November 1, 2013
Healthier Gums Boost Cardiovascular Health, Say Researchers
Brett Smith for redOrbit.com - Your Universe Online
Maintaining healthy gums could do a lot more than just make visits to the dentist less painful. According to a new report in the Journal of the American Heart Association, an improvement in gum health is directly related to a slowing of atherosclerosis, a dangerous condition marked by the narrowing and hardening of the arteries.
"These results are important because atherosclerosis progressed in parallel with both clinical periodontal disease and the bacterial profiles in the gums. This is the most direct evidence yet that modifying the periodontal bacterial profile could play a role in preventing or slowing both diseases," said Dr. Moise Desvarieux, an associate professor of epidemiology at Columbia University and study co-author.
In the study, the international team led by Columbia researchers followed 420 northern Manhattan residents. Study volunteers were checked for periodontal infection. The researchers analyzed over 5,000 plaque samples for 11 bacterial strains associated with periodontal disease and seven control bacteria. Fluid around participants’ gums was sampled to determine levels of the protein interleukin-1β, a biomarker for inflammation. The scientists also determined participants’ level of atherosclerosis in both carotid arteries using a high-resolution ultrasound.
Over the course of several years, the researchers found that an average improvement in periodontal health and a reduction of gum disease bacteria correlated to a slower thickening of the arterial wall known as intima-medial thickness (IMT) progression. Worsening periodontal infections were seen mirroring the progression of IMT. The research team also considered potential confounding factors such as body mass index (BMI), cholesterol levels, diabetes, and smoking status.
The study authors said they saw a 0.1 mm gap in IMT change over three years among participants whose gum health was worsening compared with those whose periodontal health was improving. Previous studies have found a .033 mm per year increase in carotid IMT - the equivalent to about 0.1 mm over three years - is related to a 2.3-fold increased risk for coronary events such as heart attack or stroke.
"When it comes to atherosclerosis, a tenth of a millimeter in the thickness of the carotid artery is a big deal. Based on prior research, it appears to meet the threshold of clinical significance," said study author Dr. Tatjana Rundek, a cardiologist at the University of Miami.
The researchers said subtle changes to gum health status had a significant effect on carotid IMT.
"Our results show a clear relationship between what is happening in the mouth and thickening of the carotid artery, even before the onset of full-fledged periodontal disease," said co-author Dr. Panos N. Papapanou, a professor of dental medicine at Columbia University. "This suggests that incipient periodontal disease should not be ignored."
In earlier research, Desvarieux and colleagues found higher levels of disease-causing bacteria were linked with thicker IMT.
"Our results address a gap identified in the AHA statement on periodontal disease and atherosclerosis, by providing longitudinal data supporting this association," said study author Dr. Ralph Sacco, chairman of the neurology department at the University of Miami.
"It is critical that we continue to follow these patients to see if the relationship between periodontal infections and atherosclerosis carries over to clinical events like heart attack and stroke and test if modifying the periodontal flora will slow the progression of atherosclerosis,” Desvarieux said.