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.

The Oral Health/Heart Health Connection

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.”

Study Shows Periodontal Disease Far More Common Than Previously Believed

In a study published in the online edition of the Journal of Dental Research, researchers at the CDC and the American Academy of Periodontology announced that officials have underestimated the prevalence of gum disease in the United States by as much as 50 percent.

“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.

Healthy Gums Equal Healthy Babies

Early Periodontal Treatment Staves Off Preterm Labor

Successfully treating advanced gum disease in pregnant women can significantly reduce the risk of preterm birth according to new research published in the September edition of the British Journal of Gynaecology.

Previous research has shown that women with periodontal disease are at risk for premature labor and delivery.

In this study, dentists and doctors evaluated 322 pregnant women divided into two groups: those who received periodontal treatment and those who did not. All of the women received at-home care instructions from a dental hygienist, as well as home-care supplies, such as toothbrushes, dental floss and toothpaste, but the women in the untreated group received no hands-on treatment as part of the study.

The women in the treatment group received dental scaling and root planing from a hygienist before the end of the first trimester of their pregnancies. These women were six times more likely to carry their babies to full term (past 35 weeks’ gestation) than were the women in the other group.

Based on these findings, the authors of the study have recommended that pregnant women with periodontal disease should receive root planning and dental scaling before the end of their first trimester of pregnancy to help reduce the incidence of spontaneous preterm birth.

Study Finds Men at Greater Risk for Periodontal Disease

A study recently published in the Journal of Periodontology found that men are at greater risk for developing periodontal disease due to gender-based differences in immune response.

The study’s co-author, Mark A. Reynolds, D.D.S., Ph.D., chair of the periodontics department at the University of Maryland Dental School, said that while the study concluded that males are at greater risk for periodontitis than females, the results do not support the conclusion that men are at greater risk for more rapid periodontal destruction than women.

Dr. Reynolds and his team, which included co-author, Harlan Shiau, D.D.S., D.M.Sc., conducted a systematic review of the literature (Medline, Embase, and Scopus) and a meta-analysis to estimate sex-related differences in the prevalence of periodontitis.

From 12 population surveys meeting selection criteria (representing 50,604 subjects), they found that sex exhibited a significant association with prevalence, reflecting a 9% difference between men and women (37.4% versus 28.1%, respectively), although the overall effect of sex in the meta-analysis was comparatively small (d = 0.19, 95 CI: 0.16 and 0.22).

The study’s authors concluded that the results of the review provided evidence of a higher prevalence of destructive periodontal disease in men compared to women, presumably because men may experience more harmful effects from inflammation than women and less protection from microbial pathogens, both of which would put them at higher risk for periodontal disease.

What’s Good For Your Heart

Periodontal Health Linked to Heart Health

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.

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.

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.

Brushing Teeth As Important as Washing Hands to Avoid Respiratory Infections

Periodontal Bacteria Linked to Respiratory Illness

If you want to avoid getting a respiratory infection, be sure to wash your hands frequently, right? Simply washing hands isn’t the only way to keep respiratory infections at bay. Experts say that brushing teeth plays a major factor in avoiding respiratory infections.

According to the American Academy of Periodontology, periodontal disease of is contributing factor for respiratory diseases, noting that the bacteria that cause periodontal disease also negatively impact the immune system.

Bacterial respiratory infections are thought to be acquired through aspiration of fine droplets from the mouth and throat into the lungs. These droplets contain germs that can breed and multiply within the lungs to cause damage. Recent research suggests that bacteria found in the throat, as well as bacteria found in the mouth, can be drawn into the lower respiratory tract. This can cause infections or worsen existing lung conditions. People with respiratory diseases, such as chronic obstructive pulmonary disease, typically suffer from reduced protective systems, making it difficult to eliminate bacteria from the lungs.

The American Academy of Periodontology reported that, “Scientists have found that bacteria that grow in the oral cavity can be aspirated into the lung to cause respiratory diseases such as pneumonia, especially in people with periodontal disease. This discovery leads researchers to believe that these respiratory bacteria can travel from the oral cavity into the lungs to cause infection.”

The bacteria that are multiplying in the mouth are not only being used as factories for the viruses but are also being breathed into the susceptible lungs.

The same care that is necessary for avoiding periodontal disease – twice daily brushing and once daily flossing – is necessary for helping to lower the risk of respiratory infections in those with periodontal 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.

When Someone Asks…

Have You Heard of Oral Care Probiotics?

Our bodies are homes to thousands of bacteria. Many of those bacteria simply live in and on our bodies because they are simply a convenient environment in which to live. Some of the bacteria in and on our bodies can be harmful (think of skin infections) while still others are beneficial (think of how bacteria in the gut are said to aid in digestion).

Probiotics are live microbial organisms that are naturally present throughout the body. They are often referred to as “beneficial” or “good” bacteria. Because there are bacterial colonies throughout the body, there are different types of probiotics to support good health.

Oral Care Probiotics

There has been much media attention given to the effectiveness of probiotics of to assist in digestion. So, too, are there probiotics that can help support gum and tooth health by competing with harmful bacteria for both nutrients and space in the mouth. In doing so, oral care probiotics also help eliminate the bacteria that creates the volatile sulfur compounds responsible for bad breath.

Oral care probiotics are available in the convenient, easy-to-use, travel-friendly form of mints to be taken twice per day after brushing. Called EvoraPlus, these probiotic mints are available at many major retailers and online.

EvoraPlus also offers a completely safe and natural way to gently whiten teeth to their maximum potential by producing a byproduct of a continuous low dose of natural hydrogen peroxide. Because it is such a low dose of hydrogen peroxide, there are none of the negative side effects associated with using other over-the-counter whitening products, which instead employ high doses of harsh, chemical hydrogen peroxide.

EvoraPlus oral care probiotics offer a cutting edge solution for tooth and gum health, fresher breath and naturally whiter teeth.

Tooth Loss, Cavities, Gingivitis, Periodontal Disease All Linked to Lower Process of Thought

Study Links Periodontal Disease, Cognition

Researchers at Boston University Henry M. Goldman School of Dental Medicine (GSDM) released a definitive link between tooth loss/periodontal disease to cognitive decline in one of the largest and longest prospective studies on the topic to date, released in this month’s issue of the Journal of the American Geriatrics Society.

In what could be called ground-breaking research in the fields of dementia and Alzheimer’s, Dr. Elizabeth Krall Kaye looked for patterns in dental records from 1970 to 1973 to determine if periodontal disease and tooth loss predicted whether people did well or poorly on cognitive tests. She found that for each tooth lost per decade, the risk of doing poorly increased approximately eight to 10 percent.

More cavities usually meant lower cognition – or the process of thought – too. People with no tooth loss tended to do better on the tests.

Dr. Kaye suggests that doctors whose patients are testing poorly for cognitive standards may want to consider dental health. “The findings should also give dentists yet another reason to prevent tooth loss and periodontal disease and encourage patients to do as much as they can to prevent dental disease,” she explained.

With both periodontal disease and dementia/Alzheimer’s incidence rising sharply as Baby Boomers age, these findings could change the future of the hundreds of thousands of people predicted to develop Alzheimer’s and dementia in the next several decades.