preventing periodontitis and coronary artery disease according to a new study published in this month’s issue of the Journal of Periodontology. Study Abstract

Researchers examined 20 individuals with chronic periodontitis. In 13 of the 20 patients, bacterial pathogens most frequently found in severe chronic periodontitis were also found in atherosclerotic plaque of coronary vessels. In 10 cases, those species of bacteria were also present in atherosclerotic plaque and in subgingival plaque”. (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.)

“We found that patients with periodontal pathogens detected in atherosclerotic plaque had four millimeters or greater of deep periodontal pockets and a significantly higher bleeding index,” said study author Dr. Maciej Zaremba. “This supports the possibility that bacteria associated with periodontitis can permeate into coronary vessels.”

“Since periodontal and cardiovascular diseases have several common risk factors, more studies are needed to evaluate the strength of association between the two diseases,” said Dr. Preston D. Miller, DDS, and AAP president. “It is very important for people to talk to their dentist or periodontist about their periodontal health and their at-home oral hygiene routine to prevent periodontal disease and maybe even coronary artery disease.”

According to the American Heart Association, coronary heart disease is the number one single cause of death in the United States. 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 and take a free risk assessment test.

A referral to a periodontist in your area and free brochure samples including ones titled Periodontal Diseases: What You Need to Know and 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.

About the AAP

The American Academy of Periodontology (AAP) is the professional organization for periodontists—specialists in the prevention, diagnosis, and treatment of diseases affecting the gums and supporting structures of the teeth, and in the placement of dental implants. Periodontists are also dentistry’s experts in the treatment of oral inflammation. They receive three additional years of specialized training following dental school, and periodontics is one of the nine dental specialties recognized by the American Dental Association. The AAP has 8,000 members worldwide.

CHICAGO – January 14, 2000 – Researchers suggest periodontal disease can pass through saliva. This means that the common contact of saliva in families may put children and couples at risk for contracting the periodontal disease of another family member.

“If one family member has periodontal disease, all family members should see a dental professional for a periodontal screening,” said Jack Caton, D.D.S., M.S., president of the American Academy of Periodontology (AAP). “Parents need to be advised that periodontal disease is not just an adult health problem.”

In fact, studies indicate that gingivitis is nearly a universal finding in children and adolescents. Gingivitis is the first level of periodontal disease. Periodontal disease is a bacterial gum infection that progresses over time and can become more advanced with age. More about protecting children’s oral health

To ensure healthy teeth as an adult, good oral health habits should be established as a child. “Parents can encourage good at-home oral health habits in children,” said Caton. “For example, parents may want to reward children with visits from the tooth fairy not just when a tooth is lost, but also when a child receives a clean bill of health from the dentist.”

Evidence shows that periodontal disease may increase during adolescence due to lack of motivation to practice oral hygiene. “Children who maintain good oral health habits through the teen years are more likely to continue brushing and flossing than children who were not taught proper oral care,” said Caton.

Periodontal disease is a leading cause of tooth loss in adults. In addition, research has linked it to more serious health threats such as diabetes, cardiovascular and respiratory disease, and pre-term low-birthweight babies.

“It is important that family members don’t forget the basics,” added Caton. “Replace toothbrushes every few months or when the bristles begin to look frayed. Floss daily to break up the bacterial colonies between teeth that can cause periodontal disease. And, seek dental care for professional cleanings, as well as screenings for periodontal disease.”

A referral to a periodontist in your area and free brochure samples 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 periodontists—specialists in the prevention, diagnosis, and treatment of diseases affecting the gums and supporting structures of the teeth, and in the placement of dental implants. Periodontists are also dentistry’s experts in the treatment of oral inflammation. They receive three additional years of specialized training following dental school, and periodontics is one of the nine dental specialties recognized by the American Dental Association. The AAP has 8,000 members worldwide.

CHICAGO – June 20, 2002 – A case report published in the June issue of the Journal of Periodontology provides another reason why abnormalities in the mouth such as swollen or bleeding gums and oral sores should be taken seriously. Study Abstract *

“We have been hearing more about various health concerns lately, but one important area that is often overlooked is the mouth,” said Kenneth Bueltmann, D.D.S., president of the American Academy of Periodontology. “It is important for patients to have regular oral exams to not only maintain oral health, but to identify possible risks for serious medical conditions.”

