Healthy Heart Month

September, 2005

Our focus this month is primarily on the “ticker”, but it can’t be discussed without addressing the entire vascular system. So, we are going to discuss the heart’s role in circulation through the vascular system, all essential organs, and of course the brain. Diseases of the heart or the vascular system can include the heart’s main (coronary) artery, a heart attack, or stroke. So, let’s define the diseases and then focus on what’s important - prevention of such serious events! Lastly, we will explain how your gums and periodontal disease can be dangerously connected.

The coronary arteries allow blood to flow to the heart and oxygenate or fuel this critical muscle. Obviously, these are pathways that we don’t ideally want constricted in any form or fashion. A thickening of these walls by fatty plaques is called atherosclerosis. If it becomes overly constricted, then one experiences angina which is a squeezing or compressing sensation/pain. It simply means the heart’s demand for oxygen can’t be met.

Heart attacks, a word that commands the respect of everyone, occur when the heart muscle is damaged or dies in areas due to a lack of oxygen or flow through the coronary arteries. This usually occurs when one of the fatty plaques in the coronary arteries ruptures or breaks and a blood clot forms (remember the “clot” connection later when we discuss daily aspirin).

A stroke is essentially a “heart attack of the brain”. If the arteries leading to the brain are cut off or disrupted, permanent damage occurs to areas of the brain where oxygen was deprived. Since the brain is the control center of the body, damaged areas are exhibited externally by loss of the ability to move or control specific parts of the body, like speech, or use of an arm or leg, etc.

Let’s get to the point. How do we prevent these tragic events? First of all, let’s respect our familial histories. If vascular disease, stroke, or diabetes runs in your family, you need to be mindful of your risk factors and solidify an ongoing relationship with a physician or cardiologist, and as you’ll learn in a second, your dentist. Beyond that, don’t smoke! Eat right (keep the salt and saturated fats low)! Exercise consistently (4-6 times per week, at least 30 minutes)!

Control your blood pressure, weight, and LDL cholesterol! Lifestyle changes can sometimes successfully correct these problems. Other times, medications are necessary. Never forget to stick to the lifestyle changes if medications are started. Ask your doctor about C-reactive proteins as vascular inflammatory markers, and we in the dental community will explain those markers as they relate to your gums.

Once blood pressure is controlled, some in the medical profession recommend taking daily aspirin to prevent clots that can lead to heart attacks and strokes. Ask your physician if this practice is recommended for you. If you take blood thinners and need dental treatment, we now have a laser that will establish the clotting that the blood thinners may prevent while removing gum bacteria. You may have noticed that we are much more vigilant about recording your blood pressure and pulse these days in our dental office. We’re all in this health adventure called life together.

That brings us to the important dental connection. A recent study published in The New England Journal of Medicine concluded that elevated CRP (C-Reactive Proteins) levels are a more significant predictor of heart attacks than high (LDL) cholesterol levels! They then recommend CRP and cholesterol screening for risk assessment of cardiovascular disease. Another study published earlier this year in the Journal of Periodontology found that the inflammatory effects from periodontal disease, the chronic bacterial infection of the gums, causes byproducts of gum disease-causing bacteria to enter the bloodstream and trigger the liver to make these proteins such as CRP. What is the significance? Once triggered, they can inflame arteries and promote blood clot formation. (Study Abstract) As we learned earlier in this article, that clot can trigger heart attacks and strokes.

Dr. Steven Offenbacher, member of the American Academy of Periodontology (AAP), has stated, "To reduce levels of CRP, and presumably the risk of cardiovascular disease, not only would it be important to lose weight if you are overweight, but it would also be important to get your gums treated.” "Based on this information and the potential to prevent heart attacks and strokes, I foresee patients receiving routine CRP testing in their dentist or periodontist office in the near future," said Dr. Gordon Douglass, president of the American Academy of Periodontology. "This could help early diagnosis of potential heart disease sooner rather than later, as most people see their dentist or periodontist at minimum two times a year." (AAP website, http://www.perio.org/consumer/happy-heart.htm)

We each control our own destinies, when you think about it, and life/health is not a sprint but a marathon. Try to build your life and influences around healthy environments and people. We need each other to encourage and support us along the way. Fight the good fight and stay the course! Most importantly, add brushing and flossing to the historical mainstays recommending diet, no smoking, and exercise.

Here's to health!

