Periodontitis patients and arterial damage

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        Bleeding gums a sign of periodontitis
        By Christiane Loell Mar 21, 2011, 3:07 GMT

        Berlin – Bleeding gums, breath odour, loose teeth, and teeth sensitive to hot and cold food and drinks are all symptoms of periodontitis. A usually chronic gum infection, it is caused by bacteria on the teeth and is linked to illnesses including diabetes, cardiovascular disorders and rheumatism. Smoking is seen as a risk factor. What can be done to stop it? Get rid of the bacteria, experts advise.

        Many people think there is no harm in a little gum bleeding, noted Dietmar Oesterreich, vice-president of the German Dental Association. ‘But if all the teeth are affected, there is a permanent, approximately palm-sized wound through which bacteria can enter the body, which has to defend itself against them,’ he said. Periodontitis should therefore be treated.

        According to experts, periodontitis is usually the result of poor oral hygiene. But general illnesses, smoking, stress and heredity can also play a role. An aggressive form of the infection, caused by certain bacteria, can befall people with a weakened immune system.

        ‘These germs don’t scurry around the oral cavity. They stick to the teeth in what is called biofilm,’ explained Sabine Koehler, a dentist in the German city of Aachen and executive board chairwoman of the German internet portal Dentists’ Medical Counselling Service. The biofilm can become dental plaque and harden into tartar, she said.

        Metabolic products of the bacteria loosen the gums (gingiva) and cause inflammation. The gums swell and start to bleed. If the condition is allowed to persist, gingival pockets and bone loss can result. Then the teeth may become loose and even fall out.

        Dentists have various ways to remove biofilm from the teeth and clean out gingival pockets. ‘The aim is to eliminate the inflammation by cleaning tooth surfaces thoroughly,’ Oesterreich remarked. He said this could be done under local anaesthesia with a hook-like scraping tool or ultrasonic scaler.

        In cases of advanced periodontitis, some of the inflamed gingival pockets may have to be surgically removed. ‘Sometimes we also treat it with antibiotics,’ said Ulrich Schlagenhauf, president of the German Periodontology Society.

        At Schlagenhauf’s clinic in the German city of Wuerzburg, a small-scale study of possible links between periodontitis and arterial damage was carried out. Physicians taking part in the study measured patients’ pulse wave velocity, which is elevated when arteries have become stiff due to arteriosclerosis, for example.

        ‘The study was very small. There were only about 100 patients. But we have indications that many periodontitis patients have arterial damage,’ Schlagenhauf said. ‘If an internist detects arterial damage, it’s probably worthwhile to send the patient to a dentist. Conversely, problems in the oral cavity can prefigure cardiovascular problems.’

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