The 2000 Surgeon General’s Oral Health Report recommends a thorough oral examination to detect signs of nutritional deficiencies as well as a number of systemic diseases, including microbial infections, immune disorders, injuries and some cancers.

The case report published in the Journal of Periodontology describes how excessive swollen gums, fatigue and weight loss experienced by a 53-year-old man led to the diagnosis of acute myelomonocytic leukemia. The patient consulted his dentist regarding abrupt gingival inflammation throughout the mouth. The dentist referred him to a periodontist who took a biopsy, which revealed leukemia. Blood tests confirmed the findings and chemotherapy treatment was administered.

“Oral health professionals, especially periodontists, should be aware that enlarged gums may represent an initial manifestation of an underlying systemic disease, such as leukemia or diabetes, and they should collaborate with health providers for diagnosis,” said Dr. John Fantasia, chief, division of oral pathology, department of dental medicine at the Long Island Jewish Medical Center.

He continued, “In fact, many patients see their dentist more often than their physician; thus, oral health professionals should conduct a thorough examination of the mouth to identify potential abnormalities.”

The Surgeon General’s report further reiterates that oral health means much more than healthy teeth. It means being free of periodontal diseases, chronic oral-facial pain conditions, oral and throat cancers, as well as many other diseases and disorders that affect the mouth area.

“It is important not to become alarmed by every change in the way your gums look or feel in light of this information,” said Bueltmann. “We just want people to realize that oral health shouldn’t be taken for granted.”

He continued, “Gum swelling is quite common and may involve one area of the gums surrounding a tooth or the entire gums in the mouth. In addition, there are many causes of swollen gums that could be as minor as hypersensitivity to chewing gum, reactions to prescription medications or a popcorn kernel logged into the gums.”

One of the most common reasons for swollen, bleeding gums is gingivitis, the mildest form of periodontal disease where gums become red, swell and bleed easily with brushing or flossing due to plaque buildup. There is usually little or no discomfort at this stage, and it is reversible with professional cleaning and good oral home care. Research shows that nearly one in three U.S. adults aged 30 to 54 have this or a more serious form of periodontal disease. However, gum swelling could also be a way your mouth is telling you that something is amiss with your health. Other reasons for swollen, bleeding gums could be more serious conditions such as leukemia or diabetes.

“The most important message this tells us is that if you experience swollen gums, bleeding upon brushing or flossing, or any other abnormal symptoms in your mouth, you should call your dentist or periodontist for a complete examination sooner rather than later,” said Bueltmann.

A referral to a periodontist in your area and free brochure samples are available by calling 800-FLOSS-EM or visiting the AAP’s Web site.

About the AAP

The American Academy of Periodontology (AAP) is the professional organization for periodontists—specialists in the prevention, diagnosis, and treatment of diseases affecting the gums and supporting structures of the teeth, and in the placement of dental implants. Periodontists are also dentistry’s experts in the treatment of oral inflammation. They receive three additional years of specialized training following dental school, and periodontics is one of the nine dental specialties recognized by the American Dental Association. The AAP has 8,000 members worldwide.

CHICAGO – August 15, 2000 – Oral health is often a good indicator of what is happening in the rest of the body. Therefore, a visit to a periodontist may benefit more than an older person’s gums.

According to a recent online poll about patients over age 60 conducted by the American Academy of Periodontology (AAP), periodontists often refer their patients to medical doctors for serious health problems. Of the 173 periodontists polled, 78 percent said they have referred patients to medical doctors to evaluate for diabetes, 66 percent have referred patients for a cardiovascular disease evaluation and 21 percent for osteoporosis based on their exam of the patient. One respondent wrote in that if he notices a skin lesion on the face or neck he notes it and encourages the patient to see a dermatologist for a skin evaluation.

“It is good to see that so many periodontists are referring their patients to physicians when patients exhibit conditions consistent with diabetes or cardiovascular disease,” said Jack Caton, D.D.S., M.S., president of the AAP.

Periodontists report more than half of older patients do not understand taking certain medications may affect the health of their mouth. For example, many medications, including diuretics, may reduce salivary flow. Dry mouth can cause increased plaque buildup, which increases the risk for periodontal disease. In addition, some calcium channel blockers may cause the gums to grow over the teeth. “I recommend older patients take a list of medications they are taking with them to their periodontists,” said Caton.

The majority of periodontists reported that most of their older patients believe they can keep their natural teeth for a lifetime. They also said their older patients are concerned with the aesthetic look of their smile. However, their older patients are less likely than younger patients are to have cosmetic periodontal surgery.

