Gum Disease Getting More Respect

May 1, 2007

Posted by Maggie Spilner

Evidence from a variety of studies on gum disease is apparently making health insurance companies include some kinds of dental coverage for patients with heart disease, diabetes, and for pregnant women. If insurance companies are taking note, you know you should, too!

Until recently, a disconnect between the dental and medical professions has kept regular dental care a luxury for millions of Americans. Somehow, having an infection in your gums didn’t seem as important as an infection in some other part of your body. But, in recent years, studies have linked gum disease, called periodontitis, to heart disease, stroke, diabetes, Alzheimer’s disease and even premature birth.

That disconnect between head and heart seems to be falling away as studies confirm that inflammation in the mouth may lead to inflammation elsewhere in the body. (If you are facing a transplant of any kind, a healthy mouth is imperative to avoid organ rejection.) And a recent study in the New England Journal of Medicine showed that treatment of diseased gums resulted in lower inflammatory markers 6 months later.

The study included 120 patients with severe gum disease, divided into two groups. One group received routine periodontal care. The other group received more intensive therapy, including extractions of highly diseased teeth and scaling of tooth roots. Although those receiving intensive treatment showed higher inflammatory markers (like c-reactive protein) 24 hours after the procedures than the routine care patients, 2 to 6 months later, the intensive care patients showed less inflammation than the routine care patients. They also showed improved endothelial function. Endothelium is the layer of cells that line the interior of your blood vessels and endothelial dysfunction is an early indicator for atherosclerosis (hardening of the arteries). (Tonetti, M. DMD PhD N Engl J Med 2007:356:911-20.)

It’s too early to determine if treating gum disease can prevent heart disease or diabetes. (A study undertaken to treat the periodontal disease of at- risk pregnant women did not result in fewer premature births, as hoped.) But it seems that keeping your teeth and gums in tip-top shape should be a part of a preventative health regimen. If you do have heart disease or diabetes, or any type of vascular disease, check with your insurance provider to see if you can get special dental coverage.