From my perch, the research studies linking periodontal disease to systemic health are more robust and more frequent than their counterparts in tooth decay.
There may be good biological reasons for this but there also may be other factors such as the research in caries remains focused on restorative materials rather than on the biology of this disease.
In this context, I note a recent article linking dental decay to atherosclerosis and published in a relatively obscure journal. Briefly, this research study of 292 Austrian adults of mean age 54 years found that:
- the independent risk factors for atherosclerosis were age, number of cavities per tooth, periodontal disease, and being a man
- the number of restorations per tooth lowered atherosclerosis.
As the study reported, the development of (root) caries and periodontal disease, are intertwined:
Streptococcus mutans, a significant contributor to caries, can be found in the atheromatous plaques of the vascular wall (10). It can be presumed that dental caries may also have a proatherogenic effect. Minimal carious lesions, caries with and without involvement of the pulpal cavity, and chronic apical periodontitis represent different stages of the same inflammatory process.
Indeed, the origins of the two diseases is commonly at the gingival margin where the biofilms interact (see magnified picture).
So as dental teams, we need to be mindful of following the conventional wisdom that gum disease is the primary risk to overall health, and caries is not. Both diseases have influence and from our Facebook response by older Canadian women, the patient sees little difference between its gums and its teeth.
Biofilm at the gingival margin
