About time they publish something like this

The Age, 9th October 2006

A rotting tooth can infect your life

Peter Weekes

MELBOURNE researchers have developed a world-first test that reveals which teeth are at threat of imminent decay. They say the test will help reduce the risk of heart attack and premature birth, and control some forms of diabetes.

Researchers at Melbourne University are about to publish the results of a successful clinical trial of the test that allows dentists to accurately predict if a tooth is at risk of developing gum disease, which if left untreated could be fatal.

"People can die of dental infection if you have a spreading infection going down into the throat or chest cavity, or occasionally into the brain," said associate professor at the University of Sydney and chairman of the Association for the Promotion of Oral Health, Dr Hans Zoellner.

"In New Zealand, the unofficial estimate is that one or two people die of it every year. I suspect in Australia the number is similar, but no one is counting."

Fortunately, in most cases the disease can be treated before it becomes deadly, but it involves a hospital stay and a heavy course of antibiotics.

The new test for potential gum disease will allow dentists to resolve the problem long before hospital admission is required and also prevent other problems.

"Periodontal (gum) disease is a very good predictor of people getting cardiovascular disease," said Melbourne University associate professor Stuart Dashper. "People with untreated chronic periodontal disease have a much higher risk of getting cardiovascular diseases than people with healthy mouths."

In the past 10 years or so, scientists have discovered that many illnesses can be traced to a person's oral health, and gum disease in particular.

Periodontal disease is unlike other diseases where a person gets an infection from a bacterium outside the body. The bug that causes gum disease is among the 700-odd bacteria that are always in a person's mouth, but once one or two proliferate, they can cause widespread inflammation, bleeding and pain. A mouth with gum disease affecting all teeth has an area of infection about the same size as a human hand.

Bacteria in plaque eat away at the ligament holding the tooth in place and can then get into the jawbone and blood supply.

Melbourne University senior lecturer and head of periodontics, Ivan Darby, who also worked on the study, said once oral bacteria entered the blood supply, the whole body was affected.

"One of the things it affects is the build-up of fatty plaque in your arteries that leads to heart disease. We have found the DNA of the bugs that cause gum disease . . . in the fatty plaque in the arteries around the heart."

A Danish study last month also found an increased risk of coronary heart disease among those aged under 60 who had more than four millimetres of jawbone loss from gum disease.

Oral bacteria may also trigger a build-up of the hormones that induce women into labour prematurely. Professor John Newnham, of the University of Western Australia, said an "association" between the two was known, and he was in the midst of a $1 million study designed to find if a link existed.

What researchers do know is that an oral infection releases three bacteria into the body's circulation: cytokines, which cause inflammation and are involved in the initiation of labour; prostaglandins, used by hospitals to induce labour; and a unique mouth bacterium that can "translocate" and has been found in the amniotic fluid that surrounds the embryo.

Professor Newnham's study follows a similar one in Chile last year, which found periodontal therapy reduced pre-term birth and low birth-weight infant rates by 68 per cent in women with pregnancy-associated gingivitis.

Dr Darby said international research had also revealed that periodontal therapy limited the wild swings in diabetics' sugar levels. "What has been shown recently is that if you treat the gum problems of people with diabetes, you can improve their glycaemia control so you don't get these wide fluctuations," he said.

The bite stuff

· Brush and floss twice daily, and get regular check-ups.

· Quit smoking. Gum disease can be added to the long list of reasons why it's healthier not to smoke.

· Drink water. Helps reduce mouth inflammation by producing more saliva. Saliva dilutes toxins in the mouth created by plaque.

· Eat healthier. A balanced diet enhances your overall health.

SOURCE: Medical Network

THE NAKED TOOTH
Bacteria can enter the bloodstream through the damage caused under a tooth.

DIABETES
Periodontal therapy has been shown to reduce the wild fluctuations in a diabetic's blood-sugar count.

JAW
Bacteria can eat away at the jaw bone that holds the teeth in place.

FOETUSES
Oral bacteria can spur the production of the hormone that tells the female body it is time to give birth.

BRAIN
Oral bacteria can enter the bloodstream and reach the brain, causing damage.

HEART
The DNA of oral bacteria has been found in plaque that clogs the arteries, which leads to heart attacks.

SOURCE: University of Melbourne, Association for the Promotion of Oral Health, University of Copenhagen, Unversity of Western Australia and University of Chile.