Forsyth Institute Receives $20.7 to Fight Periodontal Disease
The Forsyth Institute , the world’s leading independent, oral health research organization, has received $20.7 million to fight periodontal disease. Three related projects will study periodontal disease progression from microbiological, genetic, host immune response and clinical perspectives. This research, funded by the National Institute of Dental and Craniofacial Research (NIDCR), will take place over a four-year period. The ultimate goal is to gain an understanding of why people develop gum disease, how the disease progresses, how to predict active disease before it occurs, and ultimately, how therapies can be developed to improve periodontal and overall health.
According to the Forsyth Institute, forty percent of adults in the United States have some form of periodontal disease. It is one of the most common infectious diseases and, in its more severe forms, causes loss of the bone that supports the teeth. In addition, there are strong associations between periodontal disease and systemic diseases including diabetes, metabolic syndrome, cardiovascular disease, pre-term birth, and certain cancers.
Previous work at Forsyth has demonstrated that the progression of the disease is not continuous, but is episodic. Thus, to understand its pathogenesis, patients must be studied to identify sites in the mouth that are undergoing active disease progression, which is the focus of these studies. The Forsyth projects, respectively led by Dr. Ricardo Teles, Director of the Center for Clinical and Translational Research; Dr. Bruce Paster, Head, Department of Molecular Genetics; and Dr. Jorge Frias-Lopez, Assistant Member of Staff, Department of Molecular Genetics, will examine clinical parameters, expression of host derived molecules, bacterial ecology, and bacterial gene expression during active disease. It will also seek to identify biomarkers in blood, saliva, and gingival crevicular fluid (a fluid that oozes from the gum margin) samples from 500 individuals, both with and without existing gum disease. The data gathered by Forsyth’s scientists as well as aliquots of the samples will be made available to the scientific community and will represent the largest available information base and depository of samples for periodontal disease.
“The knowledge developed through these three linked projects will provide unique and extraordinarily valuable insights into the periodontal disease process, as well as serve as a one of a kind resource to the scientific community,” said Philip Stashenko, President and CEO of The Forsyth Institute. “This work represents the multidisciplinary epitome of periodontal disease research. We may be able to finally lay a firm foundation to understand why periodontal disease progresses. It is extremely rare for three projects to receive awards linked to one clinical trial, and this support from NIDCR is a testament to the promise of this research.”
The three projects were funded due to the strength of each projects and the overall potential impact of the collaborative research. The Forsyth team will also work with four other oral health research centers around the country. The Michigan Center for Oral Health Research is the first clinical research partner. Four additional research facilities will join the project shortly.
Worried About Your Health? Visit Your Dentist More Often
A recent study published in the journal Health Economics revealed that regular dental check-ups could reduce the risk of serious medical conditions by a third.
The study, led by a University of California, Berkeley, researcher could give women a little extra motivation to visit their dentist more regularly. The study suggests that women who get dental care reduce their risk of heart attacks, stroke and other cardiovascular problems by at least one-third.
While the analysis, which used data from nearly 7,000 people ages 44-88 enrolled in the Health and Retirement Study, did not find a similar benefit for men, however, dental experts are still urging male patients to take good care of their teeth and gums.
The study compared people who went to the dentist during the two years leading up the study, with data relating to those who had not visited the dentist during the previous two years.
The findings add to a growing body of research linking oral and cardiovascular health.
“Many studies have found associations between dental care and cardiovascular disease, but our study is the first to show that general dental care leads to fewer heart attacks, strokes, and other adverse cardiovascular outcomes in a causal way,” said study lead author Timothy Brown, assistant adjunct professor of health policy and management at UC Berkeley’s School of Public Health.
The fact that men and women did not benefit equally from dental care did not completely surprise the researchers. “To my knowledge, previous studies in this area have found that the relationship between poor oral health and cardiovascular disease markers varies by gender, but none have examined differences between men and women with regard to actual cardiovascular disease events,” said Brown, who is also associate director of research at UC Berkeley’s Nicholas C. Petris Center on Health Care Markets & Consumer Welfare.
“We think the findings reflect differences in how men and women develop cardiovascular disease,” said study co-author Dr. Stephen Brown, a first-year obstetrician/gynecologist resident at the West Virginia University Charleston Division School of Medicine. “Other studies suggest that estrogen has a protective effect against heart disease because it helps prevent the development of atherosclerosis. It’s not until women hit menopause around age 50 to 55 that they start catching up with men.”
