Inflammation Testing in Oral-Systemic Healthcare

Inflammation testing is one of the key steps to evaluating underlying systemic problems to help prevent and reduce the impact of inflammatory diseases such as cardiovascular disease, diabetes, and strokes. Oral inflammation resulting from pathogens in oral biofilm appear to have a direct impact on several important, measurable, and quantifiable tests associated with inflammatory diseases.

Below is a very simplified overview of some of the components of inflammation testing. As always, these are ways to quantify conditions that need to be addressed by the appropriate medical professional and the healthcare team, including dental professionals.

Lp-PLA2 (via PLAC Test)

The PLAC Test gives an indication if the arteries around the heart are inflamed, a very important test in assessing risk for heart attack and stroke—often more important than cholesterol testing. The PLAC Test is cleared by the FDA to evaluate risk for both heart attack and stroke. Research has shown the possibility of helping lower Lp-PLA2 by adding advanced periodontal treatment by dental professionals to the arsenal physicians have to combat elevated Lp-PLA2 levels.

hs-CRP (C-Reactive Protein)

Risk for heart attack and stroke increase with elevated C-Reactive Protein (CRP) levels, as much as with cholesterol and HDL levels. With an elevated hsCRP, there is most probably an infection somewhere in the body, and with 80% of the population having some form of periodontal disease, there’s a good chance it’s in the mouth. CRP levels have been shown to be up to 7 times higher in patients with periodontal disease. Once again, by adding advanced periodontal treatment by dental professionals to the arsenal of physicians, patients have the potential to help lower their hs-CRP levels.

MPO (Myeloperoxidase)

As a patient progresses to a later stage of risk for a cardiovascular event, quite often myeloperoxidase (MPO) is released from the coronary arteries. Elevated levels of MPO can indicate a more imminent risk of a short-term cardiovascular event such as heart attack or stroke. A periodontal bacterium from oral biofilm,T. forsythia, has been shown to be a potential trigger for neutrophil activation and release of MPO.

Once again, by adding advanced periodontal treatment by dental professionals to the arsenal of physicians, patients have the potential to help lower their MPO levels.

A1C (Glycated Hemoglobin Levels)

This test gives an indication how the patient’s blood sugar levels are being regulated. The higher your glycated hemoglobin levels (A1C) are, the higher your average blood glucose levels are. Elevated A1C typically occurs in those with diabetes and insulin resistance. Periodontal disease and diabetes are closely connected. 93% of those with diabetes have been shown to have periodontal disease. Research now shows us that with advanced periodontal treatment, dental professionals can help lower A1C levels, possibly more than some medications with virtually no adverse side effects. Non-surgical periodontal treatment has been shown to improve glycemic control in patients with Type 2 diabetes. Advanced periodontal treatment has been shown to reduce health complications for patients with diabetes, reducing annual healthcare costs by about 40%. Integrating advanced periodontal treatment into diabetes management can have a positive effect on both the costs and complications of individuals with elevated A1C.

While this is a simplified overview of the complex subject of inflammatory testing, it is an important subject for the dental profession to understand. It’s becoming very evident that inflammation testing can play a key role in the path to reducing inflammatory diseases and the subsequent healthcare costs associated with them. “By more accurately assessing an individual’s near-term cardiovascular risk, healthcare providers can deploy resources more strategically,” says Jake Orville, President and Chief Executive Officer of Cleveland HeartLab.

AAOSH has played a key role in the advancement of the understanding of the intersection of inflammatory testing and oral-systemic health. I strongly suggest each and everyone one of you attend this year’s AAOSH 4th Annual Scientific Session to continue your understanding of this area of healthcare.

In addition, I would suggest anyone who can attend the Cleveland HeartLab Symposium, September 12-13, 2014, in Cleveland, Ohio. As a value to AAOSH members, we have arranged a discount attendance fee—$200 off registration with promo code AAOSH.