Periodontal diseases as a risk for systemic disease

A prominent periodontist and researcher who studies the links between oral health and systemic health, Dr Ray Williams from the University of North Carolina Chapel Hill, has presented a series of lectures in Australia.

Periodontal disease as a risk for systemic disease: bringing dentistry and medicine together presented to the Australian Society of Periodontology NSW Branch and others detailed the past decade's research on periodontal disease and its effect on systemic conditions.

"My lecture focused on the link between periodontal disease and systemic disease and how the treatment of periodontal disease effects systemic disease," Dr Williams said. "This relates back to the groundbreaking report released in 1989 that demonstrated a relationship between periodontitis and a higher likelihood of heart attack.

"Our initial reaction was to see if this finding was real or spurious. Now, some years later, it seems that periodontal disease not only has a correlation to cardiovascular disease, but also many other systemic conditions.

"Subsequent studies showed that mothers-to-be with periodontal disease were 7.4 times more likely to have a preterm, low birth weight infant.

"There is also a link between pancreatic cancer and periodontal disease. A study of 50,000 men over a 16-year period by Harvard Medical School showed that if an adult male has periodontal disease, he is 64% more likely to develop pancreatic cancer.

"As a follow on to this, we are keen to know the results of interventions in these situations. What happens if you treat the mother-to-be for instance? Can you reduce the likelihood of a preterm birth if you treat the periodontitis? The answer in several studies is yes but more research is needed.

"We also have early intervention studies with cardiovascular disease but not definitive findings. If you treat a person for periodontitis who is at risk of a second heart attack, then there is a trend that shows that periodontal treatment may reduce the likelihood of the heart attack but more research needs to occur in this area as well."

Dr Williams said that the underlying connection between periodontal disease and systemic diseases is inflammation. Diseases like Alzheimer's, arteriosclerosis, diabetes and more are all groups of diseases that are connected by inflammation and affected by the inflammatory response.

"The ultimate question is to what degree does good oral health slow the onset or reduce the severity of these diseases," he said. "As dentists begin to talk to cardiologists and endocrinologists, we start to see the links. If a person with diabetes and severe periodontitis is orally rehabilitated for example, will this affect the blood glucose levels in the person with diabetes?

"These days we are looking at periodontal disease as another inflammatory condition that is not that different from some other diseases that affect people. Is the mouth a site of inflammation that reaches to the extremities of the body and if so, what should we be doing about it? If good oral health is important to overall health, what is the responsibility for the dental profession?"

Dr Williams said that dentists at the specialist and GP level as well as dental hygienists are very interested in the role they can play.

"Hygienists in particular want to know what their role is in talking to people and general dentists are becoming comfortable with the concept as well. Dental groups are working to develop guidelines for medicine and dentistry to help educate practitioners on courses of action and patients on the importance of a healthy mouth.

"If you tried to summarise this, you would say that dentistry has a long and dedicated history of trying to provide good oral care to people and we now appreciate that there is more involved than just teeth and gums. The responsibility of dentistry now increases as we talk about healthy people."

Dr Williams thanked sponsors of the lecture program for their continuing support of endeavours to facilitate the education of both professionals and consumers on the importance of oral health to overall health.