A referral to a periodontist in your area and free brochure samples 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 periodontists—specialists in the prevention, diagnosis, and treatment of diseases affecting the gums and supporting structures of the teeth, and in the placement of dental implants. Periodontists are also dentistry’s experts in the treatment of oral inflammation. They receive three additional years of specialized training following dental school, and periodontics is one of the nine dental specialties recognized by the American Dental Association. The AAP has 8,000 members worldwide.

CHICAGO – January 30, 2003 – Canadian researchers found that patients with Kindler syndrome had an earlier onset of periodontitis and that the disease progressed more rapidly than in non-Kindler patients. Study findings were published in the January Journal of Periodontology. Study Abstract *

Researchers believe Kindler syndrome is caused by an unidentified genetic disorder that gives the appearance of two congenital diseases of the skin, epidermolysis bullosa dystrophia and poikilodoerma. Epidermolysis bullosa dystrophia is a condition in which the skin and mucous membranes are fragile. Any friction or trauma to skin and/or mucous membranes causes blisters and the skin to come off. Poikiloderma is a condition characterized by pigmentary and atrophic changes in the skin, giving skin a spotted appearance.

The study looked at 31 patients (18 with Kindler syndrome and 13 without) from rural Panama to determine the extent to which periodontal disease is associated with Kindler syndrome.

“The major finding of this study was that individuals with Kindler syndrome develop periodontitis at an earlier age and the disease progresses rapidly,” said Colin Wiebe, D.D.S., study author and periodontist at the University of British Columbia. “Therefore, we believe it is important to include Kindler syndrome in the category of medical disorders predisposing to destructive periodontal disease.”

Definition criteria for periodontitis in this study was clinical attachment loss (CAL) of at least 4 mm. Based on this criteria, 72 percent and 46 percent of the Kindler and control patients respectively had periodontitis. The median age for Kindler patients with periodontitis was 17 years, and the only Kindler patients without periodontitis were under 10 years old. In the control group, patients with periodontitis had a mean age of 35 years and only one patient under 20 had periodontitis.

Kindler patients had an average CAL of 6 mm by age 20, while it was estimated to take 60 years to accumulate the same level of destruction in the control groups.

“Previous studies have suggested a link between periodontal disease and Kindler syndrome, but this study confirms the risk these patients have for developing periodontitis at a much younger age than a dentist would normally expect,” said Gordon Douglass, D.D.S., president of the American Academy of Periodontology.

He continued, “Of considerable interest is the additional information that can be learned about the relationship of periodontal disease and the genetic defect of these patients. Once the defect has been identified, we can take the information and apply it to other patients who are genetically predisposed to periodontal disease, which may help us determine positive treatment outcomes for periodontal disease.”

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.

CHICAGO – January 30, 2001 – New research confirms findings that periodontal disease may increase a person’s risk for the respiratory disorder Chronic Obstructive Pulmonary Disease (COPD), the sixth leading cause of mortality in the United States. The study, published in this month’s Journal of Periodontology, also noted a correlation between the amount of periodontal disease and lung capacity. Study Abstract *

For this study, researchers analyzed the periodontal and respiratory health of 13,792 patients. Patients with periodontal disease, defined by mean periodontal attachment loss (MAL) of greater than 3 millimeters, were found to have nearly a one-and-a-half times greater risk of COPD. A distinct trend also was noted in that lung function seemed to diminish with increased periodontal attachment loss. This suggests that periodontal disease activity may promote the progression of COPD.

“Identification of potential risk factors that contribute to the development of chronic bronchitis or emphysema – respiratory diseases that comprise COPD – may suggest interventions that could prevent or delay the onset of the disease, or slow its progression,” explained Frank A. Scannapieco, D.M.D., lead researcher of the study. “Based on these and previous research findings, it is conceivable that improved oral health may help prevent the progression of COPD. This is good news for the estimated 16 million Americans who suffer from it.”

Scannapieco cautioned that research does not conclude that periodontal disease causes COPD. “We know that the onset and progression of COPD is dependent on smoking, and that repeated bacterial infections can worsen the lung disease. It is possible that periodontal bacteria could travel to the lungs through saliva or normal breathing and in some way promote lung infection. Another possibility is that the inflammation caused by periodontal disease may contribute to inflammation of the lining of the lung airway, which limits the amount of air that passes to and from the lungs.”

