More and more evidence points to the relationship between strokes and periodontal (perio) disease. Studies in the Infectious Diseases Unit, Hospital Luigi Sacco, Milan, Italy have reported that the thickness of the carotid arteries was reduced after treatment for mild to moderate gum disease.
 
Strokes are caused by blockage in a blood vessel (most common) or bleeding of a vessel. The studies that were conducted showing a link between strokes and periodontal issues were those strokes caused by blockages. These occur when there is a thickening of the carotid and other arteries. Deposits of calcium and cholesterol – that are in blood vessels and arteries – break off and block the blood from reaching the brain. (The deposits are often referred to as plaque deposits. This is not to be confused with periodontal plaque.)
 
The bacteria found in periodontal disease are the perpetrator. The protein in the bacteria is similar to that found in periodontal disease. While the bacteria are in the mouth, the body sets up a defense mechanism to attack the disease. The chemical given off by the body first attacks the periodontal disease then attacks the proteins in the blood vessels. This in turn builds up the deposits in the arteries. When the fatty substances break off the lining of the blood vessels they can travel to the brain and block the blood, causing the stroke.
 
There are about 800,000 strokes in the US each year, with over 140,000 deaths. It is the third leading cause of death. Strokes strike both men and women and can occur at any age.
 
Perio disease is a chronic infection of the soft tissue around the teeth. The gum tissue is destroyed and pockets are formed around the tooth. Symptoms include loose teeth, deep pockets, bad breath that won’t go away, painful or bleeding gums and red or swollen gums. There are no symptoms in the early stages of periodontitis. Professional dental visits are necessary to insure the disease is caught early. Periodontitis is caused by the plaque (in this case dental plaque) build up from not keeping the area around the teeth and in between teeth clean.
There are risk factors for stroke that one cannot control. These include age, gender, and family history. There are risk factors, however, that can be controlled. One factor is periodontal disease. This can be managed successfully by individuals. Although oral surgical procedures may be necessary for severe cases, most treatment requires good oral hygiene. The American Dental Association (http://www.ada.org/public/topics/cleaning.asp) recommends brushing teeth twice a day, flossing once a day, and professional cleanings twice a year.
 
The National Center for Biotechnology Information who published the study showing the link between strokes and periodontal disease, reported that the thickening of the carotid arteries “are positively influenced by periodontal treatment.” (http://www.ncbi.nlm.nih.gov/pubmed/19074511?dopt=Abstract)
 
This information reinforces the belief that many in the dental profession have known for years, that there is a significant link between oral health and overall health.

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1. Gum Disease – Battling the Almost Inevitable Gum Disease
2. Cleaning Your Teeth Help Keep Your Immune System Healthy
3. Periodontal Disease Association With Endometriosis

Chances are high that you will have periodontal disease or gum disease in your lifetime. Over 80% of adults do. With those odds, it may seem inevitable that you will have it, but why not be in the 20% that don’t? You can, all it takes is diligent, thorough and proper oral care.  

First – THE DESCRIPTION: periodontal disease is the chronic infection of the soft tissue around the teeth caused by plaque producing bacteria. The gums hold the teeth in place. As the gums become infected, they loosen their hold on the teeth and pockets are formed. These pockets collect debris and cause more infection and bone loss to the tooth. Imagine the tooth as a fence post in the ground, cemented in place. The post starts out sturdy and strong with no movement. The cement is doing its job. Now imagine that chemicals (from acid rain or blowing debris or winter salt trucks) start to erode the cement. Soon the post becomes wobbly and the wood under the ground starts to rot. The cement in this example is the gum tissue and the post is the tooth. Unfortunately, gum disease is worse than one rotting fence post. It is infectious and contagious. It can spread from tooth to tooth in the mouth and from one person’s mouth to another through saliva.  

Second – THE SYMPTOMS: This is not so easy. Often gum disease has no symptoms so it is left untreated until it becomes so bad irreparable bone loss occurs. Outward signs of periodontitis are:

• Bad breath that won’t go away
• Red or swollen gums
• Bleeding gums especially after tooth brushing
• Tender or sore gums
• Loose teeth
• Receding gums

 Third – THE DIAGNOSIS: During regular six month cleanings, a dentist can diagnose periodontal disease in its very early stages. Xrays determine if any bone loss has occurred. Periodontal probing determines the depth of the pockets or space that the gums have loosened around the tooth. High levels of plaque or tartar build up that have spread to below the gum line is another indication.  

Fourth – THE TREATMENT: If you have perio issues, there are several steps that a dentist may recommend depending on the severity of the case. The most important action is meticulous at home daily oral care. Teeth must be brushed twice or more times each day for at least two minutes and flossed at least once per day. Other treatments include prescription oral rinses, three month perio cleanings, scaling and root planing (SRP) and surgery.  

Last but not least – PREVENTION: The most important preventative measure to avoid the insidious gum disease is to take excellent care of your teeth. Proper cleaning at least twice a day is imperative. The goal is to keep the bacteria that cause the plaque at very low levels.   Not everyone gets gum disease, make sure you are among those that don’t.

Related posts:

1. Periodontal Disease
2. Clean Teeth Could Mean Clean Arteries – Less Chance of Stroke
3. Periodontal Disease Association With Endometriosis