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Dr. Robert Genco, currently distinguished professor and chairman of Oral Biology at the State University of New York, Buffalo, and his team found that diabetics were three times more likely to suffer from periodontal disease and 15 times more likely to become edentulous than non-diabetics. Then came the eye-opener. The researchers also saw that diabetics with periodontal disease had poorer blood sugar control compared to those without periodontitis.

Now the scientists were thinking in terms of a two-way street: While diabetes could affect a patient's periodontia, periodontal problems might also have systemic effects. Before long, researchers elsewhere began studying epidemiological databases in search of other possible perio-systemic links.

One such investigation, which has received lots of attention lately, is the possible association between periodontitis and cardiovascular disease. In 1993, researchers in Wisconsin, headed by Dr. Frank DeStefano, reported the results of an epidemiological study based on 14 years of follow-up data collected during the Centers for Disease Control and Prevention's National Health and Nutrition Examination Survey (NHANES). Nearly 10,000 people, from age 25 to 74, participated in the dental portion of the study.

The scientists adjusted for known heart disease risk factors such as age, gender, blood pressure, diabetes, cholesterol and more. But they had no data on the smoking habits of two-thirds of the subjects. Researchers found that, overall, people with periodontal disease had a 25 percent increased risk for a heart attack compared to people with healthy mouths; men from age 25 to 49 had a 75 percent increased risk. (Scientists measure the strength of associations between exposures and diseases in terms of odds ratios, or percent of increased risk. Some epidemiologists regard risk increases of less than 100 percent as merely an indication that an association exists. Evidence becomes more convincing as the percentage rises above 100 percent. Smoking, for instance, is thought to increase a person's risk for oral cancer by about 400 percent.)

Reference:
McCann, Daniel. Perio/systemic links: How strong are they? Dental Practice Report; 2002 May: 20.

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