最新研究发现牙周炎可以增加心血管疾病和糖尿病发生的危险性　
　　一篇新发表于《现代医学研究与热点》上的专家文章对与口腔卫生、牙龈相关疾病和其他系统的感染性疾病（如心血管疾病和糖尿病）之间的潜在关系进行了分析。作者最后认为，当前研究显示牙周炎（一种慢性的牙龈感染性疾病）可以增加心血管疾病和糖尿病发生的几率。报告认为，初级保健医师应该告知病人保持口腔健康的重要性以及因此身体有可能获得的各种好处。

牙周炎

　　在英国，一个多学科（心脏病学，内分泌学以及牙周病学等）专家组首次坐在一起，共同对最新的临床进展进行研究，以期确定牙周炎和系统状况之间是否存在着联系。除了研究牙周炎和心血管疾病之间的关系之外，专家组还发现糖尿病组的受试对象的牙周炎显得更加严重，而且患心血管疾病的几率也比较大。　　　　这篇报道的主要作者——美国著名牙周病专家，北卡莱罗纳大学牙科学院的Ray Williams博士说，“现在，牙医和内科医生应该更加紧密的合作以更好地了解和改善病人的健康状况。作为全身保健的一个重要组成部分，促进口腔健康应该被视为以减少心血管疾病和糖尿病为目的的，同饮食、锻炼以及戒烟一样重要的健康生活方式的一个组成部分。”

　　研究人员认为慢性牙周炎的传染性和感染性（不仅能影响牙龈，但也有可能影响周围支持牙齿的韧带和骨骼）会对人的整体健康产生重要的系统性影响。具体原因现在还不清楚，但有可能是因为口腔细菌进入血液和／或系统为了对其进行消除而做出的感染性反应的结果。进一步的研究将会确定牙周炎的感染病理生理学，心血管疾病，糖尿病和其他的口腔细菌级联之间的联系。

　　来自沃里克郡的英国著名的全科医师，同时也是这篇报告作者的Roger 博士继续说；“随着糖尿病人数量的增长，我们应该采取所有可以采取的措施来保证糖尿病患者能够对自己的疾病进行有效的管理并减少心血管病发症的发生。维护口腔健康也许是另外一项减少这种危险性需要注意的方面。”
　　“在好几年前，我们就已经注意到患有心血管病和糖尿病的患者会更容易患牙龈疾病，”本文的另一位作者——来自英国利兹的以心脏病为研究重点的Mark Davis医生评论说，“我很高兴英国卫生保健专家们能够认识到这两者之间的联系。而现在正是应该立即采取措施来确定这种联系，并告知患者保持口腔健康的重要性的时候了。”

　　在过去十年中，很多人已经开始注意到牙周炎可能不仅仅是促使心血管、糖尿病，还有可能是不良妊娠结果、呼吸系统疾病、肾脏疾病或一些特定癌症发生的潜在危险因素。有一种叫做“局部传染理论”的观点认为口腔内部的感染或传染可以到达身体的其他部位或器官，这种看法在20世纪20年代曾经流行过一段时间，但后来人们逐渐对其失去了兴趣。之后，由于1989年的一篇来自芬兰的阐述心血管疾病和牙周炎关系的著名报告的出现，人们又开始重新认识口腔健康和全身健康之间的关系了。由于牙周病在心血管病和代谢性疾病中的位置显得越来越重要，所以世界心脏病联盟以及美国糖尿病协会的大会委员会都将它列为最近或即将召开的国际大会的议题。

　　一篇新发表的名为“牙周病可能会影响全身健康“的报告代表着第一次有如此众多的英国专家在一起对这个重要的领域中的这个不断发展壮大的课题进行研究。这次会议由Colgate-Palmolive公司赞助。

New Report Links Periodontitis With Increased Risk For Cardiovascular Disease And Diabetes, UK
A new expert report published in the journal Current Medical Research and Opinion examines the potential link between oral hygiene, associated gum disease and other systemic diseases involving inflammatory processes such as cardiovascular disease (CVD) and diabetes. The authors conclude that current evidence suggests periodontitis (a chronic inflammatory disease of the gums) is associated with an increased risk for CVD and diabetes. Primary care practitioners are encouraged within the report to educate their patients about the importance of maintaining a healthy mouth for conferring potential public health benefits.

For the first time in the UK, a multidisciplinary group of experts in the fields of cardiology, endocrinology and periodontology reviewed the latest clinical evidence to examine the emerging evidence for an association between periodontitis and systemic conditions. In addition to finding a link between periodontitis and increased likelihood of CVD, the group found that periodontitis is also often more severe in subjects with diabetes mellitus, a group already at increased risk for cardiovascular events.

Dr Ray Williams, a leading periodontist in the US at the University of North Carolina School of Dentistry and lead author of the report said, "There is an urgent need for dentists and physicians to work more closely together in understanding and improving patient health. The promotion of good oral health, as part of better overall health care should be seen as a natural extension of current healthy lifestyle messages around diet, exercise and the cessation of smoking, which are designed to help reduce the burden of CVD and diabetes."

The infectious and inflammatory burden of chronic periodontitis (which affects not only the gums, but also the ligament and bone holding the teeth in place) is thought to have an important systemic impact on overall health. The exact reasons are unknown, but may be the result of oral bacteria entering the bloodstream and/or the systemic inflammatory reaction produced in response to the oral bacteria. Further research to determine the inflammatory pathophysiology of periodontitis, CVD and diabetes and the oral bacteria cascade, should identify potential links between the conditions.

Dr Roger Gadsby a leading UK GP from Warwickshire and one of the report's authors continued; "With diabetes on the increase, every effort should be taken to ensure that people with diabetes take every step to effectively manage their diabetes to reduce their risk of developing cardiovascular complications. Maintaining good oral health may be an additional part of reducing this risk."

"We have known for years that patients with CVD and diabetes are much more likely to present with gum disease," commented Mark Davis, a GP and occupational physician with a special clinical interest in cardiology from Leeds, and one of the authors of the report. "I am pleased that the link is being recognised by healthcare professionals in the UK. It is now time to take action to confirm the importance of this link and to educate patients about the importance of good oral health."

Within the last decade periodontitis has attracted much interest as a potential risk factor not only for CVD and diabetes, but also for its association with adverse pregnancy outcomes, respiratory disease, kidney disease and certain cancers. The idea that oral infection and inflammation within the mouth can reach distant sites and organs in the body, or the 'focal infection theory', was a popular concept in the 1920s but interest waned. Then in 1989, with compelling reports from Finland of the link between CVD and periodontitis, there has been a major effort to elucidate the relationship of oral health to general health .The emerging position of periodontal disease in cardiovascular and metabolic disease research has been recognised by the World Heart Federation and by the American Diabetes Association congress committees as a topic for inclusion within recent and forthcoming international congress programmes.
The new report, 'The Potential Impact of Periodontal Disease on General Health' represents the first time that such a broad group of UK experts has convened to explore the growing body of research into this important area. This meeting was funded by Colgate-Palmolive as a service to medicine.