U.S.
Food and Drug Administration
FDA Consumer magazine
May-June 2002
Table
of Contents
By Harold C. Slavkin, D.D.S.
The mouth, as the gateway to the body, is constantly barraged by invaders--viruses, bacteria, parasites and fungi. Transmissible infectious diseases, notably cavities (dental caries) and periodontal disease, are predominant among the ills that can compromise oral health.
A study published in the January issue of the Journal of Periodontology confirms earlier findings that people with periodontal disease are at a greater risk of cardiovascular disease and other systemic diseases.
The researchers found that diseased gums released significantly higher levels of bacterial pro-inflammatory components, such as endotoxins, into the bloodstream in people with severe periodontal disease compared to people with healthy gums. As a result, these harmful bacterial components in the blood could travel to other organs in the body, such as the heart, and cause harm.
While the study supports earlier findings, there is still much research to be done to understand the link between periodontal disease and systemic diseases. The connections, however, between oral bacteria and overall health continue to grow.
For example, researchers say the presence of antibodies to certain oral bacteria identified in amniotic fluid and fetal cord blood suggests that mothers with periodontal disease may be as much as six to seven times more likely to have a pre-term, low-birth-weight baby.
Other associations between oral and overall health include:
Heart disease and stroke. While no causal effect has been established between stroke, cardiovascular disease and gum disease, some data support an association. Medical studies suggest the involvement of two bacterial strains: Chlamydia pneumoniae and Heliocobacter pylori.
Diabetes. People with diabetes are at significantly higher risk for severe gum disease. Research indicates that good diabetes management will slow down the progression of gum disease and that blood sugar levels are more easily controlled if periodontal disease is treated.
Pre-term, low-birth-weight babies. Numerous studies are currently being conducted to determine if treating the periodontitis in pregnant women will decrease the number of pre-term, low-birth-weight babies.
In 2001, approximately 40 percent of Americans had one of several chronic diseases and disorders.
Osteoarthritis, osteoporosis, oral and pharyngeal cancer, AIDS, Parkinson's disease, and periodontal disease each represent striking examples of the mouth-body connection.
Do national, state and private-industry health policies really reflect the fact that the mouth is part of the body? Why do we segregate dental, mental and vision health care from medical care? Is there more to oral health than brushing, flossing and tooth whitening?
These questions herald new opportunities as many of us consider academic professional health education, patient care, and research and health policies.
The scientific and technological foundations of dentistry, medicine, nursing, and pharmacy, as well as the allied health professions, are expanding rapidly along with the changing demographics of industrial nations, expectations for enhanced quality of life, and changes in the management and financing of health care.
Health professional schools are responding to these challenges and opportunities. Public and private sector funding for clinical research will continue to enhance multicenter, prospective and randomized clinical trials, as well as behavioral interventions to advance health promotion, risk assessment, and disease prevention. Students and practitioners alike will need to be prepared to adopt evidence-based health care.
Federal health and regulatory agencies and private industry are applying a new and evolving understanding of human genetics to research on the causes and treatment of disorders related to oral health. This research, and the development of new drugs and other treatments it could promote, will significantly enhance the capacity to improve the health and well-being of all Americans.
Harold C. Slavkin, D.D.S., is dean of the School of Dentistry at the University of Southern California, and past-director of the National Institute of Dental and Craniofacial Research, Bethesda, Md.
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