When gums speak volumes

*

High-risk groups

Although gum disease could worsen many conditions, experts and dental insurance companies are most interested in heart disease, diabetes and pregnancy -- conditions in which successful periodontal treatment could yield ample benefits.

Studies surveying large groups show that people with severe gum disease have significantly higher rates of cardiovascular disease. Besides influencing the function of blood vessel walls, byproducts from the bacterial infection can enter the bloodstream and trigger the liver's release of a substance called C-reactive protein, studies have suggested. C-reactive protein is thought to inflame arteries and promote blood clot formation.

Now researchers are testing whether treating severe gum disease will result in fewer heart attacks, strokes and other cardiovascular problems. Amar, for example, is studying whether treating gum disease aggressively leads to fewer cardiac problems in people with both gum disease and heart disease.

Intriguing links can also be drawn between gum disease and diabetes. Diabetics tend to have more severe gum disease and have it at an earlier age than people without diabetes, research shows. Having gum disease increases the amount of time a diabetic's blood sugar remains high. But diabetics who receive good periodontal treatment have a better response to diabetes therapies.

"We've known for years that diabetic patients who have periodontal disease do not respond to therapy," says Miller.

A study published last month in the Journal of Periodontology found that gum disease even predisposes certain people to developing early signs of diabetes.

But it's still too early to say if aggressive treatment of gum disease in high-risk individuals could have a big effect on other illnesses. A study published in November in the New England Journal of Medicine serves as a cautionary tale and shows why much more research on this subject is needed.

That study tested whether treating gum disease in pregnant women could reduce the risk of premature birth. Before the study, gum disease was considered a likely cause of premature birth. Several studies suggested that bacteria in infected gums could spread to the womb and initiate early labor. And one study in Chile even showed treating gum disease in pregnancy reduced preterm birth rates.

However, a large, federally funded trial in this country found that treatment of gum disease, while safe during pregnancy, did not cut the rates of premature birth.