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Walnut Creek (925) 279-3326
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Chandler (480) 895-3111
Phoenix (602) 269-5914

Complicated cases will be reffered to UCSF

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Online Dental Education Library

Our team of dental specialists and staff strive to improve the overall health of our patients by focusing on preventing, diagnosing and treating conditions associated with your teeth and gums. Please use our dental library to learn more about dental problems and treatments available. If you have questions or need to schedule an appointment, contact us.
 

Bacterial Link Between Heart Disease and Gum Disease Clarified 
September 30th, 2015 By Managing Editor, DiabetesinControl.com 

A study, published in Infection and Immunity, has clarified the mechanism behind a known link between gum disease and heart disease. Periodontitis, which results in an infection that damages the soft-tissue surrounding teeth and the bone supporting the teeth, is commonly caused by Porphyromonas gingivalis. P. gingivalis is a Gram-negative anaerobe that colonizes mouth tissues for lengthy periods of time after initial infection. It is commonly found within the arterial plaques common to heart disease patients. 

The study authors discovered that the bacteria alters the gene expression of pro-inflammatory proteins that also promote coronary artery atherosclerosis. This was discovered by infecting cultured human aortic smooth muscle cells with P. gingivalis. Aortic smooth muscle cells were used because they contract the aorta after the pumping of the heart stretches it out. 

After P. gingivalis was injected into the cells, the bacteria released gingipains. Gingipains are enzymes that change the ratio between different angiopoietins (inflammatory proteins) in such a way that inflammation is increased. The pro-inflammatory angiopoietin 2 had its expression increased by the gingipains, whereas the anti-inflammatory angiopoietin 1 had its expression reduced. P gingivalis was found to affect the levels of these proteins independent of tumor necrosis factor (TNF). 

The study is significant because it helps to pinpoint the relationship between periodontitis and heart disease. Further research can help clarify potential targets for treatment of atherosclerosis. 

Practice Pearls: 

Periodontitis and heart disease share a common pathogen, P. gingivitis. 
A study found that P. gingivitis alters gene expression to increase production of the pro-inflammatory protein angiopoietin 2 and decreases presence of the anti-inflammatory protein angiopoietin 1. This results in increased atherosclerosis. 
The study further clarifies the cardiovascular risk of poor oral health and hygiene. 
Paddock C. Scientists uncover bacterial mechanism that links gum disease to heart disease. published in the journal Infection and Immunity. September 14, 2015. 

We recommend 

PERIODONTAL DISEASE AND DIABETES 
Diabetes in control , 2006 
Is Periodontal Disease Influenced by Diabetes Type? 
Diabetes in control , 2014 
Diabetes Linked to Tooth Decay 
Diabetes in control , 2011 
Scientists uncover bacterial mechanism that links gum disease to heart disease 
Catharine Paddock PhD, Medical News Today, 2015 
Periodontitis and heart disease: Researchers connect the molecular dots 
American Society for Microbiology News via MDLinx, 2015 
The Biphasic Virulence Activities of Gingipains: Activation and Inactivation of Host Proteins



Standards and Best Practice

With all of the increased media attention on infection outbreaks such as AIDS and multi-drug resistant strains of viruses, it's no wonder people have heightened concerns about infection control during a medical procedure.

Gloves, gowns and masks are required to be worn in all dentist offices today—a far cry from just a few decades ago—when fewer than one-third of all dentists even wore such personal protective equipment, or PPE.  After each patient visit, disposable PPE-such as gloves, drapes, needles, and scalpel blades-are thrown away, hands are washed, and a new pair of gloves used for the next patient.

All hand instruments used on patients are washed, disinfected and/or sterilized with chemicals or steam after each use.

One of the most effective methods for preventing disease transmission—washing one’s hands—is practiced in our office.  It is routine procedure to wash hands at the beginning of the day, before and after glove use, and after touching any surfaces that may have become contaminated.

Water Quality and Biofilms

Concerns about the quality of water used in a dentist's office are unfounded, provided the dentist follows the infection control guidelines of the Centers for Disease Control and the American Dental Association.

Some health "experts" in recent years have called into question the risks associated with so-called "biofilms," which are thin layers of microscopic germs that collect on virtually any surface. Essentially, these bacteria and fungi occur everywhere, including faucets in your home; your body is no less accustomed to being exposed to them than in any other situations.

In fact, no scientific evidence has linked biofilms with disease. If you have a compromised or weakened immune system, you are susceptible to germs everywhere. Consequently, let our office know if you have such a condition so additional precautions, if any, can be taken.