Oral Inflammation and Health

Periodontal Disease and Coronary Heart Disease. Periodontal disease is an inflammatory response to bacteria that reside within the gum tissue. Scientists at the CCID have recently demonstrated that periodontitis is a significant independent risk factor for the fatality and morbidity associated with cardiovascular diseases such as atherosclerosis, myocardial infarction and stroke. We now understand that periodontal infections significantly increase the risk of stroke and myocardial infarctions 2-3 fold, even after adjusting for other more traditional risk factors like hypertension, triglycerides, body mass, etc. Despite this important new clue for new risk factors for cardiovascular disease we have little understanding regarding the mechanism(s) of this association, and whether Periodontal Disease actually causes Cardiovascular Disease. This represents a new direction for dental research and treatment, and presents an exciting opportunity for CCID activities. Since periodontal disease is both preventable and treatable and may be responsible for as many deaths due to cardiovascular disease as smoking each year - the potential for intervention represents an enormous opportunity that may have a dramatic impact on the health of the public. The translation of this new information into diagnostics, preventive measures and therapies for periodontitis-mediated cardiovascular incidents represents an important goal for the CCID.

Periodontal Disease and Delivery of Preterm Low Birth Weight Children. Similarly, scientists at the CCID have discovered that periodontal infections appear to be a significant risk factor for delivery of preterm low birth weight children. Results from a case-control study suggest that pregnant mothers with severe periodontal disease are seven times more likely to have preterm low birth weight infants than mothers with less periodontal disease, adjusting for traditional preterm low birth weight (PLBW) obstetric risk factors such as prenatal care, race, genitourinary tract infections, weight gain, smoking and drug use. In our study the effect of periodontal disease as a contributor to PLBW was as large as smoking or alcohol consumption. These UNC findings represent an exciting new clue regarding potential causes of PLBW which account for two-thirds of all deaths among newborns. Problems of this magnitude represent opportunities for CCID-based solutions.

Periodontal Disease and Insulin Dependent Diabetes Mellitus. It is well established that diabetes is a risk factor for severe periodontal disease and coronary heart disease, atherosclerosis and stroke. Studies from UNC indicate that IDDM patients have hyperresponsive monocytes that produce elevated levels of proinflammatory factors that may exaggerate the inflammatory response to infectious agents such as periodontopathogens. Likewise, gingival crevicular fluid from these IDDM patients has elevated levels of inflammatory mediators that are further exacerbated by the presence of periodontal disease. Recent data also have indicated that treating periodontal infection in diabetic patients reduces the glycosylated hemoglobin level (a marker of glycemic control) by 15%. These findings provide further evidence that oral inflammatory diseases place a systemic burden on the host. Furthermore, the diabetic patient represents a special high-risk subgroup of patients that should be targeted for oral therapeutic strategies.