Periodontics and its influence on the aspects of systemic health.

Periodontal disease is an aggravating factor for systemic health

Periodontitis treatment is fundamental in reducing heart attack, pulmonary complications and diabetes risks, as well as the preterm birth probability.

Dentists, the main responsible for the mouth care, must be fully aware of the infectious diseases in order to prevent systemic situations from developing or evolving. In this scenario resides the relevance of the treatment of the periodontics diseases, which are source of bacteria.

The attention with the periodontics patients, which have heart and pulmonary diseases, diabetes, as well as the pregnant women, must be done with extra care. Recent studies show evidence of a link between periodontitis and preterm birth of low weigh babies caused by the presence of infection. “Manipulating the periodontal region is to act in the focus of the infection with microorganisms of a very high pathogenical potential, capable of even destroy the whole periodontics bone”, says Dr. Wilson Sallum, professor of Periodontics at the College of Odontology of the Campinas University (Unicamp).

The basic principle of the cardio-vascular disease is similar to the periodontal one, which is infectious and vascular. Although periodontitis is not considered one cause for heart problems, it may contribute for complications. According to Dr. Sallum, the risks for heart attack are higher in such situations. Every disease that interferes in the blood vessels certainly will have cardiovascular influence.
In the case of pulmonary disease, it is extremely important that patients maintain buccal hygiene. Treating periodontitis is crucial not to aggravate the clinical scenarios given that the mouth is part of the breathing apparatus and can allow bacteria to reach the lungs. “A badly kept mouth will generate risks of pulmonary disease and that is another evidence that buccal hygiene is prevention,” comments Dr. Sallum.
In the cases of diabetes, the relationship with periodontitis is bi-directional. One can aggravate the other. The work of the dentist has to be even more careful, including analysis of tests carried out recently and rigid follow up of the glycemic levels. The direct contact with the doctor that is responsible for the treatment of the diabetes is a differential.

In all situations, the periodontist will need to make good use of the anamnesis to collect information about the systemic health of the patient in order to identify as many risks as possible during treatment. “In the cases of diabetes, for instance, among every 10 patients who tell us that have the disease under control, seven do not, actually,” says Dr. Sallum.

Chances of preterm delivery can increase 10% for women with periodontitis.
Periodontitis and premature births – It is known that premature deliveries have multifactorial origins and among risk factors are cases of infection. According to the WHO, that is considered the second most important cause of death in children aged 5 or less. 15 million babies are born prematurely every year in the world and more than a million die days after birth. In Brazil, there are more than 270 thousand premature babies per year, or rather, 9.2% of registered births.

Preterm delivery can cause serious problems to the health of the child, who will be more susceptible to delays in development (including neurological), contamination by infectious diseases, respiratory complications, cardiac diseases and even death during childhood.

Infectious periodontitis is classified as one of the risk factors for premature birth. In spite of studies being relative new, it is known that the chances increase in 10% in pregnant women who have periodontitis. And, during pregnancy, women are more prone to develop periodontal diseases. “Pregnancy hormones increase the chances of developing gingivitis and periodontitis due to an increase in vascular permeability and possible tissue edema”, explains Dr. Saulo Duarte Passos, head professor of Pediatrics at the College of Medicine of Jundiaí (FMJ), who works in the area of pediatric and maternal and child infectious control.

Dr. Wilson Sallum explains that periodontitis can contribute to a premature delivery because the periodontal pocket releases the same oxytocin that acts in early and full term labors (from 37 to 40 weeks). Monthly odontological follow up should be carried out for chemical mechanical control of the dental biofilm, because the good buccal health of the pregnant woman will contribute to natural sequence of the pregnancy events.

Treatment should not be interrupted during pregnancy, however, it is recommended for the dentist to be in constant contact with the patient’s obstetrician, especially in the first three months of pregnancy. In the cases of history of miscarriages or hemorrhagic problems, attention should be even greater. “The more severe the periodontal disease, the greatest the risk of premature births and also a low-weighed baby, even if the delivery is not premature,” affirms Dr. Passos.

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