When gums speak volumes

"My gums were really bad, but I didn't know that mattered," says Rodriguez, 26, of Long Beach. "They said I had to be bacteria-free before my surgery. I learned a lot

And as doctors and dentists now suspect, gum disease is no little thing. Research compiled over the last five years suggests that gum disease -- especially if the condition has persisted for a long time without treatment -- can contribute to diabetes, cardiovascular disease and stroke, pregnancy complications, and perhaps even Alzheimer's disease, osteoporosis and some types of cancers. Infections in the mouth also may increase the risk to people undergoing several types of surgery, including transplantation and cardiac valve replacement.

"For years the mouth was never considered a part of the body," says Dr. Salomon Amar, a periodontist at Boston University. "Gum disease was not considered something that could have any impact."

But as recently as last month, a study published in the New England Journal of Medicine found that treating severe gum disease can improve the function of blood vessel walls, improving heart health. And in this month's Journal of Periodontology, two studies found periodontal bacteria (bugs normally found in inflamed gums) in the arteries of people with heart disease and in the placentas of pregnant women with high blood pressure.

It's still too soon in the evolution of this research to say with certainty that gum disease directly causes other illnesses. But the evidence is compelling enough that it's beginning to unite dental and medical professionals -- two groups that have had only a nodding acquaintance.

And it's leading to one of the most sweeping changes in the dental insurance industry in more than a decade. Several health insurance companies -- particularly those that offer both dental and medical insurance -- are beginning to offer free or low-cost "enhanced" dental benefits to certain high-risk patients who might experience broader health benefits by having a cleaner mouth.

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Inflammation's role

Gum problems begin when the bacteria in plaque, the sticky film that forms on teeth, persists long enough to inflame the gums. Usually, inflammation is considered a positive response to bacteria -- a sign that the body is fighting back. But if inflammation rages unchecked, it does more harm than good.