The periodontium plays a key role in the interplay between oral health and systemic disease. Infection in these tissues, primarily by gram-negative anaerobic bacteria, can initiate a series of inflammatory and immunologic changes leading to the destruction of connective tissue and bone. Long considered a localized infection, periodontal disease is now linked to a variety of conditions with systemic implications.

Recent research has found a relationship between periodontal infection and more serious health problems such as cardiovascular disease, diabetes and pre-term low birth weight babies. Tobacco use, stress, medications, hormonal changes, diabetes, heart disease and genetics can increase the risk for infection, the speed that it spreads and the severity of bone loss without any swelling nor bleeding noted by the patient. The bacteria associated with periodontal disease can travel into the blood stream and pose a threat to other distant parts of the body.

Researchers have found that people with periodontal disease are almost twice (2x) as likely to suffer from coronary artery disease than those without periodontal disease. Scientists theorize that the bacteria that cause periodontal disease can trigger white blood cells to release pro-inflammatory mediators that may lead to heart disease and stroke. Another theory is that bacteria from the mouth attach to fatty acid plaques in the coronary arteries and contribute to clot formation. These clots can obstruct normal blood flow and lead to heart attacks.

Scientists have also found that oral pathogens can release toxins that enter the human placenta via the mother's blood circulation, interfering with normal fetal development. This process is thought to abnormally accelerate the production of inflammatory mediators that normally build to a threshold level throughout pregnancy, then cue the onset of labor. Instead, the elevated levels of these inflammatory mediators trigger premature delivery. In fact, there is growing evidence that pregnant women with periodontal disease may be seven (7x) times more likely to have a premature birth. The hormonal changes that occur cause a more sensitive reaction to dental plaque, resulting in increased gingival swelling, bleeding and redness.

Periodontal disease is often considered the sixth complication of diabetes - to the extent that people with noninsulin-dependent diabetes are three (3x) times more likely to develop periodontal disease than are people without diabetes. Also, support exists that the relationship between periodontal disease and diabetes is bi-directional-i.e., because acute bacterial infections are known to cause insulin resistance, it is theorized that periodontal disease may make it more difficult for people who have diabetes to control their blood sugar level. That is why it is critical that people with diabetes be treated to eliminate periodontal infection.

There are a number of conditions that can affect one's ability to defend against infection. Genetics plays a roll for the 15 year old who is losing their front teeth which they've barely had for 10 years. One of their parents probably had a denture before they were out of high school. Or the 80 year old who has never flossed, but has all their teeth. They represent approximately 4% of what is seen clinically. Nicotine (smoking), adrenaline (stress) and caffeine (in excess) are all stimulants whose job is to shunt blood flow away from the digestive tract to the muscles and brain - part of the fright, flight, fight syndrome. People with a gum infection under these conditions can loose bone faster, since they don't get adequate white blood cells to the mouth. Smoking also reduces salivary flow allowing plaque to build up more readily. Plus chemicals in smoke inhibit the defensive activity of the white blood cells. There is no doubt: even the healthiest mouth is laden with bacteria under scoring the need for good dental hygiene