“This study shows that periodontal disease is a bigger problem than we all thought. It is a call to action for anyone who cares about his or her oral health,” Dr. Samuel Low, professor of periodontology at the University of Florida College of Dentistry and president of the American Academy of Periodontology, said in a news release from the organization.
Since periodontal disease is known to do more than just harm the gums, these findings are quite serious. Without treatment, periodontal disease can become a gateway for serious diseases like heart disease, stroke, diabetes, and impaired kidney health, among other things.
“Given what we know about the relationship between gum disease and other diseases, taking care of your oral health isn’t just about a pretty smile. It has bigger implications for overall health, and is therefore a more significant public health problem,” Low added.
Paul Eke of the U.S. Centers for Disease Control and Prevention and colleagues examined the mouths of more than 450 people older than 35 years of age, finding more cases of gum disease than previous studies had. Researchers postulated that previous studies had less stringent guidelines for periodontal disease.
“Not only should you take good care of your periodontal health with daily tooth brushing and flossing, you should expect to get a comprehensive periodontal evaluation every year,” Low said.
More and more, patients and practitioners are realizing that good at-home oral health habits are important for more than just nice-looking teeth. Keeping teeth healthy and clean is also important for maintaining good heart health.
According to a recent study published in the Journal of Periodontology, people with periodontal disease are at a higher risk for developing cardiovascular disease than those with healthy gums. The study found that study participants with gum disease had higher levels of harmful bacteria in the bloodstream – up to four times more than study participants with healthy gums.
Columbia University researchers looked at three forms of bacteria common in patients with gum disease and found that patients with one or any combination of the three bacteria also had hardening of the arteries.
These are just two examples of dozens of ongoing studies that continue to link good oral health with good heart health.
Patient education is key in this area, since the average patient will simply assume that brushing and flossing teeth is only essential to maintaining healthy teeth and gums. Incentive to be more proactive at brushing and flossing may increase should patients have a better understanding of how their oral health affects their overall health, including the link between periodontal health and heart health.
It’s a simple formula – good oral care can help maintain a healthy heart.
Researchers analyzed the data from the 1999 to 2002 Behavioral Risk Factor Surveillance System, an ongoing telephone survey operated by state health agencies with assistance from the Centers for Disease Control and Prevention.
The study was conducted based on 41,891 adults aged 40 to 79 years old in 22 states and the District of Columbia.
Study participants who still had all of their natural teeth, 4.7 percent had heart disease.
From there, risk of heart disease increased dramatically. Those who were missing one to five teeth were 21 percent more likely to have heart disease. Heart disease increased by 60 percent among those missing six to 31 teeth, and by 81 percent among those with no remaining natural teeth.
The results of this study join the growing body of research linking gum disease and tooth loss with an increased risk of heart disease.
More Research Regarding the Relationship Between Oral Health and Cardiovascular Health
Study Links Hypertension, Periodontal Bacteria
The hundreds of bacteria in the human mouth are there for a reason. Many of them are completely innocuous bacteria that like the conditions of the human mouth – it is, after all, warm, dark and wet, which are ideal conditions for growing many types of bacteria.
A handful of the bacteria in the mouth help support the health of teeth and gums. Another handful of bacteria found in the human mouth can be harmful not only to oral health, but to the health of the body as a whole.
Researchers believe that the true link between oral health and heart health lies in the balance of those bacteria.
A recent study published in the May 5, 2010 edition of the Journal of Hypertension revealed that those with significantly higher levels of periodontal bacteria in plaque samples of those with hypertension.
Seven investigators from Columbia University, the University of Miami, the University of Minnesota, and the French School of Public Health collected 4,533 subgingival plaque samples from 653 patients enrolled in the Oral Infections and Vascular Disease Epidemiology Study (INVEST). They analyzed the samples for the presence of 11 different species of periodontal bacteria, including Actinomyces naeslundii and Prevotella intermedia.
The researchers, led by Moise Desvarieux, M.D., Ph.D., found that the odds ratio for prevalent hypertension was 3.05 among the patients in the highest tertile of bacterial burden compared to those in the lowest tertile.
