Gum Health Associated With Carotids

GumsOver the years I have attended lectures led by Bradley Bale, MD and Amy Doneen, RN who promote the theory that inflammation is one of the major causes of acute heart attack and stroke.  They measure inflammation in men and women with normal lipid levels, normal blood pressure who are non-smokers and exercise but still have cardiovascular events such as heart attacks and strokes.  They talk about the formation of soft lipid plaque or foam cells forming in the walls of the blood vessels and then erupting into the lumen of the blood vessel under the influence of inflammation setting off a clotting cascade that leads to heart attacks and strokes acutely. They measure the degree of inflammation using a series of blood tests patented by the Cleveland Clinic and look for atherosclerosis by doing carotid ultrasounds in a special way to measure carotid artery intimae thickness which they believe correlates with the presence of atherosclerosis, soft plaque and the risk of an acute event.  When all traditional major  risk factors such as smoking, blood pressure, blood glucose level, high blood pressure , activity level and family history have been taken into account and treated there are individuals who still have inflammation and acute events.  They believe oral periodontal disease is the culprit and suggest treating it.

They receive confirmation of their theory in an online article in the Journal of the American Heart Association written by Moise Desvarieux, MD, PhD of Columbia University’s Mailman School of Public Health in NYC with his colleagues.  They demonstrated that by reducing periodontal disease over a three year period there was less progression of carotid artery intima media thickening.  As the gums improved and the oral microbes that are associated with periodontal disease decreased the progression of intimal thickness slowed.

It is clear that more research is needed but while it is ongoing simply seeing your dentist regularly and caring for your teeth and gums can go a long way to reducing your risk of a heart attack or stroke. The long hypothesized relationship between mouth disease and vascular disease has much stronger evidence after this study and it makes it necessary for those of us discussing prevention and risk factor reduction to ask you at your visits “are you up to date on your dental visits and dental hygiene?” It additionally adds clout to the argument that health insurance includes dental coverage as well!

Malaria Cases on the Rise in the U.S.

MalariaThe Center for Disease Control and Prevention (CDC) has reported the number of malaria cases in the U.S. hit a new high in the last reportable year – 2011. There were 1925 cases, including five deaths, which is an increase of 14%.  Not only were there more cases but there were more cases reported as “severe” than in previous years.  Most of the imported cases came from Africa although India had the largest number of cases at 223. Nigeria was next at 213.

The CDC reviewed the use of medications in 929 civilian cases and found that only 57 of the 929 had followed the CDC medication recommendation regimen.  Malaria is a serious disease and causes significant illness and mortality. As our population becomes more mobile, patients need to seek the advice of physicians knowledgeable in travel medicine and follow their recommendations.  

My web site has a link to the CDC website which provides travel information and I maintain a professional relationship with local travel services which keep in stock some of the more uncommon vaccines you need when traveling to exotic locations. Feel free to discuss travel plans in advance by calling the office for an appointment.