William H. Pippin, DDS

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2011-03-09T09:46:00.001-08:00

Dear Friends,

I'm no longer posting to this blog. For updates please visit my Facebook page at
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Thank you.

Dr. Bill Pippin

HPV Vaccination Recommended for Boys and Girls for Prevention of Oropharyngeal Cancer

2010-10-26T18:16:00.000-07:00

October 21, 2010 — Human papillomavirus (HPV) is a risk factor for oropharyngeal squamous cell carcinoma (OSCC), and might account for the steady increase in OSCC incidence, even in subjects who do not smoke or consume alcohol, according to Swedish researchers.

A review of recent studies, conducted by Trobjorn Ramqvist, MD, and Tina Dalianis, MD, PhD, and published online October 13 in Emerging Infectious Diseases, suggests that changes in sexual practices are behind the surge in OSCC cases linked to sexually transmitted HPV. The key factors appear to be multiple sex partners, starting sexual activity at a younger age, and increased oral sex.

The data are startling. For example, from 1970 to 2002, tonsillar cancer (which is the most common OSCC) increased in Stockholm, Sweden, by 2.8-fold, and by 2006/07, 93% of all tonsillar cancers in that city were HPV-positive.

Dr. Dalianis, who is professor of tumor virology and the head of the Department of Oncology–Pathology at Karolinska Institutet in Stockholm, told Medscape Medical News that "we realized that there was an increase in HPV-induced tonsillar cancer, but we did not realize it was so eminent until we separated the 2 groups (HPV-negative and -positive tonsillar cancer cases) the way we did."

The most common OSCC is tonsillar cancer, followed by base of tongue cancer. Overall 5-year survival for OSCC is about 25%, and HPV-positive OSCC generally has better clinical outcomes than HPV-negative disease.
Dr. Dalianis said that HPV (most commonly type 16) was found in 45% to 100% of OSCCs in various studies.
"It was also observed that patients with HPV-positive OSCC were younger and lacked the traditional risk factors of smoking and alcohol consumption," the authors write. "We suggest the increased incidence of OSCC depends on HPV infection and results in an increased proportion of HPV-positive OSCCs."

Dutch Expert Questions Proportions of HPV Positivity
Using data from the Swedish Cancer Registry, the researchers found that the incidence of HPV-positive tonsillar tumors almost doubled over each decade from 1970 to 2007, for a cumulative 7-fold increase over that period.
Similarly, HPV-positive base of tongue cancers increased from 54% in 1998/99 to 84% in 2006/07.

However, another expert, asked to comment on the study by Medscape Medical News, raised questions about the high proportion of HPV-positive tumors found in the Stockholm registry data.

Boudewijn J.M. Braakhuis, PhD, is from the section of tumor biology in the Department of Otolaryngology/Head and Neck Surgery at VU University Medical Center in Amsterdam, the Netherlands. Dr. Braakhuis, whose work focuses on oral and oropharyngeal cancers, said that the proportion of HPV-positive OSCCs in the Amsterdam area is about 20%.

Dr. Braakhuis said that the Swedish analysis is hampered by the lack of a standardized method for measuring HPV involvement. Dr. Braakhuis's group proposes doing p16 staining followed by general primer polymerase chain reaction with typing, which might reduce the risk for false positives.

The Case for HPV Vaccination
Dr. Dalianis said that there is a significant association of HPV-positive tonsillar cancer with early initial sex, and with the number of oral or vaginal sex partners. She also noted that one study reported "that not only oral sex, but also open-mouthed kissing, was associated with the development of oral HPV infection."
Noting that this could mean that oral-to-oral contact might play a role in oral HPV transmission, Dr. Dalianis said that this has implications for the timing of vaccinating children to prevent HPV.

Dr. Dalianis is "a strong supporter of giving the HPV vaccine to both girls and boys," and writes that "it is crucial to monitor the effects of the present HPV vaccination, not only on the incidence of cervical cancer but also on the incidence of OSCC."

