Standish Street Dental Practice | Cosmetic Dentistry Burnley


Does Periodontal Treatment Improve General Health?

Over the past 15 years, there have been several reports and studies showing that poor oral health, especially the extent and severity of periodontal disease, is associated with a range of systemic conditions.

For example, has periodontal disease has been demonstrated to be a risk for an adverse pregnancy outcome and what impact does periodontal intervention have on diabetic control? Does improving oral health reduce the risk of further coronary events?

The basic philosophy of periodontal treatment is to reduce or remove the inflammatory component in the gingival and periodontal tissues. Success of treatment, that is resolution of inflammation, is characterized by a reduction in bleeding on probing, reduction in probing pocket depths and a change in gingival contour. Patients will also notice the benefits of periodontal treatment. There will be a reduction of bleeding on brushing, change in gingival appearance and perhaps reduction in bad breath and taste. The primary goal of periodontal therapy is to preserve the dentition and prevent further attachment loss. However, consideration now needs to be given to the potential systemic benefits of reducing periodontal inflammation on a variety of body systems and disease processes.

There is increasing evidence that periodontal disease is a significant risk factor for an adverse pregnancy outcome. This risk has been estimated to be 7.5 fold; that is, patients with periodontal disease are 7.5 times more likely to experience an adverse outcome to their pregnancy when compared to patients who are free of periodontal disease. Five intervention studies have been completed to date to evaluate the effect of periodontal intervention on pregnancy outcome. Four of these studies show a significant benefit of periodontal intervention in reducing the risk of an adverse pregnancy outcome (pre-term low birth weight, PLBW, gestational age 7 weeks, pre-eclampsia, miscarriage), whilst one study shows no benefit. It is worth noting that, for each study, very different populations and ethnic backgrounds have been chosen.

Glycaemic control in diabetics - It is now well established that patients with diabetes show an increase in susceptibility to periodontal disease, in terms of prevalence, severity and progression. There is increasing evidence that the diabetes-periodontitis relationship could be bi-directional. That is, patients with diabetes show an increased susceptibility to periodontal disease and treatment of underlying periodontal disease may improve diabetic glycaemic control. The evidence suggests that periodontal therapy does have an effect on diabetic control, but the impact is small. Type 2 diabetic patients benefit more from periodontal intervention than type 1 diabetics with respect to their glycaemic control. Such intervention may be important in the borderline diabetic patients in which oral hypoglycaemic medication is being considered.

Periodontal disease and systemic markers of inflammation - The association between periodontal disease and cardiovascular diseases reported in the early 90s has suggested that the common pathway between these two conditions is mediated via inflammatory markers. C-reactive protein(CRP), an acute phase protein, has been studied extensively. CRP is regarded as a biomarker of systemic inflammation. Raised levels of CRP (>2.1 mg/1) are considered a risk for cardiovascular disease. Six intervention studies concluded that patients with periodontitis had raised levels of CRP and that periodontal therapy does reduce CRP levels. It is now widely recognized that cholesterol, especially serum levels of low-density lipoprotein (LDL) cholesterol are significant risk factors for atheroma formation and coronary heart disease (CHD). Periodontitis has also been shown to be associated with raised levels of serum cholesterol.

Conclusion - Evidence appears to be increasing that oral health is a significant risk for a variety of systemic diseases. Visiting the hygienist regularly and maintaining a good routine of brushing and flossing is vital to both retain your dentition and to optimise your general health.

Source - Dental Update article on Periodontology

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