Study suggests that the chronic bacterial infections found in periodontal diseases may affect reproduction success and the outcome of infertility treatment.

CHICAGO (June 22, 2004) – Researchers found that women undergoing ovulation induction for infertility treatment for more than three menstrual cycles experience higher gingival inflammation, bleeding and gingival crevicular fluid (GCF). This study appeared in the recent issue of the Journal of Periodontology.

In this study, the gingival inflammation levels of women undergoing infertility treatment and subjected to ovulation induction were investigated and compared with women who were not using these drugs. It found that despite similar plaque levels, women who received ovulation induction medications for more than three menstrual cycles had higher levels of gingival inflammation, bleeding and GCF. GCF is a fluid that contains enzymes and tissue breakdown products that have been examined as potential markers for the progression of periodontitis.

“These effects are presumably correlated with the increased levels of progesterone and estrogen,” explains Dr. Cenk M. Haytac, Cukurova University, Adana, Turkey. “Gingiva is a target tissue for estrogen since it contains specific high-affinity estrogen receptors.”

Several studies provided evidence that the presence of infection is associated with unsuccessful embryo development and implantation failure in in vitro fertilization patients. Since periodontal diseases are chronic bacterial infections, the study suggests that periodontal status may also affect reproduction success and the outcome of infertility treatment.

“It is reasonable to assume that if low levels of plaque are established and maintained during the infertility treatment, gingival inflammation would not effect the success of infertility treatment,” said Michael P. Rethman, D.D.S., M.S., and president of the American Academy of Periodontology. “This would require meticulous oral hygiene and routine professional cleanings, perhaps at the beginning of each menstrual cycle to ensure the presence of healthy gums.”

Periodontal diseases are risk factors for several systemic conditions including preterm low birthweight babies. “It will be interesting to see if further intervention studies will determine the effects of periodontal status and the periodontal therapy on the outcome of infertility treatment,” said Rethman.

“A woman undergoing infertility treatment is often given drugs to stimulate the ovaries to produce as many healthy follicles as possible to increase the chances of conception,” said Haytac. “This method has been used worldwide for more than 30 years, and the World Health Organization estimates that approximately 8% to 10% of couples worldwide experience some form of fertility problem.”

A free brochure titled Women and Periodontal Disease is available by calling 1-800-FLOSS-EM or using the AAP’s online request form. The AAP’s Web site (www.perio.org) can provide more information and a referral to a nearby periodontist.

The AAP was established in 1914 and focuses on the prevention, diagnosis and treatment of diseases affecting the gums and supporting structures of the teeth and in the placement and maintenance of dental implants.

**EDITOR'S NOTE: A copy of the report published in the Journal of Periodontology’s titled “The Effects of Ovulation Induction During Infertility Treatment on Gingival Inflammation” is available by calling Amy Duff at 312/573-3244.

CHICAGO (June 22, 2004) – People with deep periodontal pockets had an increased risk for electrocardiographic abnormalities (ECG) according to a recent study printed in this month’s issue of the Journal of Periodontology.

Japanese researchers examined general and oral health of 1,111 people and included 957 people who had greater or equal to 10 teeth and did not have a medical history of cardiovascular disease were included.

“We found that people with deep periodontal pockets with a mean value greater than two millimeters had an increased risk for ECG abnormalities compared with people who had pockets with a mean value less than two millimeters. And, people with severe attachment loss with a mean value greater than 2.5 millimeters had a significant risk for ECG abnormalities.” said Dr. Yoshihiro Shimazaki, Department of Preventive Dentistry, Kyushu University Faculty of Dental Science, Japan. “Considering these results, the relationship between periodontitis and ECG abnormalities observed in this study suggests a relationship between periodontitis and cardiovascular disease.”

Periodontitis is a chronic inflammatory bacterial infection. Past studies report that periodontitis results in higher systemic levels of C-reactive protein (CRP), interleukin-6 and neutrophils suggesting that elevated levels of these inflammatory substances cause inflammatory changes to atherosclerotic lesions, which increases the risk of cardiac events.

“This study adds to the growing body of evidence that links periodontitis to cardiovascular disease,” said Michael P. Rethman, D.D.S., M.S., and president of the American Academy of Periodontology. “In order to examine the degree of cardiovascular risk from periodontitis compared with other risk factors, cohort studies are required. For example, because problematical ECG results are a widely appreciated risk factor for cardiovascular disease, it could be clinically valuable to know the effects of periodontal treatment on ECG exams.”

As ECG examinations cause no discomfort and take only a few minutes, it is widely used to screen for heart disease in health examinations. ECG abnormalities are significantly related to subsequent death from coronary heart disease and one of the most sensitive predictors of fatal coronary heart disease.

Comprehensive periodontal therapy is provided by dental specialists – known as periodontists – who are graduates of three-year residencies that they undertake after graduating from dental school. General dentists and dental hygienists can also provide more limited periodontal care.

A free brochure titled Ask Your Periodontist About Periodontal Disease and Heart Disease is available by calling 1-800-FLOSS-EM or using the AAP’s online request form. The AAP’s Web site (www.perio.org) can provide more information and a referral to a nearby periodontist.

The AAP was established in 1914 and focuses on the prevention, diagnosis and treatment of diseases affecting the gums and supporting structures of the teeth and in the placement and maintenance of dental implants.

**EDITOR'S NOTE: A copy of the report published in the Journal of Periodontology’s titled “Relationship Between Electrocardiographic Abnormalities and Periodontal Disease: The Hisayama Study” is available by calling Amy Duff at

312/573-3244.

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