Dr. Braakhuis agreed: "One may expect that vaccination will decrease the number of HPV-positive oropharyngeal cancers" after decades.
Another important point uncovered in the review is that the incidence of head and neck squamous cell carcinoma is decreasing and OSCC is increasing, which might presage a risk for overtreatment if the intensified regimens used for head and neck squamous cell carcinoma are applied to HPV-positive OSCC, which has a better prognosis than HPV-negative disease.

"It is possible that increasing numbers of OSCC patients with a better prognosis are being treated with intensified therapy. As a result, many patients have substantial chronic unnecessary side effects. It is therefore necessary to identify which patients need and which do not need intensified treatment," the study authors write. The suggestion is that OSCC patients with HPV-positive tumors who have never smoked might be candidates for less intensive treatment.

Dr. Dalianis and Dr. Braakhuis have disclosed no relevant financial relationships.

Doctors Remove Tooth Stuck in Man’s Ear for 33 Years

2010-10-25T18:18:00.000-07:00


Published October 18, 2010 | FoxNews.com

Doctors finally discovered the cause of a 47-year-old man’s ear pain
and constant ear infections, which has been plaguing him since he was
a teenager.

Stephen Hirst, who lives in the U.K., had a tooth stuck in his ear,
The Star reported.

“It’s a mystery how it got there,” Hirst said. “I would think it’s a
first tooth, looking at it, because it can’t be big enough to be an
adult tooth. I think it’s a bottom tooth, one of the front incisors.”

Hirst said he was often in so much pain, he would “scream” in agony,
and he has been to countless doctors trying to figure out what the
problem was. Doctors at the Royal Hallamshire Hospital in Sheffield,
South Yorkshire, England told him they were determined to find the
problem and offer a solution.

“The nurse put a suction tube in my ear and cleaned it, then (tried) a
microscope probe,” Hirst said. “Finally, she used some tweezers and
got it out.”

Hirst said his ear pain is gone for the first time since he was 14.

Click here to read more about this story from The Star.

http://www.thestar.co.uk/news/My-tooth-in-ear-agony.6583975.jp

Tooth Brushing and Heart Disease

2010-09-21T09:17:00.000-07:00

June 7, 2010 — Individuals who do not brush their teeth twice a day have an increased risk of heart disease, a new study shows [1].

The study was published online May 27, 2010 in BMJ; corresponding author is Prof Richard Watt (University College London, UK).

The researchers note that while it has been established that inflammation in the body (including mouth and gums) plays an important role in the buildup of atherosclerosis, this is the first study to investigate whether the number of times individuals brush their teeth has any bearing on the risk of developing heart disease.

High fructose intake associated with higher blood pressure

2010-07-25T13:36:00.000-07:00

July 12, 2010 — High fructose intake in the form of added sugar is independently associated with higher blood pressure (BP), according to the results of a cross-sectional analysis of data from the National Health and Nutrition Examination Survey (NHANES 2003 to 2006), reported online ahead of print July 1 in the Journal of the American Society of Nephrology.

"The recent increase in fructose consumption in industrialized nations mirrors the rise in the prevalence of hypertension, but epidemiologic studies have inconsistently linked these observations," write Diana I. Jalal, from University of Colorado Denver Health Sciences Center in Aurora, and colleagues. "We investigated whether increased fructose intake from added sugars associates with an increased risk for higher BP levels in US adults without a history of hypertension."

In the study sample of 4528 adults without a history of hypertension, median fructose intake was 74 g/day, which is approximately equivalent to 2.5 sugary soft drinks each day. Increased fructose intake of at least 74 g/day was independently and significantly associated with higher odds of elevated BP levels, after adjustment for demographics; comorbid conditions; physical activity; total kilocalorie intake; and dietary confounders including total carbohydrate, alcohol, salt, and vitamin C intake. Increased risk associated with fructose intake of 74 g/day or more was 26% for a BP cutoff point of 135/85 mm Hg or higher, 30% for a BP cutoff point of 140/90 mm Hg or higher, and 77% for a BP cutoff point of 160/100 mm Hg or higher.

