There are two most common dental problems, dental caries and gum diseases.We do get worried if the teeth develop cavities. These are visible as black or brown discolorations on the teeth and as soon as we see them we try to fix the appointment with the dentist. Gum / periodontal disease also begin early in life.Its progression is slow and painless, and thus it becomes perceptible to the individual only when the disease is in an advanced stage, manifested by pain and bleeding gums so normally these gum diseases are ignored.

Normally the lay person feels that the teeth are important for beautiful smile and to chew the food, the general health is not related with the teeth. The hard fact is that teeth are intimately connected with the rest of the body. They are anchored in the jaws through their roots, which are rooted in the bone. From the end of the root blood vessels enter the tooth and run all the way into the crown. It can be inferred that the health of the teeth and the surrounding gums will influence the health of the jaw bone. Dental caries and periodontal disease are caused by bacteria. Bacterial infiltration from the gum leads to infiltration directly in the soft tissues surrounding a tooth. It also affects the bone around the tooth. This infection can travel to the other parts of the body through blood. Untreated teeth infections may cause death due to cavernous sinus thrombosis; just as bacterial spread from a throat infection can as bacterial endocarditis.

Oral health does not mean having only healthy teeth. It means much more than that. It is an integral part of general health. There are various theories which explain the link between gum/periodontal disease and heart disease. One theory is that when oral bacteria enter the blood stream they attach to fatty plaques in the coronary arteries (heart blood vessels), thus reducing its lumen. This in turn, hinders the normal flow of blood, restricting the amount of nutrients and oxygen required for the heart to function property.   According to another theory the health of the oral cavity is not a separate component of general health but proving a direct association is difficult and not completely understood. This is because both cardiovascular and gum disease are chronic diseases and share many common risk factors, including the age, smoking habit, socio economic status and glycaemic control thus, the specificity of the association between the two is not clear – cut 

According to some studies there is no significant relationship between the periodontal diseases and the heart problem but at the same time they do not rule out the small relationship between them. On the other hand researchers have found that people with gum/ periodontal disease are almost twice more likely to suffer from coronary artery disease than those without periodontal disease. Periodontal diseases can also exacerbate the existing heart conditions.

Bacteria causing periodontal disease (periodontal pathogens) have been found in the fat deposits on the walls of the blood vessels supplying blood to the heart (atherosclerotic plaques). Anthero – thrombo genic mediators such as C- reactive protein are elevated in periodontal disease. There are findings of a meta analysis may be related to the number of remaining teeth (tooth loss being the ultimate outcome of untreated gum disease). It is there fore becomes very essential to take care of oral health with a view to having a healthy heart. The above facts add strength to the hypothesis that gum disease may be a risk factor for coronary artery disease. Given the high mortality rate among those suffering from cardiovascular diseases, and the relatively minor morbidity of periodontal therapy maintenance of gum/periodontal health should be among the precaution for the prevention of heart disease.

When should we suspect gum disease?

The bleeding from the gums as such without provocation, or upon brushing, inter- dental cleaning with floss/ inter- dental brush is an important indication of gum disease.

If the gums at the union of the tooth and the gum are loose and not well attached with the tooth. The gums are swollen at the margins with the teeth.

Many times people live in ignorance of the gum disease they are having. A professional examination is helpful. it is recommended that dental check-up is done every six months.  

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