“For a long time we’ve known that people who smoke, are exposed to environmental pollution, or are genetically predisposed are at increased risk for development of COPD,” explained Michael McGuire, D.D.S., president of the American Academy of Periodontology (AAP). “Now mounting evidence suggests that periodontal disease may work in concert with these factors and contribute to the progression of this disease.”

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.

About the AAP

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

CHICAGO – Embargoed for Release: October 18, 1999 – Patients referred to periodontists often have no idea they have undiagnosed and uncontrolled health problems, some of which can affect their oral health and dental treatment, according to a study published in the current issue of the Journal of Periodontology. Study Abstract *

Dental patients routinely complete medical questionnaires and review their health histories with dental professionals during their initial visit. The study compared self-reported medical histories from 39 consecutive patients with moderate to advanced periodontal disease to laboratory data obtained when patients were then referred to a hospital for a urinalysis, complete blood count and a standard blood chemistry panel.

While no patients in the study reported having diabetes, 15 percent tested positive for the disease. In addition, only 5 percent of participants reported a history of abnormal cholesterol, while 56 percent tested positive for exceptionally high values, putting them at greater risk for strokes and heart attacks.

“These and other underreported conditions found in the study are alarming because it’s important for patients to know what diseases they have or are at high risk for so that they can take steps to control the diseases,” said the study’s lead researcher, Dr. Kelly Thompson. “From a dental practitioner’s standpoint, these findings also mean that we may not always be made aware of what we’re up against. Undiagnosed and uncontrolled diabetes can have a profound impact on oral health and can greatly affect treatment procedures and outcomes.”

A two-way relationship between periodontal disease and diabetes exists. Diabetics are more likely to develop infections like periodontal disease, and periodontal disease makes it more difficult for people who have diabetes to control their blood sugar. Furthermore, people with diabetes and periodontal disease are more prone to recurrent periodontal abscesses (areas around teeth that are inflamed, infected and painful).

Research also points to a link between periodontal disease and heart disease. People with periodontal disease may be almost twice as likely to suffer from coronary artery disease as those without periodontal disease.

“This suggests that it may be especially important for people with periodontal disease to be aware when they have other risk factors for heart disease, such as high cholesterol,” said Dr. Jack Caton, president of the American Academy of Periodontology (AAP). “The findings also point out one more reason for increased collaboration between the dental and medical communities.”

The study cites a need for dental professionals to emphasize to patients the importance of routine physical examinations and preventative care. “Our patients who exhibit risk factors could benefit from physician referrals,” said Thompson.

A referral to a periodontist in your area and free brochure samples 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 periodontists—specialists in the prevention, diagnosis, and treatment of diseases affecting the gums and supporting structures of the teeth, and in the placement of dental implants. Periodontists are also dentistry’s experts in the treatment of oral inflammation. They receive three additional years of specialized training following dental school, and periodontics is one of the nine dental specialties recognized by the American Dental Association. The AAP has 8,000 members worldwide.

CHICAGO – July 18, 2002 – Researchers from the Eastman Dental Institute at the University College in London identified severe periodontitis in a person with Marfan’s syndrome, a rare heredity disorder that causes connective tissues to be weaker than normal. The case report is published in the July issue of the Journal of Periodontology. Case Report Abstract *

“Reports of oral findings in Marfan’s syndrome patients have focused mainly on skeletal abnormalities. This case is notable since the detected periodontal breakdown was severe and could be only partly explained by known risk factors, such as cigarette smoking and inadequate oral hygiene,” said Maurizio Tonetti, D.M.D., PhD, professor and chair of the department of periodontology at the University College London. “It also supports our hypothesis that a variety of connective tissue disorders may increase susceptibility to periodontal tissue breakdown.”

Severe periodontitis is an advanced form of a chronic bacterial infection (periodontal disease) that inflames the supporting tissues of the teeth and destroys attachment fibers (periodontal ligaments) and supporting bone that hold teeth in the mouth. The main cause of periodontal diseases are bacterial plaque, sticky, colorless film that constantly forms on the teeth. Other factors that contribute to the disease include the following: smoking/tobacco use; genetics; hormonal changes; stress; certain medications; clenching or grinding your teeth; poor nutrition; systemic diseases; and notably, diabetes.

An oral examination determined the 41-year-old patient had swollen and receding gums, severe periodontal ligament attachment loss on all teeth and bleeding gums at 76 percent of the areas examined. The patient had no family history of periodontitis.

