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People with severe gum
disease may be prone to releasing bacterial poisons known as endotoxins
into their bloodstream, which may help explain the link between
gum infections and cardiovascular disease.
The mouth can be a major
source of chronic or permanent release of toxic bacterial components
in the bloodstream during normal oral functions.
This could be the missing
link explaining the abnormally
high blood levels of some inflammatory markers observed in patients
with periodontal disease.
Periodontal disease occurs
when bacteria in plaque infect the gums and bones that anchor the
teeth. If left unchecked, these bacteria will creep below the gum
line, where they produce toxins that create a chronic inflammatory
response that triggers the body to break down the tissues and bone
around the teeth, leaving pockets of space that can become infected.
Previous research has
found that people with periodontal disease are more likely to suffer
strokes and coronary artery disease -- both conditions that may
be associated with inflammation of the blood vessels. While researchers
have shown that bacteria in the mouth can be released into the bloodstream,
they have not shown that endotoxins -- poisons emitted by some bacteria
-- can also enter the bloodstream via the mouth.
Investigators sought
to determine whether endotoxins could in fact be released into the
bloodstream by a usual and frequent oral habit, such as chewing
gum, and if people with more severe gum disease might release more
endotoxin into their blood.
To investigate, the researchers
had 42 people with moderate to severe periodontal disease and 25
people with healthy gums chew gum 50 times on each side of their
mouth.
The investigators also
measured the level of endotoxins circulating in each individual's
bloodstream before chewing and 5 to 10 minutes afterwards.
According to the report
the average amount of endotoxins present in the blood were significantly
higher in all the patients after the gum chewing. Those
with severe periodontal disease were nearly four times as likely
to have significant levels of endotoxins after chewing than those
with healthy gums.
These findings provide
additional evidence for a link between the bacteria present in the
mouth of those with periodontal disease and inflammatory reactions
linked to heart disease, the authors conclude.
Around 15% of adults
aged 21 to 50 and around 30% of people over 50 suffer from severe
periodontal disease.
Journal of Periodontology
January 2002;73:73-78
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