Top Dentists in Delaware: The Heart of the Matter
periodontist G. William Keller
photograph by Jared Castaldi
The evidence is growing: periodontal disease is directly linked to cardiovascular disease and diabetes. That makes taking care of your mouth important not only for protecting your teeth but protecting your life.
“The older generation thought of the mouth as separate from the body,” says periodontist Michele Broder. “But dentistry is a subspecialty of medicine.”
Though the phenomenon isn’t well understood, it is believed that dangerous inflammation of the heart and arteries is caused by bacteria that has entered the blood stream through the pocket between the teeth and gums, according to the Journal of Periodontology. Endodontist Robert C. Director points out that though the association is strong, no direct causality is proven.
Still, it’s not the kind of information anyone should gamble with if they’re concerned about their health. “When you come to us, we check your personal health history,” says periodontist G. William Keller. “We ask, if you have periodontic disease, when was the last time you had a heart checkup? It’s no guarantee of heart disease, but you should make sure.”
Inflammation does two things, Keller says: it causes the muscle around the arteries to contract, which causes hardening, and it causes the lining of the arteries to swell, which can make the artery rupture (aneurysm) or narrow the interior so much that the heart must work extra hard to pump blood, which can result in myocardial infarction—a heart attack.
“More cardiologists are recognizing the link,” says endodontist Greg Dearing. “It’s a new phenomenon for physicians—and dentists, as well.”
Keller blames periodontic disease for other systemic health problems. “Respiratory disease is coming to the fore,” he says; bacteria that sneaks into the bloodstream through the mouth can enter the lungs and cause pneumonia. Periodontal disease can cause pre-term births due to the contraction of a uterus stimulated by inflammation. Periodontic disease increases the risk of diabetes, and diabetes makes it harder to prevent periodontal disease. Keller says periodontal disease also increases the risk of osteoporosis; inflammation inhibits the formation and function of bone-building osteoblasts, allowing bone-destroying osteoclasts to take over. “It can be especially dangerous for post-menopausal women,” Keller says.
The takeaway? Yet again: daily brushing and flossing, combined with regular checkups and professional cleanings, is the best way to prevent trouble.