Recommendations Periodontal disease is a common, mixed oral infection affecting the supporting structures around the teeth. Seventy-five percent of the adult has periodontal disease (gingivitis), and 20% to 30% exhibit the sever destructive form (periodontitis). Germs inhabiting the human mouth cause the common inflammatory conditions of gingivitis and periodontitis. As a person develops these conditions, bacteria and their products can penetrate host tissues and enter the bloodstream resulting in systemic effects.

Mounting evidence indicates that oral inflammation may be a significant risk factor for several systemic conditions, such as heart disease, premature babies, and complications from diabetes.

Recent intervention data indicates that patients with periodontal disease who receive treatment exhibit decreases in CRP, and acute-phase biomarker and predictor of heart disease. Similarly, pregnant women with untreated periodontal disease are more than 4 times more likely to have a premature birth compared with mothers with periodontal disease who received treatment during their pregnancy. In addition, patients with diabetes and periodontal disease may exhibit improvements in glycemic control secondary to therapy targeted at reducing oral inflammation.

These consistent relationships between oral inflammation and systemic disease suggest an interdisciplinary model in managing patients who are at risk. Patients, dentists, physicians, and other health care providers should be aware of the emerging interrelationships between oral infection, inflammation, and systemic disease. Clinicians and patients also should appreciate the value of preventive strategies that reduce oral inflammation, improve dental health, and enhance overall patient wellbeing. Frequent check ups (every 3 months) are often required to maintain good oral health.

Medical Research Although more than 500 bacterial species inhabit the human oral cavity, only a characteristic subset of flora cause periodontal disease, which includes 2 common oral inflammatory conditions: gingivitis and periodontitis. As an individual progress from periodontal health to gingivitis and periodontitis, pathogenic bacteria organized as a bio film around the teeth stimulate the local expression of host inflammatory mediators (prostaglandins, intereulin-1, and tumor necrosis factor alpha). In addition, bacterial pathogens and their products (lipopolysaccharide endotoxin) penetrate gingival tissues and enter the vascular system (bacteremias and endotoxemias) resulting in potential systemic effects.

Observational studies involving subjects with periodontal disease implicate inflammatory events in several body systems. Accordingly, patents with periodontal disease exhibit elevated serum levels of hepatic acute-phase markers, such as C-reactive protein.

Individuals with periodontal disease are 30% more likely to have cardiovascular disease, and pregnant mothers with periodontal disease are 4 to 7 times more likely to have a preterm, low birth weight infant. Although patients with diabetes are 3 times more likely than nondiabetics to present with periodontal disease, limited clinical trail data suggest that interventions reducing gingival inflammation also may improve glycemic control in patients with diabetes.

Patients, dentists, physicians, and other health care providers should be aware of the emerging interrelationships between periodontal infection, oral inflammation, and systemic disease. Clinicians and patients also should appreciate the value of preventive strategies that reduce oral inflammation, improve dental health, and enhance overall well-being.