Holistic Dentist: San Diego

Arguments for Association between Periodontal Disease and Heart Disease

From the perspective of this Holistic Dentist San Diego, cardiovascular disease is an umbrella classification for diseases the include atherosclerosis, congestive heart failure, hypertension, congenital heart defects, and hemorrhaging stroke. Currently cardiovascular disease is the leading cause of morbidity and mortality in developed or high-income nations. It is also making notable inroads in developing nations. Inflammation is a main factor in the pathogenesis of cardiovascular disease. Inflammation of cells cytokines triggered by health problems such as diabetes mellitus, smoking and obesity plays a critical role in initiating the formation of plaque in the walls of the blood vessels. A Holistic Dentist San Diego Example

Holistic Dentist San Diego:

"Research has been conducted to explore a possible association and correlation between periodontal disease and cardiovascular disease. Periodontal disease is also known as gum disease. It is often preceded by gingivitis or inflammation of the gum. It starts by gingivitis bacteria inhabiting the plaque build-up, which causes the gums to become inflamed. A sign of gingivitis is the bleeding of the gums when brushing the teeth."

From the perspective of a Holistic Dentist San Diego Periodontal disease starts with the growth of bacteria in the mouth and, if not treated properly, this condition can end up with loss of teeth because of the destruction which occurs to the tissue surrounding the teeth. Periodontal disease can increase the levels of inflammation of cells which can, in turn, contribute to inflammation-induced atherosclerosis. Some scientists assert that Porphyromonas gingivalis can attack aortic and heart endothelial cells through fimbriae. Porphyromonas gingivalis are rod-shaped pathogens found in the mouth just below the gingival surface. A study conducted by Joshipura et al. among 40,000 men aimed at examining “the incidence of coronary heart disease (CHD) in relation to a number of teeth present and periodontal disease” revealed a significant association between periodontal disease and increased IHD among the subjects who had very few teeth. This indicates that tooth loss was significantly associated with CHD, particularly among research participants who manifested a history of periodontal disease.

Holistic Dentist San Diego:

"According to claims by Schulze and Busse, periodontal bacteria do invade the blood circulatory system and when these oral pathogens and their inflammation mediators get into the blood stream they induce “chronic low-level bacteremia impaired perfusion and vasospasm.” Periodontal disease can elevate cholesterol levels, C-reactive protein as well as plasma fibrinogen, which is a link to augmented risk of cardiovascular disease. I specifically created a homemade, best toothpaste to give my patients an opportunity to combat this."

From the perspective of a Holistic Dentist San Diego, In the absence of randomized clinical trials to determine the effect prevention and treatment of periodontal disease on cardiovascular disease, longitudinal studies have become the highest source of credible evidence in this area. Out of eight longitudinal studies reviewed by investigators in this area six of them indicated that poor periodontal health was a precursor for cardiovascular disease. In a 15-year longitudinal study which was based on data from NHANES I, DeStefano and associates discovered that in 9,760 participants of both genders periodontal disease was found to be a significant predictor of coronary heart disease (CHD).

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Holistic Dentist San Diego:

"The American Academy of Periodontology is concerned about periodontal health in the general population in the light of new research findings which have linked gum disease to heart attacks and strokes. The concern was further exacerbated by the American Association for the Advancement of Science, which underscored the fact that the presence of bacteria in gum disease can trigger formation of blood clots likely to contribute to heart trouble and stroke. The American Academy of Periodontology also claims that periodontal disease is associated with other chronic inflammatory diseases besides cardiovascular disease such as diabetes. For this reason the Academy has been working closely with the Centers for Disease Control and Prevention (CDC) on periodontal disease surveillance among the general public."

Arguments against Association between Periodontal Disease and Heart Disease

From the perspective of a non Biocompatible, Holistic Dentist San Diego, Although some studies have indicated a strong association between periodontal disease and heart disease, other studies have failed to show any association or correlation at all. Dhadse, Gattani and Mishra claim that intervention studies aimed at determining the relationship between periodontal disease and coronary heart disease have utilized C-reactive protein as a main cardiac outcome as well as statistical methods, which have been found to be unsuitable for the skewed distribution of heart disease in their findings. As such they question their fellow researchers’ findings in this area. They further challenge intervention studies and insist that they should be methodologically structured in a manner that focuses on determining the exact link between periodontal disease and cardiovascular disease. But the question begs: are Dhadse, Gattani and Mishra claiming to have exclusive knowledge about how to accurately assess the relationship between periodontal disease and heart disease and that all the findings of prior intervention studies are questionable? It is noteworthy that the statement made by scientists from the American Heart Association (AHA) does not dispute the findings of observational studies which have demonstrated a positive association between periodontal disease and atherosclerotic cardiovascular disease although AHA is quick to add that these findings do not support a causative relationship. The AHA scientists further acknowledge that periodontal interventions have resulted in significant reduction of systemic inflammation as well as reduction in endothelial dysfunction. But they insist that there is currently no evidence to indicate that periodontal interventions prevent cardiovascular disease.

Holistic Dentist San Diego:

"In conclusion, it is necessary to understand that while the American Heart Association repudiates the possibility of periodontal disease as a causative factor for cardiovascular disease, they accept that there is an association between the two. It is also necessary for the American Heart Association to explain to the general public what the difference is between the two in order not to undermine efforts being made by individuals and organizations such as the American Periodontal Academy and the CDC to reduce the incidence of periodontal disease in the broader community."

Holistic Dentist San Diego References:
World Health Organization (2002). The Ten Leading Causes of Death by Broad Income Group. Retrieved June 28, 2013 from http://www.who.int/mediacentre/factsheets/fs310.pdf
Meurman, J.H., Sanz, M., Janket, S. J. (2004). Oral health, atherosclerosis, and cardiovascular disease. Critical Reviews in Oral Biology and Medicine, 15 (6):403–413
Deshpande, R. G., Khan, M. B., & Genco, C. A (1998). Invasion of aortic and heart endothelial cells by Porphyromonas gingivalis. Infection and Immunity, 66 (11):5337–5343.
Joshipura, K. J., Rimm, E. B., Douglass, C.W., et al. (1996). Poor oral health and coronary heart disease. Journal of Dental Research, 75 (9):1631–1636
Schulze, A., & Busse, M. (2008). Periodontal disease and heart disease. Clinical Sports Medicine International, 1 (8): 9-12
Destefano, F., Anda, R.F., Khan, H.S., Williamson, D.F. et al. (1993). Dental disease and risk of coronary heart disease and mortality. British Medical Journal, 306, 688-691
Griffin, R.M., & Chang, L. (2013). Periodontal Disease and Heart Health: Brushing and flossing may actually save your life. Retrieved June 29, 2013 from http://www.webmd.com/heart-disease/features/periodontal-disease-heart-health
American Academy of Periodontal Disease (2011). CDC: Half of American Adults have Periodontal Disease. Retrieved June 30, 2013 from http://www.perio.org/consumer/cdc-study.htm
Dhadse, P., Gattani, D., & Mishra, R. (2010). The link between periodontal disease and cardiovascular disease: How far we have come in last two decades? Journal of Indian Society of Periodontology, 14 (3): 148–154. doi: 10.4103/0972-124X.75908
Lockhart, P.B., Bolger, A.F., Papapanou, P.N., Osinbowale, O. et al. (2012). Circulation, Journal of the American Heart Association. Print ISSN: 0009-7322. Online ISSN: 1524-4539. doi: 10.1161/CIR.0b013e31825719f3. Retrieved June 30, 2013 from http://circ.ahajournals.org/content/early/2012/04/18/CIR.0b013e31825719f3.full.pdf+html
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