NO TEETH BIG PROBLEM

Number of Teeth as a Predictor of Cardiovascular Mortality in a Cohort of 7,674 Subjects Followed for 12 Years Background: That oral health is related to the development of different cardiovascular disorders is reported in a number of studies. This study investigates if different parameters of oral health are associated with future mortality in different cardiovascular disorders in a dose-dependent manner. Conclusion: This fairly large, prospective study with a long follow-up period presents for the first time a dose-dependent relationship between number of teeth and both all-cause and CVD mortality, indicating a link between oral health and CVD, and that the number of teeth is a proper indicator for oral health in this respect.

LANAP at the AAP meeting

I hope you have the oportunity to go to the AAP this year.


lloyd Tilt will be speaking on Sunday he will show his 10 year data.

I guess in Perio 10 years is considered innovative?

IP2: INNOVATIONS IN PERIODONTICS SESSION 2
10:15 - 11:45 am




http://perio.org/meetings/am/2009AdvanceProgram.pdf

Interesting thing about periodontists is all available accounts seem to suggest that Dr. Grace Rogers may have been the first practicing Periodontist in 1914.




You would think 10 years of data would be allot considering periodontics has been existence less than 100 years.

Though, it is still considered INOVATIVE?

Periodontal disease a risk marker for stroke

Periodontal disease a risk marker for stroke.

Men with a history of bone loss due to periodontitis run a higher risk of having a stroke, according to a study in the Annals of Neurology (May 28, 2009).

The potential role of periodontitis in the risk of cardiovascular disease has received much attention in the past decade, and evidence of an association between periodontitis and cerebrovascular disease, especially ischemic stroke, has been stronger compared to other types of cardiovascular disease, the study authors noted.

Although the link has been reported before, their research examined the clinical measures of periodontitis as opposed to self-reports or other assessments not involving periodontal probing, lead study author Thomas Dietrich, D.M.D., of the University of Birmingham School of Dentistry said.

The researchers analyzed data from 1,137 men in the Veterans Affairs Normative Aging Study, an ongoing study that began in the 1960s with healthy volunteers from the greater Boston area. Participants underwent medical and dental exams every three years for an average of 24 years.

A trained periodontist conducted the dental exams, including full mouth radiographs and periodontal probing at each tooth. Cerebrovascular disease was defined as a stroke or transient ischemic attack.

Dr. Dietrich and his colleagues evaluated the incidence of cerebrovascular events in relation to mean radiographic alveolar bone loss (a measure of periodontitis history) and cumulative periodontal probing depth (a measure of current periodontal inflammation).

Bone loss key

Overall, 80 incident cases of cerebrovascular disease occurred during a combined 27,506 person-years, and periodontal bone loss was "significantly associated" with an increased hazard rate of cerebrovascular disease, according to the researchers. They found a stronger effect among men younger than 65 compared to older men.

In comparison, periodontal probing depth was not associated with a significantly increased rate of cerebrovascular disease.

The exact mechanism of the association is unclear, said Dr. Dietrich, noting that both causal and noncausal factors may explain it.

There could be direct or indirect effects of the periodontal infection and inflammatory response, or some people may have an increased proinflammatory susceptibility that could contribute to both cerebrovascular disease and periodontal disease, the authors wrote. Current epidemiologic studies are not able to differentiate between these causal and noncausal pathways, even with perfect control of all established cardiovascular risk factors.

And why was periodontal bone loss significantly associated with an increased hazard rate of cerebrovascular disease, while periodontal probing depth was not?

"This is more consistent with a noncausal mechanism, since treatment of periodontitis or tooth loss would not affect the underlying susceptibility to inflammatory disease," Dr. Dietrich said.

A significant link was found between history of periodontitis as measured by alveolar bone loss and incidence of cerebrovascular disease in men, independent of established cardiovascular risk factors, the authors noted. Furthermore, they found evidence for a stronger association between periodontal bone loss and incidence of cerebrovascular disease among younger men.

