Odonto Stetic – Periodontitis

PERIODONTITIS AND ITS RELATIONSHIP WITH CARDIOVASCULAR DISEASES AND DIABETES MELLITUS

High blood pressure is one of the main risk factors for the development of ischemic heart disease and the principal risk factor for cerebrovascular accidents (strokes). It’s essential to understand that the mouth is not an isolated structure within the body, and while the importance of the oral cavity is recognised, little is known about the relationship between periodontitis and infections in other organs or systems of the human body (1).

In periodontitis, gram-negative bacteria (P. gingivalis) are present, which can access the vascular system of the underlying connective tissue, and from there, enter the general circulation, offering high possibilities for the exchange of toxic bacterial products between the periodontal pocket and the circulatory system (2). This release of bacteria into the body generates an inflammatory response from the immune system, which can cause stimulation of adhesion and cholesterol deposition in the vascular pathways, leading to the narrowing of the vessel lumen (3). Each individual responds differently to bacterial aggression, and in some people, an exaggerated inflammatory response can occur, exacerbating the situation in patients with preexisting cardiovascular diseases. Specifically, research indicates that periodontitis is associated with the onset of endothelial dysfunction, atherosclerosis, and an increased risk of myocardial infarction.

Cardiologists and dentists agree that diseases affecting the gums (especially periodontal infections) are a risk factor for coronary episodes, some of which are so severe that they can endanger the patient’s life (4). While the most important risk factor for developing heart disease is genetic, there are bacteria like P. gingivalis and others capable of intracellularly invading endothelial cells and causing direct damage by evading the host’s immune response (5).

This inflammation can affect the control of diabetes mellitus in the same way it can affect the function of beta cells, generate insulin resistance, and even promote the development of Type 2 diabetes (6).

Periodontitis and diabetes are chronic, common, and complex diseases with a bidirectional relationship. That is, poor diabetes control is associated with an increased prevalence and severity of periodontitis, and severe periodontitis is associated with poor glycemic control. Periodontitis is characterised by inflammation of the tissues supporting the teeth and is considered the sixth major diabetic complication worldwide (7).

DENTAL RECOMMENDATIONS:

1. Maintain proper oral hygiene measures.
2. Brush your teeth after each meal, at least twice a day, and use dental floss daily to prevent the development of dental plaque and periodontal disease.
3. Regularly examine your mouth to detect problems early, checking each tooth and including the gums.
4. If you have sores, wounds, gum bleeding, ulcers, tooth loss, mouth pain, white patches, or bad breath, consult your dentist.
5. If you use dentures, ensure their hygiene and condition, and make sure they fit well and do not cause rubbing or wounds.
6. Keep your blood glucose levels at appropriate levels.
7. Quit smoking, as it worsens periodontal disease.
8. Visit your dentist regularly for a comprehensive examination and to discuss how to maintain good oral health.
9. Undergo periodontal treatments if necessary to achieve a proper state of bone and gum and thus avoid tooth loss.

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