"These results suggest that high fructose intake, in the form of added sugar, independently associates with higher BP levels among US adults without a history of hypertension," the study authors write.

Depressed People Eat More Chocolate

2010-05-11T11:54:00.000-07:00

May 3, 2010 — A new cross-sectional study suggests individuals with depressive symptoms eat more chocolate, but it does not explain why.

"There is a lot of lore about chocolate and depression and precious little in the way of scientific evidence, which is what motivated us to do this study," Beatrice A. Golomb, MD, PhD, of the Department of Family and Preventive Medicine, University of California, San Diego, told Medscape Psychiatry.

The study, published in the April 26 issue of the Archives of Internal Medicine, included 931 adults not using antidepressants. The mean age of study subjects was 57.6 years and mean body mass index was 27.8 kg/m²or less; 70.1% were male, 80.4% were white, and 58.8% were college educated. Subjects provided information on chocolate consumption (frequency and amount) and completed the Center for Epidemiological Studies-Depression (CES-D) scale.

Subjects who screened positive for depression, defined as a CES-D score of 16 or higher, reported consuming significantly more chocolate than those not screening positive for depression (8.4 vs 5.4 servings per month; P = .004).

Those with CES-D scores of 22 or greater, indicating probable major depression, consumed 11.8 servings of chocolate per month (P value for trend < .01). These associations were evident for men and women.

According to the researchers, several nutrient factors that could be linked to mood, such as increased caffeine, fat, carbohydrate, or energy intake, bore no significant correlation with mood symptoms, suggesting relative specificity of the chocolate finding.

"The study," Dr. Golomb emphasized, "does not address the issue of whether chocolate is beneficial or harmful in terms of mood, as this is an observational and cross-sectional study."

"A lot of people perceive that they get a mood lift when they eat chocolate; whether that's true or whether that’s short lived, which is why people with higher depression scores are still seen as eating more chocolate," is unclear, Dr. Golomb said.

There was no evidence in the study that chocolate had a sustained benefit on mood. "In our sample, if there is a 'treatment benefit,' it did not suffice to overcome the depressed mood on average," she and colleagues note in their report.

Future prospective studies are needed to elucidate the foundation of the chocolate-mood association and determine whether chocolate has a role in depression "as a cause or cure," they conclude.

Commenting on the findings, Gordon Parker, MD, PhD, of the School of Psychiatry, University of New South Wales, Australia, who was not involved in the study, said people who crave chocolate and judge it as beneficial when depressed may be "more likely to have certain personality styles." These personality styles that underpin chocolate cravings reflect "neuroticism or what we would call emotional dysregulation."

"Thus, rather than view chocolate craving as a symptom, it may well be an attempt by individuals who are emotionally dysregulated to reset their ‘mood state,’ and then this invites the question as to what are the components in chocolate that might settle emotional dysregulation."

Oral Cancer on the Rise

2010-03-31T13:13:00.000-07:00

Approximately 35,000 people in the US will be newly diagnosed with oral cancer in 2010. This is the fourth year in a row in which there has been an increase in the rate of occurrence of oral cancers, in 2007 there was a major jump of over 11% in that single year.

http://oralcancerfoundation.org/

Headache Prevention

2010-03-01T18:41:00.000-08:00

Dental Implants: An Overview

2010-03-01T18:18:00.000-08:00

Gum Disease Increases Risk for Diabetes

2009-12-22T08:54:00.000-08:00

Study finds over 90 percent of people with gum disease are at risk for diabetes
December 14, 2009

The study, led by Dr. Shiela Strauss, Associate Professor of Nursing and
Co-Director of the Statistics and Data Management Core for NYU's Colleges of
Dentistry and Nursing, examined data from 2,923 adult participants in the
2003-2004 National Health and Nutrition Examination Survey who had not been
diagnosed with diabetes. The survey, conducted by the National Center for
Health Statistics of the Centers for Disease Control and Prevention, was
designed to assess the health and nutritional status of adults and children in
the United States.

