Cardiology

Question 0

Average number of years of life lost because of a heart attack

Answer 0

16.6 (2013)

Question 1

How many women and men that die of a heart attack have no idea they have vascular disease?

Answer 1

64% of women, 50% of men (2013)

Question 2

How much higher is the risk of CAD if perio disease (PD) is present?

Answer 2

25% increased risk of coronary disease and peripheral artery disease. Men <50 72% increased risk of CAD (Oral & Systemic Health Review, July 2005)

Question 3

How much more likely to have a heart attack with sever perio?

Answer 3

3.8 times more likely (Oral & Systemic Health Review, July 2005)

Question 4

How much more likely to have a stroke of Perio?

Answer 4

Twice as likely (Oral & Systemic Health Review, July 2005)

Question 5

What does a stress test detect?

Answer 5

Artery that is more than 70% blocked. 86% of heart attacks occur in arteries that are less than 70% occluded (i.e. stress test misses most).

Question 6

How many miles of vasculature in average adult?

Answer 6

6,000 miles

Question 7

What is the surface area of the infected periodontium?

Answer 7

Up to 9cm2. Compare to how physicians react to non-healing 2 cm ulcer. How can we help the medical field to make the connection? Total surface area of periodontium in adult = size of palm of hand (Grossi, S; Dental plaque attack; Compendium, special issue Vol. 22 No. 1)

Question 8

How does inflammation affect vasculature?

Answer 8

It is causal of BOTH development of atherosclerotic changes and destabilization of plaques/promotion of thrombosis.

Question 9

What is the odds-to-risk ratio of hypertension in otherwise healthy patients with high periodontal bacterial loads?

Answer 9

3. Systolic was 9 mmHG higher and diastolic was 5mmHg higher. This was burden of pathogen (gram-negative), not necessarily visual perio.

Question 10

How is A1c affected by successful perio therapy?

Answer 10

.4% – to get Rx approval from FDA, change must be .1%.

Question 11

How does simply brushing your teeth affect CRP levels?

Answer 11

Twice a day: levels are about 3 1 x day: about 3.5 Not daily: about 4

Question 12

What is the relationship between insulin resistance and atherosclerosis?

Answer 12

70% of adults are insulin resistant. IR damages arteries regardless of the sugar. IR is an arterial inflammatory problem that begins 20 yrs prior to diabetes.

Question 13

Increased OR of CV event with poor home care

Answer 13

1.7 x higher rate in patients age 50 that had “poor” or “never” oral hygiene (BMJ 5/27/2010)

Question 14

P. gingivalis OR for heart attack (age 35-61)

Answer 14

Pg: 13.6 x higher risk – adjusted for other factors including smoking and lipids

Question 15

If the four bad perio bugs are above threshold

Answer 15

Endothelial integrity threatened Prothrombotic state Additional inflammation Dyslipidemia

Question 16

Fusobacterium nucleatum

Answer 16

Adheres to and invades endothelial cells via FadA Result: endothelial permeability increases and the bacteria enters the arterial wall – creates cracks in the tennis court for other bacteria to enter

Question 17

How prevalent are periodontal pathogens in arterial plaques?

Answer 17

Two or more pathogens in 64% of plaques. All had at least one. Many had multiple.