"Even if this association was predominantly noncausal, periodontitis could be an important marker of risk for cerebrovascular disease, given its relatively high prevalence and the strength of the association," they concluded.

Large epidemiologic studies using molecular and genetic approaches in various populations are necessary to determine the strength of the association between periodontitis and cerebrovascular disease and to elucidate its biologic basis, they added.

Patients With Moderate To Severe Periodontitis Need Evaluation For Heart Disease Risk

Additional research is called for and patients with moderate to severe periodontitis should receive evaluation and possible treatment to reduce their risk of atherosclerotic cardiovascular disease (CVD), according to a special consensus paper by editors of The American Journal of Cardiology and Journal of Peridontology in the July 1, 2009 issue of The American Journal of Cardiology, published by Elsevier. Periodontitis, a bacterially-induced, localized, chronic inflammatory disease, destroys connective tissue and bone that support the teeth. Periodontitis is common, with mild to moderate forms affecting 30 to 50% of adults and the severe generalized form affecting 5 to 15% of all adults in the USA. In addition, there is now strong evidence that people with periodontitis are at increased risk of atherosclerotic CVD - the accumulation of lipid products within the arterial vascular wall. The explanation for the link between periodontitis and atherosclerotic CVD is not yet clear, but a leading candidate is inflammation caused by the immune system. In recent years the inflammation is now recognized as a significant active participant in many chronic diseases. Other explanations for periodontitis and atherosclerotic CVD are common risk factors such as smoking,Diabetes mellitus, genetics, mentalanxiety, depression, obesity, and physical inactivity. Regardless of the cause, the expert panel believes that the current evidence is strong enough to recommend that doctors assess atherosclerotic CVD in their patients with periodontitis. The research recommends that patients with moderate to severe periodontitis should be informed that there may be an increased risk of atherosclerotic CVD associated with periodontitis, and those patients with one or more known major risk factor for atherosclerotic CVD should consider a medical evaluation if they have not done so in the past 12 months. "This consensus paper is important because it will draw attention to the fact that patients with periodontitis, especially moderate and severe forms of the disease, can have increased risk for coronary disease," commented to David Dionne, Executive Publisher of The American Journal of Cardiology. Notes: The article is "The American Journal of Cardiology and Journal of Periodontology Editors' Consensus: Periodontitis and Atherosclerotic Cardiovascular Disease" by Vincent E. Friedewald, MD, Kenneth S. Kornman, DDS, PhD, James D. Beck, PhD, Robert Genco, DDS, PhD, Allison Goldfine, MD, Peter Libby, MD, Steven Offenbacher, DDS, PhD, MMsc, Paul M. Ridker, MD, MPH, Thomas E. Van Dyke, DDS, PhD and William C. Roberts, MD. It appears in The American Journal of Cardiology, Volume 104, Issue 1 (July 1, 2009) published by Elsevier. Source: Maureen Hunter Elsevier

Gum disease is Contagious

From AAP web site
Families and Periodontal Disease
Periodontal (gum) disease may be passed from parents to children and between a couple
Several recent studies support the association between periodontal (gum) disease and family members:
Periodontal (gum) disease may be passed from parents to children and between a couple, according to an article in the September 1997 issue of the Journal of the American Dental Association. Researchers suggest bacteria that cause periodontal disease pass though saliva. This means that the common contact of saliva in families puts children and couples at risk for contracting the periodontal disease of another family member. Periodontal disease can lead to tooth loss.M
Up to 30% of the population may be genetically susceptible to developing severe periodontal disease, according to a study published in the Journal of Clinical Periodontology. These findings could result in the early identification and treatment of at-risk patients.
Based on this research, The American Academy of Periodontology (AAP) recognizes that treatment of gum disease may involve entire families. If one family member has periodontal disease, the AAP recommends that all family members see a dental professional for a periodontal disease screening.

Diabetes: It's Connection to Oral Health

Here is an interesting article. Article

Diabetic patients are at greater risk for tooth decay due to the presence of higher bacteria levels found in saliva when diabetes is not under control. As diabetes can lower resistance to infection, periodontal disease can develop.