Using guidelines established by the American Diabetes Association, Dr. Strauss
determined that 93 percent of subjects who had periodontal disease, compared to
63 percent of those without the disease, were considered to be at high risk for
diabetes and should be screened for diabetes. The guidelines recommend diabetes
screening for people at least 45 years of age with a body mass index (a
comparative measure of weight and height) of 25 or more, as well as for those
under 45 years of age with a BMI of 25 or more who also have at least one
additional diabetes risk factor. In Dr. Strauss's study, two of those
additional risk factors - high blood pressure
and a first-degree relative (a parent or sibling) with diabetes - were reported
in a significantly greater number of subjects with periodontal disease than in
subjects without the disease.

Dr. Strauss's findings, published today in the
online edition of the Journal of Public Health Dentistry, add to a growing body
of evidence linking periodontal infections to an increased risk for diabetes.
Dr. Strauss also examined how often those with gum disease and a risk for
diabetes visit a dentist, finding that three in five reported a dental visit in
the past two years; half in the past year; and a third in the past six months.
"In light of these findings, the dental visit could be a useful opportunity to
conduct an initial diabetes screening -- an important first step in identifying
those patients who need follow-up testing to diagnose the disease."
"It's been estimated that 5.7 million Americans with diabetes were undiagnosed
in 2007," Dr. Strauss added, "with the number expected to increase dramatically
in coming years. The issue of undiagnosed diabetes is especially critical
because early treatment and secondary prevention efforts may help to prevent or
delay the long-term complications of diabetes that are responsible for reduced
quality of life and increased levels of mortality among these patients. Thus,
there is a critical need to increase opportunities for diabetes screening and
early diabetes detection."

>From PhysOrg.com
http://www.physorg.com/news180015527.html

Tongue Piercing Cause of Death

2009-10-15T06:15:00.000-07:00

Man, 22, Dies After Tongue-Piercing Causes Brain Abscesses
Wednesday, October 14, 2009

They may seem cool to teenagers and young adults, but having your
tongue pierced can be deadly, BBC News reported.

A 22-year-old man died of multiple brain abscesses just weeks after
piercing his tongue, according to a report in the Archives of
Neurology.

According to doctors, an infection can spread from the site of the
piercing and go up to the brain.

"Dentists are all too aware of the health problems that can be caused
by oral piercings," said Professor Damien Walmsley, a scientific
adviser to the British Dental Association. "There are many potential
complications, ranging from pain and swelling to chipped or cracked
teeth. Patients who have oral piercings can also suffer with recession
of the gums and prolonged bleeding.

"Piercing of oral sites also carries with it a risk of infection. The
clear message is that oral piercing is ill-advised and should be
avoided."

Prevent Periodontitis To Reduce The Risk Of Head And Neck Cancer

2009-09-08T18:03:00.000-07:00

ScienceDaily (2009-09-08) -- Chronic periodontitis, a form of gum disease, is an independent risk factor for head and neck squamous cell carcinoma. This suggests the need for increased efforts to prevent and treat periodontitis as a possible means to reduce the risk of this form of cancer.

http://www.sciencedaily.com/releases/2009/09/090908023642.htm

Treating Periodontal Disease May Help Rheumatoid Arthritis

2009-06-15T12:08:00.000-07:00

According to a recent article appearing on WebMD, “It was exciting to find that if we eliminated the infection and inflammation in the gums, then patients with a severe kind of active rheumatoid arthritis reported improvement on the signs and symptoms of that disease,” says Nabil Bissada, DDS, chairman of the department of periodontics at the Case Western Reserve University School of Dental Medicine. “It gives us new intervention.”

The study by Bissada and colleagues is published in the Journal of Periodontology.