Your friends and partners at 21st Century Dental

	Dental Professionals Blood Drive		Healthy Heart Month September, 2005 Our focus this month is primarily on the “ticker”, but it can’t be discussed without addressing the entire vascular system. So, we are going to discuss the heart’s role in circulation through the vascular system, all essential organs, and of course the brain. Diseases of the heart or the vascular system can include the heart’s main (coronary) artery, a heart attack, or stroke. So, let’s define the diseases and then focus on what’s important - prevention of such serious events! Lastly, we will explain how your gums and periodontal disease can be dangerously connected. The coronary arteries allow blood to flow to the heart and oxygenate or fuel this critical muscle. Obviously, these are pathways that we don’t ideally want constricted in any form or fashion. A thickening of these walls by fatty plaques is called atherosclerosis. If it becomes overly constricted, then one experiences angina which is a squeezing or compressing sensation/pain. It simply means the heart’s demand for oxygen can’t be met. Heart attacks, a word that commands the respect of everyone, occur when the heart muscle is damaged or dies in areas due to a lack of oxygen or flow through the coronary arteries. This usually occurs when one of the fatty plaques in the coronary arteries ruptures or breaks and a blood clot forms (remember the “clot” connection later when we discuss daily aspirin). A stroke is essentially a “heart attack of the brain”. If the arteries leading to the brain are cut off or disrupted, permanent damage occurs to areas of the brain where oxygen was deprived. Since the brain is the control center of the body, damaged areas are exhibited externally by loss of the ability to move or control specific parts of the body, like speech, or use of an arm or leg, etc. Let’s get to the point. How do we prevent these tragic events? First of all, let’s respect our familial histories. If vascular disease, stroke, or diabetes runs in your family, you need to be mindful of your risk factors and solidify an ongoing relationship with a physician or cardiologist, and as you’ll learn in a second, your dentist. Beyond that, don’t smoke! Eat right (keep the salt and saturated fats low)! Exercise consistently (4-6 times per week, at least 30 minutes)! Control your blood pressure, weight, and LDL cholesterol! Lifestyle changes can sometimes successfully correct these problems. Other times, medications are necessary. Never forget to stick to the lifestyle changes if medications are started. Ask your doctor about C-reactive proteins as vascular inflammatory markers, and we in the dental community will explain those markers as they relate to your gums. Once blood pressure is controlled, some in the medical profession recommend taking daily aspirin to prevent clots that can lead to heart attacks and strokes. Ask your physician if this practice is recommended for you. If you take blood thinners and need dental treatment, we now have a laser that will establish the clotting that the blood thinners may prevent while removing gum bacteria. You may have noticed that we are much more vigilant about recording your blood pressure and pulse these days in our dental office. We’re all in this health adventure called life together. That brings us to the important dental connection. A recent study published in The New England Journal of Medicine concluded that elevated CRP (C-Reactive Proteins) levels are a more significant predictor of heart attacks than high (LDL) cholesterol levels! They then recommend CRP and cholesterol screening for risk assessment of cardiovascular disease. Another study published earlier this year in the Journal of Periodontology found that the inflammatory effects from periodontal disease, the chronic bacterial infection of the gums, causes byproducts of gum disease-causing bacteria to enter the bloodstream and trigger the liver to make these proteins such as CRP. What is the significance? Once triggered, they can inflame arteries and promote blood clot formation. (Study Abstract) As we learned earlier in this article, that clot can trigger heart attacks and strokes. Dr. Steven Offenbacher, member of the American Academy of Periodontology (AAP), has stated, "To reduce levels of CRP, and presumably the risk of cardiovascular disease, not only would it be important to lose weight if you are overweight, but it would also be important to get your gums treated.” "Based on this information and the potential to prevent heart attacks and strokes, I foresee patients receiving routine CRP testing in their dentist or periodontist office in the near future," said Dr. Gordon Douglass, president of the American Academy of Periodontology. "This could help early diagnosis of potential heart disease sooner rather than later, as most people see their dentist or periodontist at minimum two times a year." (AAP website, http://www.perio.org/consumer/happy-heart.htm) We each control our own destinies, when you think about it, and life/health is not a sprint but a marathon. Try to build your life and influences around healthy environments and people. We need each other to encourage and support us along the way. Fight the good fight and stay the course! Most importantly, add brushing and flossing to the historical mainstays recommending diet, no smoking, and exercise. Here's to health! Your friends and partners at 21st Century Dental



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Healthy Heart Month