DO WE KNOW OUR CARDIAC HEALTH ENEMY ENOUGH ?

Cardiovascular diseases, is a general nomenclature for a group consist of blood vessel diseases which are called cardiac or artery and vein. Therefore, cardiovascular disease means any disease that effects circulatory system. Cardiovascular diseases include various cardiac and vessel related conditions like coronary heart disease, atherosclerosis, acute myocardial infections, stroke.

Cardiovascular diseases are the major causes of death globally. In recent twenty year, despite the decrease of mortality ratio related with cardiovascular diseases in high income countries, disease and mortality ratio has astonishingly fast increase in low and middle income countries.

In Turkey, according to the studies of  ‘Cardiac Diseases and Risk Factors in Turkish Adults’ (CDRFTA),which were started in 1990 and still continuing, 90 men of every one thousand men over the age of 20 and 71 of every one thousand women over the age of 20 has cardiovascular disease.  Recommendations of CDRFTA include advices about oral and dental health.

The incidance of gingiva diseases which we call periodontal diseases is high in Turkey as in the world. Periodontal loss increasing with the age is the major cause  of early tooth loss.

Periodontitis, is an infectious disease having a course characterized with bone loss created by inflammation caused by microorganisms in the supportive tissues of tooth. Primary cause of periodontitis is microorganisms. However, severity of the disease is determined by the response of body against those organisms.

Periodontitis , leads increase of systemic inflammation levels. Beside, bacteria and their products can be transferred with blood circulation or freely or inside circulating cells like monocytes or neutrophiles  to far areas like cardiac tissues.

In recent years, patogens related with periodontal diseases are shown to be associated with systemic conditions like cardiovascular disease, stroke, premature or low weighted babies, pulmonary infections, diabetes, osteoporosis, obesity, rheumatoid arthritis, renal diseases and even Alzheimer disease. The major cause of periodontal disease is poor oral hygiene. Extra oral risk factors include; smoking, diabetes, genetics, mental anxiety, depression, obesity and sedentary life style.  The risk factors of periodontitis and cardiovascular disease are common although they are inflammatory diseases separate from each other in a sensitive person. Serum C-reactive protein (CRP) level which is a laboratory finding that increases during inflammatory conditions in both periodontal disease and cardiovascular disease increases.

Periodontal disease and dental procedures may cause serious risks in patients having a known valvular heart disease. Because, during dental treatment, numerous microorganisms located inside gingival pocket can transfer to heart by blood and may lead a condition which is called bacterial endocarditis. Therefore, bacterial endocarditis is still a serious disease having significant morbidity and mortality.

A common report was published from American Cardiology Journal and Periodontology Journal in 2009 demonstrating the relationship between periodontitis and aterosclerotic cardiovascular disease. In this report, it is recommended that patients with moderate and severe periodontitis should be informed about the possible increased risk of cardiovascular disease and also patients having more than one risk should be evaluated medically.

The most effective method for preventing the risks like gingiva problems which are also known as gingivitis and periodontitis, odontogenic infections, dental caries is proper and regular oral care. During evaluation of our patients dental and gingival treatment plans, considering general health as a whole will provide us a healthier solution.

CANAN KABADAYI

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