Expert Commentator: Dr. Martin Marcus 9/22/2009

Today we, as health care professionals, are more cognizant of the links between bacterial inflammation and its effect on all body parts. Most talked about and certainly a hot topic is the relationship between periodontal (gum) disease and cardiovascular (heart) disease. Periodontal disease is a bacterial induced, localized, chronic inflammatory disease which destroys connective tissue and the bone which supports the teeth.


Over the past 2 decades, inflammation has emerged as an integrative factor for cardiovascular disease.  Inflammation can operate in all phases of the disease from initiation through progression and ultimately complications of artherosclerosis. 

Periodontitis begins with a microbial infection followed by host-mediated destruction of the soft tissues caused by hyperactive enzymes and factors that cause clinically significant breakdown of the connective tissue and bone.  Bacterial accumulations, biofilms, on the teeth are essential to the initiation of the progression of the disease.  When the biofilms on the teeth are not disrupted on a regular basis, a small set of anaerobic bacterial species, including P. gingivalis, disrupt the host mechanism involved in bacterial clearance and are considered pathogens in periodontal disease. 

Over the years our understanding of the multifaceted periodontal disease process has evolved.  Along with that understanding has come several approaches and modalities to treat periodontal disease.  First and foremost we must continue our effective oral health care of proper brushing and flossing to eliminate plaque and bacteria daily.  In office treatment has also expanded to include deep cleaning, systemic antibiotics, host modulating drugs, laser therapy, rinses, etc.

The dentist’s greater understanding of periodontal disease and its modalities of treatment today in 2009 have given us more tools from which to work with to bring better health to treat periodontal disease.  We now are understanding just how beneficial that health is as it correlates to more than oral health, but the entire body’s health starting with heart disease. 

Martin J. Marcus, DDS


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