85% of the population in the UK suffer from gum disease with a lesser proportion suffering from chronic periodontitis a chronic type of gum disease which left untreated results in the breakdown of the supporting periodontium and bone which supports the tooth. The main cause of this is dental plaque which is made up of bacteria and food which accumulates around the tooth, however much research has identified that many of those affected are predisposed to the condition and are also at a higher risk of suffering from generalised chronic diseases such as diabetes mellitus and chronic heart disease. Furthermore it has also been linked to pregnant women giving birth to pre-term or low birth weight babies.
There is much research that increasingly demonstrates improved oral hygiene and control of periodontitis results in better diabetic control and a reduced risk of pre-term or low birth weight babies. In addition evidence is supports the idea that poorly controlled periodontitis, in those who are genetically predisposed, results in an imbalanced immune reaction and generalised chronic inflammatory process due to bacterial ingress into blood. Due to this process, insulin does not work effectively and the result is poorly controlled glucose levels. The mechanism by which periodontal status effects pregnancy and heart disease however is not yet well understood.
The WHO highlighted the importance of oral health and chronic disease in the 2003 'Oral Health Report' in which they stated 'oral health is integral and essential to general health and that oral health is a determinant factor for quality of life... 'moreover periodontal disease and tooth loss are linked with chronic diseases such as diabetes mellitus.'
So as a patient how seriously do you take it when your dentist advises you to improve your oral hygiene routine? Unfortunately at present there is very little awareness of the relationship of all these diseases and it is understandable that patients may not take on board the impact that oral health may have on their general condition. This perhaps is also hindered by their GP advising them to, rightly improve diet, exercise and reduce tobacco and alcohol intake but not informing them of the benefits of better oral care (an independent factor), in light of the current research.
I regret to say that it has been a very rare occasion when a patient diagnosed with either diabetes, glucose intolerance or chronic heart disease has been referred to my clinic to check their periodontal status. Further still when a patient presents with generalised aggressive periodontitis and is referred to their GP to check their general health it has mainly been greeted with confusion.
Considering the volume of research in this field surely it is time for the medical and dental fields to work more closely together to improve public awareness of this issue?
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