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Guard Your Heart
Gum disease, diabetes can be devastating duo

By Charles W Martin, DDS
Founder, DentistryForDiabetics.com

The leading causes of death among people with diabetes include and stroke.  Nearly two-thirds of adults with diabetes will die from heart disease and are at least twice as likely to have a heart attack or stroke as people without diabetes.  These stark facts highlight the need for you to be aware of these diabetes and heart/gum disease connections so you can prevent or reverse gum disease and the devastation it can wreak on your health as well as your quality of life.

In my column Links Between Diabetes & Gum Disease – The Inflammation Response, I talked about how what’s going on in your mouth affects your diabetes management and how it’s related to inflammation.  Now we know another direct link between diabetes and gum disease – the role of infection deep in the arteries of the heart.  Gum disease and diabetes are further link by another fairly new revelation, which I call the rust effect. This condition also causes damage as the bloodstream tries to deliver nutrients to your body’s cells.  This is something only people with diabetes will experience and something I talk about in my column The Rust Effect –Eating Away at Your Microvascular System.

Combined, infection and the rust effect can beat up on your body mercilessly.  They will cause you pain and they could kill you.

The Heart-Gum Disease Connection

Let’s start with the verified links between oral health and these terrible two.  The connection between heart disease and poor oral health is well known.

• Dental health is worse in people who have had an acute heart attack.
  
• Research has found that people who had an acute stroke were more likely to have an oral infection. 
  

Once we thought hardening of the arteries was due to the build-up of fatty plaques linked to high cholesterol.  Then, when the inflammation effect was discovered, some believed it was the primary cause.  Today we believe it’s the result of both.  One study found that when some plaques are ruptured by inflammation, blood clots then form over the ruptures and can block arteries, causing heart attack or stroke.

The latest research involves another culprit – bacteria from gum disease.  Some 800 bacteria live in your mouth.  Some are good but many are infectious organisms.  A common one is Porphyromonous gingivalis, P. gingivalis for short.  Some people with good oral health have P. gingivalis in their mouth, but if you have gum disease your risk of having P. gingivalis is more than 11 times greater.

Oral bacteria can make its way to your heart

Here’s what I find really scary about P. gingivalis.  Once established, it can find its way to your heart.  Scientific testing has found its DNA in the tissue of the aorta.  It shouldn’t be there and we don’t know what it does in the aorta, but it’s not good news that it’s there.

Periodontal bacteria in the bloodstream also find their way into artery-clogging plaques where they may play a role in coronary artery disease by:

• Directly infecting the cells that line the artery walls, starting an inflammation response
• Causing the cells of the arterial wall to unleash more inflammatory signals than usual.  
• Increasing plaque build-up by stimulating cells to scavenge more cholesterol out of the blood than normal.  
• Triggering a chain of events that result in coagulation leading to a blood clot.
  

In the last scenario, as the blood clot forms it may destabilize any plaque already on the artery wall.  The plaque ruptures and tissue debris spills into the bloodstream.  Too big to pass through smaller downstream branches, the debris chokes off the blood supply and the surrounding tissue dies.  The worst effects happen when the blood clot that forms over the ruptured plaque grows to the point that it stops blood flow in the artery itself.  These are the major events, the sudden heart attacks and strokes that are often debilitating and frequently fatal.

For more information about diabetes and oral health, visit http://www.dentistryfordiabetics.com and Dr. Martin’s blog, http://www.dentistryfordiabetics.com/blog.

This article was excerpted from Dr. Martin’s new book about the two-way connections between diabetes and gum disease.


Read more about Dr. Charles Martin here.

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NOTE: The information is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.