The team found that, after adjusting for conventional risk factors, the mean systolic blood pressure increased significantly with increasing cumulative bacterial burden, at 136, 138, and 143 mmHg for the first, second, and third tertile, respectively (p = 0.0004). The diastolic blood pressure also increased significantly, at 77, 79, and 81 mmHg, respectively.
The prevalence of hypertension was 57%, 62%, and 68%, respectively. This translated into more than threefold higher odds of hypertension between the third and first tertiles; after further adjustment for white blood cell count and titer of hs-CRP, this rose to 3.93. The increase between the first and third tertiles in both hypertension and diastolic blood pressure was more than twice as large for men as for women, while the increase in systolic blood pressure was nearly three times as large in men.
Good at-home oral health habits are important for more than just nice-looking teeth. Keeping teeth healthy and clean is also important for maintaining good heart health.
According to a recent study published in the Journal of Periodontology, people with periodontal disease are at a higher risk for developing cardiovascular disease than those with healthy gums.
The study found that study participants with gum disease had higher levels of harmful bacteria in the bloodstream – up to four times more than study participants with healthy gums.
Researchers at Columbia University School of Public Health found similar results, reinforcing doctors’ longstanding belief that periodontal health is directly linked to cardiovascular health.
Columbia University researchers looked at three forms of bacteria common in patients with gum disease and found that patients with one or any combination of the three bacteria also had hardening of the arteries.
Patient education is key in this area, since the average patient will simply assume that brushing and flossing teeth is only essential to maintaining healthy teeth and gums. Incentive to be more proactive at brushing and flossing may increase should patients have a better understanding of how their oral health affects their overall health, including the link between periodontal health and heart health.
It’s a simple formula – good oral care can help maintain a healthy heart.
Cardiologists to Examine Mouths & Periodontists to Question Patients About Heart Health
In July 2009, cardiologists and periodontists combined their research and published a consensus paper in the American Journal of Cardiology (AJC), a publication circulated to 30,000 cardiologists, and the Journal of Periodontology (JOP), the official publication of the American Academy or Periodontology (AAP).
This paper paves the way for cardiologists to examine a patient’s mouth and periodontologists to collect heart history information from their patients.
In addition to the clinical recommendations, the consensus paper summarizes the scientific evidence that links periodontal disease and cardiovascular disease and explains the underlying biologic and inflammatory mechanisms that may be the basis for the connection.
The paper confirms that cardiologists and periodontists agree that inflammation – the way the body naturally fights infection, injury and invasion of pathogens – can turn into a chronic condition that can cause serious health problems.
The True Connection Between Heart Health and Periodontal Disease
Cardiac Heart Health Influenced by Oral Health
Researchers in both the cardiac health and dental health fields have confirmed that periodontal disease is a known precursor to heart disease, and they know the common link – bacteria.
The bacteria that is responsible for destroying the health of both gums and teeth – Streptococcus mutans - eventually breaks down gum tissue far enough that that it is able to break through the gums and enter the blood stream, where it causes inflammation and causing atherosclerosis and coronary heart disease.
Bacteria at the Heart of Heart Disease?
Absolutely. Studies link New Study Confirms Periodontal Disease Linked to Heart Disease also show that treating periodontal disease before it becomes advanced is the first line of defense in protecting the heart from the potential harm of the bacteria of the mouth.
Who Says Bacteria Affects Heart Health? WHO!
These figures are backed by major health organizations. In fact, the World Health Organization says that cardiovascular disease accounts for 29% of deaths worldwide and that it ranks as the second leading cause of death after infections and parasitic diseases.
The American Heart Association has reported that atherosclerosis, a major component of cardiovascular disease, affects 1 in 4 persons and contributes to 39% of deaths annually in the United States.
How Do We Effectively Battle These Bacteria?
Current dental procedures to address periodontal disease include the painful, invasive practice of “scaling” teeth below the gum line in an attempt to clean the pathogenic bacteria out of the deep periodontal pockets that surround each tooth. Unfortunately, the success of this procedure rests solely on which bacteria recolonizes the pocket first – beneficial or pathogenic.
Researchers in Florida have created a combination of three probiotics that have shown the ability to effectively compete for space and nutrients with the pathogenic bacteria connected to periodontal disease and tooth decay. As an added benefit, this combination of probiotics naturally and safely freshens breath while gently whitening teeth.
