By Tara Parker-Pope

In our quest for better health, there's a key body part many of us are neglecting -- the mouth.

The link between oral health and overall health has been discussed in medical and dental journals for years, but the issue has yet to resonate with most doctors and patients. A report from Harvard researchers earlier this month may finally be a wake-up call. A new study found a surprising but powerful link between poor gum health and one of the deadliest diseases, pancreatic cancer.

In a study of more than 51,000 male doctors, the men with a history of gum disease were at 64% higher risk for pancreatic cancer, compared with those with healthy mouths. Although pancreatic cancer is relatively rare, the gum-disease risk translates into an additional 36 cases of pancreatic cancer per 100,000 people.

The study is the latest in a series of reports showing that the health of your mouth, teeth and gums may have a powerful impact on your overall health. Gum disease is linked with heart disease, stroke, diabetes and pregnancy problems.

A person suffering from gum disease has a mouth teeming with Porphyromonas gingivalis and other bacteria found in plaque, the sticky film that forms on teeth. These bacteria not only cause gums to become inflamed, but they can also invade other parts of the body, including cells in coronary arteries.

Nobody knows why gum disease may be linked with pancreatic cancer. It may be that chronic infection in the gums triggers inflammation throughout the body, which can fuel the growth of cancer. Or it may be that oral bacteria trigger a chemical process in the body that results in high levels of nitrosamines, cancer-causing compounds that also are in tobacco smoke.

"People think of gum disease as being in their mouth," says Dominique Michaud, the study's lead author and assistant professor at the Harvard School of Public Health. "But when it gets severe, it's not just in the mouth. It's probably in the entire body."

It's estimated that at least 35% of adults have some form of gum disease and about one-third of those have a moderate to severe form. Brushing and flossing regularly can help prevent gum disease but not always. About one-third of the population may have a genetic predisposition to the problem. Gum disease is also linked with smoking and tobacco use. Certain medications, including oral contraceptives, antidepressants and heart medicines, can also affect oral health.

Treatment for gum disease can include an oral antibiotic or antibiotic gels applied directly into the diseased pocket between the tooth and gum. The most common nonsurgical treatment is "scaling and root planing," an intensive teeth cleaning above and below the gum line that often requires a local anesthetic. For advanced cases, doctors cut away the diseased gum tissue and sometimes take grafts from the roof of the mouth to help rebuild the gum line.

One problem is that insurance coverage for dental procedures typically is limited, and as a result, many patients don't seek regular dental care. However, health plans are beginning to cover more dental treatment and preventive services, particularly among patients at high risk, such as pregnant women or patients with diabetes. Although the changes aren't yet widespread, it's worth checking with your insurer to learn what dental services are covered.

Some early research suggests that treating gum disease may lower risk for heart and other problems associated with poor oral health. A Boston University pilot study of six patients with gum disease showed that treatment for gum diseases lowered certain inflammatory markers in the body and improved the function of the endothelium, the lining of the arteries that produces chemicals related to blood flow. A larger version of that study using 160 patients with gum disease is under way, but the results aren't expected until 2009.

"All kinds of answers are going to come out of this," says Salomon Amar, associate dean for research at the Boston University School of Dental Medicine who is conducting the study. "I think historically the mouth was never considered an important part of the body."

The American Academy of Periodontology offers a tool to help you gauge your personal risk for gum disease at www.perio.org/consumer/4a.html5.

Reprinted from The Wall Street Journal
Published January 23, 2007.

--------------------------------------------------------------------------------

Read about Dr. Gotthelf's Holistic Dental Services.