Bad For The Mouth Is Bad For The Body

June 16, 2000 NEW YORK (Reuters Health) - Gum disease is caused by a chronic bacterial infection and can lead to bone loss, damaged gum tissue and even tooth loss. Now, new research suggests that gum disease may also increase the risk of preterm birth, Dr. Marjorie Jeffcoat, professor and chair of periodontics at the University of Alabama, Birmingham, reported at a meeting here on Thursday, which was sponsored by the American Dental Association. "New studies are showing relationships between these chronic infections and certain systemic (events) such as preterm birth," Jeffcoat told Reuters Health. Preterm birth is an important cause of illness in American infants, Jeffcoat noted. Though great strides have been made in caring for preterm infants, exactly what precipitates preterm birth is less clear. Studies in animals and in humans have suggested that infections in general can be a cause of preterm birth, so it is not surprising that increasing attention has been given to the relationship between infection-causing bacteria and preterm labor and delivery, Jeffcoat said. "Studies—and there have been three published to date—have demonstrated a relationship between having babies born too little, too soon and having periodontal disease, with an increase in risk ranging from three times...to eight times," according to Jeffcoat. It is not entirely clear why gum disease contributes to preterm birth. However, mouth infections cause inflammation, which is associated with a number of naturally occurring factors, such as prostaglandins and cytokines. Prostaglandin-like drugs are often used in obstetrics to induce labor or help it progress. So, given how closely related these drugs are to the body's own prostaglandins, it makes sense that infections involving severe inflammation could be associated with preterm birth, Jeffcoat explained. Jeffcoat and her colleagues are currently conducting studies to track the relationship between the presence of periodontal disease and the likelihood of preterm birth. Thus far, of more than 2,000 women studied, over 800 have given birth. "What we found that was new, was that the worse the periodontal disease, the more likely (a woman) is to have a preterm birth," Jeffcoat said. Though these data are not yet definitive, the researcher suggested that women contemplating pregnancy and those already pregnant "should ask their dentist to examine them for periodontal disease." And, everyone "should practice excellent prevention by brushing, flossing, and where appropriate, (by using) antibacterial mouth rinses or toothpastes," she added. It is possible that bone loss in the jaw—a characteristic of periodontal disease—may also be related to the bone-thinning disease osteoporosis. Jeffcoat and colleagues are trying to see if dental x-rays can be used to screen for osteoporosis. It is possible that the same changes that occur in the jaw occur in the hip, for example. The team has studied 400 patients thus far, and found "a very strong correlation." There is also evidence that the progression of periodontal disease is more rapid in patients with osteoporosis, she said. Jeffcoat advises patients to build a high peak bone mineral density during their early years, especially women. Calcium intake, exercise, not smoking, and not dieting to excess are all important for building good bone. "But remember," she concluded, "you cannot have good (overall) health without good oral health."

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