“It is important to note that this case report does not show a causal relationship between Marfan’s syndrome and periodontal diseases,” said Kenneth Bueltmann, D.D.S., president of the American Academy of Periodontology. “More research needs to be conducted to determine if there is an association between the diseases.”

However, Dr. Tonetti recommends that Marfan patients follow a preventive oral program based on professional tooth cleaning and daily brushing and flossing. And that they receive regular periodontal screenings by a periodontist.

Marfan’s syndrome is a heritable disorder of the connective tissue that affects many organ systems, including the skeleton, lungs, eyes, heart and blood vessels. The condition affects both men and women of any race or ethnic group. Scientists estimate that as many as 1 million people in the United States may have a heritable disorder of connective tissue, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases.

Periodontal diseases are serious bacterial infections that destroy the attachment fibers and supporting bone that hold your teeth in your mouth. When the attachment fibers are destroyed, gums separate from the teeth, forming pockets that fill with plaque and even more infection. As the disease progresses, these pockets deepen even further, more gum tissue and bone are destroyed and the teeth eventually become loose. Approximately 15 percent of adults between 21 and 50 years old and 30 percent of adults over 50 have the disease.

A referral to a periodontist in your area and free brochure samples 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 periodontists—specialists in the prevention, diagnosis, and treatment of diseases affecting the gums and supporting structures of the teeth, and in the placement of dental implants. Periodontists are also dentistry’s experts in the treatment of oral inflammation. They receive three additional years of specialized training following dental school, and periodontics is one of the nine dental specialties recognized by the American Dental Association. The AAP has 8,000 members worldwide.

CHICAGO – June 2, 2003 – Researchers from Case Western Reserve University have found a significant association between obesity and prevalence of periodontal disease, especially among individuals aged 18 to 34 years. Study findings were published in the May issue of the Journal of Periodontology. Study Abstract *

The study looked at 13,665 people, and all participants underwent a periodontal examination. Body mass index and waist circumference were used to indicate obesity. The prevalence of periodontal disease amoung obese individuals aged 18-34 years was 76% higher than normal weight individuals in this age group.

No significant association was found between body weight and periodontal disease in the middle and older age groups.

Several explanations for the association between obesity and periodontal disease in younger adults and not older adults are plausible. The younger people in the study may have different dietary patterns than older study participants. Research in dietary trends in adolescents ages 11 to 18 reveal a significant decrease in raw fruit and non-potato vegetables, which are sources of vitamin C. In addition, adolescents have decreased their calcium intake, and increased their intake of soft drinks and non-citrus juices. This is important to oral health because low dietary intake of calcium and vitamin C have been associated with periodontal disease.

“Periodontists have known for awhile that people who consume less than the recommended dietary allowance (RDA) for calcium and vitamin C have slightly higher rates of periodontal disease. Young people are now drinking more soft drinks and non-citrus juices than milk and healthier beverages, decreasing their vitamin C and calcium intake” said Mohammad S. Al-Zahrani, D.M.D., Centers for Health Promotion Research, Case Western Reserve University. “Periodontitis has long been considered an ‘older person’s’ disease, as more than half of people aged 55 or older have it. We now know that widespread risk factors such as obesity may also compromise periodontal health in younger populations.”

“This is one more finding that shows healthy nutrition and adequate physical activity are necessary for overall health, and may also help to improve periodontal health by reducing the rate of progression of periodontal disease, said Gordon Douglass, D.D.S. and president of the American Academy of Periodontology.”

The study mentions other reasons for the association between obesity and periodontal disease including the social stigma associated with obesity in younger adults. Obesity for this age group may be a greater source of chronic stress than in older adults where increased body weight is considered more acceptable. Stress and how an individual copes with stress has been shown to increase a person’s risk for periodontal disease.

“These findings add one more health risk to the list, and further demonstrate the importance of preventing and managing obesity, said Douglass. “Like obesity, periodontal disease can take away a person’s confidence and smile.”

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.

About the AAP

The American Academy of Periodontology (AAP) is the professional organization for periodontists—specialists in the prevention, diagnosis, and treatment of diseases affecting the gums and supporting structures of the teeth, and in the placement of dental implants. Periodontists are also dentistry’s experts in the treatment of oral inflammation. They receive three additional years of specialized training following dental school, and periodontics is one of the nine dental specialties recognized by the American Dental Association. The AAP has 8,000 members worldwide.