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Tuesday 16 August 2011

Study links gum disease to delayed pregnancy

Various studies establish a link between gum disease and other ailments that include infertility, diabetes and arthritis
As simple as it sounds, a ‘good old toothbrush’ and proper oral hygiene may be the solution to a number of ailments associated with gum disease. These, according to experts, include inability by many women to conceive as early as their counterparts not suffering from gum disease.


Because the gum appears to be a pretty harmless part of the body and quite hidden to the eye, most people do not pay attention to it, as they concentrate on polishing the teeth. The outcome of this habit is usually bad breath, tooth decay and gum disease, with new studies and researches linking such to a number of ailments that include heart disease, miscarriage and erectile dysfunction. In July, a team of Australian researchers discovered that gum disease can even make it harder for women to conceive.


According to Prof. Roger Hart of University of Western Australia, women with gum disease take on average 7.1 months to get pregnant compared with just five months for those with healthy mouths.


“All women should have gum disease treated before trying to conceive. It usually involves no more than four dental visits,” he said at a reproductive conference in Stockholm.


In the first study of its kind, researchers found that women with gum disease took an extra two months to get pregnant compared with those who had healthy teeth and gums. It took around seven months on average for those with poor oral hygiene to conceive, but just five months for those who brushed and flossed their teeth properly.


Gum disease or periodontal disease, as it is sometimes called, in its severe form is caused by a build-up of plaque. It leads to bad breath and bleeding gums and, if untreated, causes cavities, receding gums and tooth loss. Bleeding gums caused by failure to brush properly can allow up to 700 different types of bacteria to get into the bloodstream.


Although it is not clear how gum disease may trigger problems with conception, the study suggests that infected gums may release inflammatory chemicals, which activate the immune system and inflame the lining of the womb. This could affect implantation of a fertilised egg .Experts at the University of Western Australia in Perth, who carried out the study said the delay was similar to that posed by being obese.


Hart, who is the lead researcher, said, ‘For the first time, periodontal disease has been linked with inability to conceive. Women should be encouraged to see their dentist to have any gum disease treated before trying for a baby. It is easily treated, usually involving no more than four dental visits.”


More than a quarter of pregnant women have gum disease, he added, and there was evidence it is linked with miscarriage, stillbirth and premature birth.


The researchers questioned almost 4,000 women who were 12 weeks pregnant. A total of 26 per cent were confirmed to have gum disease.


They found delays in conceiving among those aged 35 and over, smokers and obese women – which are already known risk factors. But there was a higher level of gum disease – one in three – among the women who took more than a year to get pregnant. Of those who had healthy gums, only one in four took longer than a year, while Hart added that there was also evidence gum disease in men impaired their sperm quality.


“I would advise any couple wanting to start a family to visit a dentist first,” he noted.


A study conducted in Germany in 2009 had also showed that those with rheumatoid arthritis — an incurable condition which causes the joints to become hot and inflamed — are eight times more likely to have gum disease than otherwise healthy people. The researchers found the link after examining 57 patients with the condition. The cheering news, however, is the fact that treating gum disease might reduce the symptoms.


A small study published in 2009 found that removing tartar and plaque helped reduce the symptoms, as six weeks later, patients had lower levels of a compound in their blood that acts as a marker for the severity of rheumatoid arthritis.


“Gum disease and the link to rheumatoid arthritis is a subject that is really gaining international attention,” says Dr Paola De Pablo, a rheumatologist at the University of Birmingham. “We believe what happens is that the bacteria from the gums secrete proteins and these proteins prompt a response from the immune system which kick-starts the arthritis,” he said.


Erectile Dysfunction


Erectile dysfunction has also been linked to poor gum health. Earlier this year, Indian researchers reported that the worse the gum disease, the worse the erectile problem. Their study, published in the Journal of Periodontology, involved 70 men.


Other researches have suggested that gum disease may hinder production of a chemical called nitric oxide, which relaxes blood vessels and increases blood flow to the penis. The researchers think inflammation produced by gum disease may reduce nitric oxide levels.


Dementia


In 2009, researchers from the University of Columbia tested a group of men and women over 60 and found that those with diseased, receding gums and loose teeth were more likely to struggle with memory exercises. “There have been a few studies linking poor dental health to an increased risk of dementia,” said Clive Ballard, a professor of age-related diseases at King’s College, London. “Colleagues of mine are investigating this further and the theory is that untreated gum disease may kick-start the inflammatory process in the brain that leads to the production of amyloid plaque [a form of protein that attacks the brain cells.”


Heart disease


Having gum disease doubles the patient’s chance of developing coronary disease. In 2010, a Scottish study of 11,000 people found that simply brushing one’s teeth less than twice a day increases the risk of having heart disease. Until recently, it was suspected that when the gums became inflamed, bacteria leaked into the blood stream and caused inflammation and damage in the blood vessels leading to cardiovascular disease. “This has been the theory but it is not yet proven,” noted John Cleland, a professor of cardiology at Hull University.


It is thought that bacteria directly cause infection in the valves of the heart. “If we are sending a patient for surgery to their valves, we will have any gum disease treated first to reduce the risk of subsequent infection,” added Cleland.


Diabetes


Gum disease can increase the symptoms of type 2 diabetes.


In 2010, researchers from Edinburgh University reviewed seven previous studies and concluded that treating gum disease and reducing the inflammation around the teeth helped reduce the complications that include eye problems. It is thought the inflammation in the mouth leads to chemical changes that make insulin (which mops up excess sugar from the blood) less effective than normal.


Treating the gum disease, therefore, helps bring the blood sugar levels back to normal and stops the risk of long-term complications. A study in the Journal of Periodontology found that poorly controlled type 2 diabetic patients are more likely to develop periodontal disease than well-controlled diabetics are.


Some experts have observed that the relationship between periodontal disease and diabetes goes both ways - periodontal disease may make it more difficult for people who have diabetes to control their blood sugar. This is supported by a study reported in the Journal of Periodontology in 1997 involving 113 Pima Indians with both diabetes and periodontal disease. The study found that when their periodontal infections were treated, the management of their diabetes markedly improved.

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