There is mounting evidence that shows a link between periodontal disease -- chronic infection of the gums, or gum
disease -- and a host of serious and sometimes lilfe-threatening medical problems, from heart disease to diabetes
and respiratory disease.

So don't be surprised the next time you are examined for potential heart disease, when the Doctor pulls out a tongue

depressor and says "say aah". The Doctor is looking for signs of gum disease. In fact, when it comes to assessing a

person's general health, the first place many physicians look is in the mouth.

Some researchers believe that the bacteria shed by chronic oral infections (gum disease) can spread through the

bloodstream and contribute to disease in the heart and other parts of the body.

There are other researchers who belileve that chronic gum disease may trigger a chain of chemical events that causes

inflammation (swelling) throughout the body. When plaque lining the arteries becomes inflamed, blood clots can form,
leading to a heart attack or stroke.

Some clinical studies have found that people who have gum disease are nearly twice as likely to suffer from coronary

artery disease as those who don't. Chronic gum disease can also worsen existing heart conditions. In 2003 a study led

by a Doctor at the University of Minnesota School of Public Health, found that tooth loss caused by gum disease may

The negative effects of gum disease and poor oral health doesn't end there. Researchers have also found that gum
disease may make it more difficult for people with diabetes to control their blood sugar.

Yet, with all of the evidence of problems caused by gum disease and poor oral health, good dental care still seems to

be too low on the healthcare priority list of most people. Dental care has been referred to as "the poor relation in America's

It has been estimated that anywhere from 110 million to over 150 million Americans either do not have dental insurance,

or are paying retail at the dentist's office for services not included with dental insurance. This is over 2 to 3 times the number
who do not have medical insurance.

It is estimated that less than 60 percent of the nation's Baby Boomers have dental benefits through their employer, and

most of them will lose their dental benefits when they retire. And many of them have varying degrees of gum disease

It is interesting to note that, according to Oral Health America, a Chicago-based advocacy group, many people who do
have employment based dental benefits are shocked to learn on retirement that Medicare does not include routine dental

care. So they tend to put off seeing the dentist, because of the cost. And so, those with gum disease go on about life

while this "Silent Killer" penetrates their health and wellness.

In recent testimony before the Senate Special Committee on Aging, the President of Oral Health America warned that

the oral health of older Americans is in "a state of decay", with gum disease too often goiong unchecked.

This state of decay is due largely because Medicare doesn't include routine dental services, and in most states Medicaid

doesn't either. The history behind this is that, when these two programs were established in 1965, most Americans who

had lived long enough to qualify for benefits had already lost all their teeth.

This is no longer the case. Compared with earlier generations, older adults today generally still have their teeth, because
many of them grew up brushing and flossing, drinking fluoridated water and getting regular checkups. It has been

observed that well over 60% of today's older Americans still have some teeth. However, 85 percent have moderate to
severe gum disease, and 60 percent have tooth decay .

The frail elderly are particularily at risk for tooth decay and gum disease. One reason for this is that "Dry Mouth" -- one

side effect of taking many medications -- inibits saliva's ability to restore tooth enamel, thus contributing to tooth

decay and gum disease. And arthritis, stroke and other conditions can make brushing uncomfortable, difficult or even

As an example of this problem, in Louisiana, Medicaid dental benefits are limited to dentures. This is not much help to

people who still have their natural teeth, but are experiencing gum disease and tooth decay.

There are advocates pressing the Federal Government "to step up to the plate", to increase matching funds to the

states to help pay for oral health and gum disease treatment services, and to ensure access to care for vulnerable
populations such as low income older adults and people with disablities.

It has been said that government has been "penny-wise and pound foolish" with public health policies that ignore
the connection between gum disease and other health conditions. We have wrung about all the savings we're going
to get out of Medicare and Medicaid through managed care. Now the only other way to save money is by prevention.

This makes for a good subject of another article, dealing with preventing gum disease and achieving better oral health.