Periodontal disease is the primary chronic infectious disease in the world. Population surveys and studies done in the United States indicate that over 50% of adults have gingivitis and 30% of them have periodontitis. And that's in a country known for good teeth and good oral healthcare. The problem increases with age. Most children and teens show some signs of gingivitis, but because young children do not harbor the harmful bacteria linked to gum disease, their gingivitis rarely progresses to periodontitis.

Surveys show that periodontitis affects less than 1% of American teenagers aged 14 to 17, and only 3.6% of young adults aged 18 to 34. Among people aged 70 years old and older, however, 86% have at least moderate periodontitis. Over a quarter of them have lost some teeth.

A disease this common, that also contributes to heart disease (the nation's leading cause of death)is serious. It increases the risk of premature births, and worsens the condition of people with stroke, diabetes, osteoporosis, and respiratory infections. In fact, current research reveals that periodontal disease may be a far more serious threat to your health than previously realized. As the American Academy of Periodontology advises, if you are at risk for one of these conditions, take action now to protect your gums.

Pregnancy and periodontal disease

During pregnancy, periodontal disease is common and a cause for concern, not only for the mother's oral health, but also for the baby's well-being. One study indicated that mothers with moderate-to-severe gum disease are seven times more likely to give birth to babies who are born too early and weigh too little. How periodontal disease affects pregnancy is not completely understood. Some research indicates that the bacteria that cause inflammation in the gums can also trigger the immune system to produce inflammation in the cervix and uterus. Such inflammation can cause premature labor.

Experts advise that if you are pregnant or thinking about becoming pregnant, be sure to include periodontal screening as part of your prenatal care. Also, despite the tenderness in your gums that often comes with pregnancy, it's important to keep up good brushing and flossing habits. A soft bristle brush will be gentle on your gums. Furthermore, be sure to take prenatal vitamins, eat a nutritious diet, and drink water throughout the day.

Heart disease and periodontal disease

Recent research indicates that gum disease creates a higher risk for heart disease, heart attacks, and strokes. In one study, men with extensive gum disease were more than four times as likely to develop heart disease than men with healthy gums. Another study involving Arizona's Pima Indians, who rarely smoke, showed that those with gum disease were more than twice as likely to suffer a heart attack than those whose gums were healthy.

Researchers have offered several theories to explain the link. One possibility is that bacteria from the mouth may enter the bloodstream through abrasions in the mouth. As they travel through blood vessels, they may create blood clots in the coronary arteries (heart blood vessels), which could obstruct normal blood flow to the heart.

Or the bacteria may attach to fatty plaques in the coronary arteries and obstruct blood flow that way. They could also cause inflammation and lead to thickening of the vessel or heart walls. Any of these obstructions could restrict the amount of nutrients and oxygen that reach the heart. This could lead to a heart attack, or a stroke if the arteries leading to the brain were involved.

Diabetes and periodontal disease

For years we've known that diabetes makes people more susceptible to developing periodontal disease. We also know it makes gum disease more severe once it develops. Diabetes, for example, slows circulation, which can make gum and bone tissue more vulnerable to infection. In addition, it appears to reduce the production of collagen, an important component of the tissue that supports teeth. Another way diabetes affects gum disease is by reducing the amount of saliva. Saliva helps control the growth of bacteria and washes away sticky foods that help form plaque. Keeping diabetes under control lessens the risk.

Now research suggests that the relationship goes both ways. Periodontal disease may make it more difficult for people who have diabetes to control their blood sugar. More research is needed to figure out the details, but it appears that severe periodontal disease increases blood sugar. This lengthens the time when a person with diabetes experiences a high blood sugar level, which, in turn, puts the person at an increased risk for diabetic complications.

If you have diabetes, or are at risk for diabetes or periodontal disease, be sure to practice good oral healthcare and see a dentist or periodontist for a periodontal screening. Research has already shown that in patients with both diabetes and periodontal disease, treating the gum disease reduced the need for insulin.

Respiratory disease and periodontal disease

Bacteria from the mouth can also be carried by the bloodstream into the airways of the throat and lungs, increasing the risk for respiratory diseases and worsening chronic lung conditions like emphysema.

The costs of periodontal disease

Worldwide, periodontal disease may affect as many as three of four people, but only about 15% receive treatment. If the price tag for treating even this percentage of people with gum disease were added up, the cost would be staggering. Even so, the cost for treating gingivitis and periodontitis per patient is much less than the cost of replacing teeth by bridgework, dentures, or implants, which can run as high as $6000. Thus, cost is just one more reason to get treatment early.