Untreated Apical Periodontitis Related to Multiple Systemic Complications

 

First of all, I want to give props to the folks at the ADA who put together ADA News.  Their Weekend Huddle e-newsletter has been the source of some great information as of late.  If you haven't subscribed to it , might I recommend you click here and do so.  

Today's post touches again on the oral systemic connection.  While this one isn't a big reach for most of us in dentistry, to the general public who don't understand the intricacies of the oral systemic connection it's an important piece of information.  A recently published study in the Journal of Transitional Medicine followed 65 patients over two years to draw some conclusions.  That study is titled Successful endodontic treatment improves glucose and lipid metabolism: a longitudinal metabolomic study and that title says a lot about the improvements that can be realized by curing a dental problem.

For those readers here who don't have dental backgrounds, I'll give you some basic information to provide a bit of context.

Apical periodontitis is a situation where the internal aspect of the tooth, the nerve and blood vessels that are inside the tooth, become infected and that infection spreads to the apex, which is the tip of the root.  As the infection progresses, it destroys bone at the apex and a chronic (long term) infection sets in.  In the most basic sense, this is a 'pool' of bacteria and infection in the bone of the jaw.  If nothing is done to eliminate this infection, the bacteria present have an easy path to the rest of the body.  The bacteria get into the blood vessels and are carried throughout the body.

This allows the bacteria to settle anywhere it can find an area that is susceptible.  Some of the more common problems that can develop are:

• Infections of the heart, possibly even leading to a potentially fatal infection called endocarditis
• Respiratory infections, including pneumonia
• Pregnancy complications, including  preterm birth and low birth weight

This subject is especially important because statistically around 50% of adults develop apical periodontitis in at least one tooth during their life.

The good news is that this condition is treatable through either: extraction of the infected tooth, root canal therapy, and/or periapical surgery.

The study determined that after getting the infection healed, patients showed improvement in multiple cardiometabolic markers, including:

• Chloesterol
• Glycemic control
• Fatty acid profiles
• Inflammatory markers

These improvements were assocated with a lower risk of cardiovascular disease and Type 2 diabetes.

To read the ADA News article, follow this link.  If you're interested in reading the full study, you can find that here.