The study was done with 40 subjects who had rheumatoid arthritis (moderate to severe) and periodontal disease that was classified as severe.

While one study is not a reason to make wholesale changes in the way we think, it is one more piece of the puzzle between the potential links between periodontal disease and other systemic health problems that have been and continue to be explored by researchers.

To read the complete article at WebMD, click here.

Top 5 Most Annoying Dental Patient Behaviors

2009-02-27T17:35:00.000-08:00

Dentists Dish On What Drives Them Crazy While They Work...

30,000+ Dentists Converge in Chicago February 27-March 1

CHICAGO, Feb. 24 /PRNewswire-USNewswire/ -- The following is being issued by the Chicago Dental Society:

Who: The Chicago Dental Society (CDS) recently polled more than 300 members to find out some wacky, unusual, and just plain distracting behaviors they've encountered while patients are in their chair.

As we countdown to CDS's annual Midwinter Meeting, one of the largest displays of dental products in North America, here are the most annoying patient behaviors, according to those surveyed. Give your dentist a break and avoid these activities if possible.

5) Public displays of affection. Your breath may be minty fresh after a cleaning, but don't test it on your significant other until after you leave the dental office.

4) Playing games on your handheld. A few dentists reported getting knocked upside the head during an exam while their patients tried to continue playing their games at arms-length. Really, Tetris can wait.

3) Reading a book or magazine while the dentist is trying to perform an exam. You'll have to relinquish that People magazine or John Grisham novel so your dentist can get a look at your teeth.

2) Grooming. The light in the dental chair might be just right for touching up makeup or - heaven help us - plucking your eyebrows, but dentists really would prefer you save those activities for the bathroom.

And the most annoying thing patients do while in the dentists' chair?

Answering cell phone!

Why: Data was collected for the Chicago Dental Society's 144th annual Midwinter Meeting, which begins at McCormick Place in Chicago on February 26, 2009. The exhibit floor opens on February 27.

The Truth About Whitening

2009-02-26T14:00:00.000-08:00

I get many inquiries from patients regarding in office whitening techniques such as so called laser whitening and Zoom. Studies show that the light or laser has absolutely no beneficial effect upon the results of teeth whitening. In other words the chemical applied to the teeth does the work, not the light.

The active ingredient in virtually all teeth whitening products is either hydrogen peroxide or carbamide peroxide, which releases hydrogen peroxide in the mouth. There is no science behind the light.

I have tried several in office whitening systems, and the results have been inferior to the take home systems.

Dentists who offer in office whitening often charge hundreds of dollars more than we charge for the take home whitening because the patient is taking up valuable chair and staff time. The teeth look whiter when the patient leaves the office because the treatment dehydrates the teeth, but they revert back to the original shade after a few hours. Many offices still give the patient a take home bleaching tray to "touch up" or finish the job.

So, if you are willing to pay more in the pursuit of instant gratification for a result that at best is equivalent to or at worst is inferior to take home whitening, then go for it.

Periodontitis And Myocardial Infarction: A Shared Genetic Predisposition

2009-02-24T17:06:00.000-08:00

http://www.sciencedaily.com/releases/2009/02/090213115011.htm

ScienceDaily (Feb. 24, 2009) — A mutual epidemiological relationship between aggressive periodontitis and myocardial infarction has already been shown in the past. Scientists at the universities of Kiel, Dresden, Amsterdam and Bonn have now presented the first evidence of a shared genetic variant on chromosome 9, which maps to a genetic region that codes for the "antisense RNA" Anril, as reported in the latest edition of the specialist journal PLoS Genetics.

The first author, Dr Arne Schaefer from the Institute for Clinical Molecular Biology at Kiel University, sees clear similarities in the genetic predisposition: "We have examined the aggressive form of periodontitis, the most extreme form of periodontitis which is characterized by a very early age of onset. The genetic variation associated with this clinical picture is identical to that of patients who suffer from cardiovascular disease and have already had a myocardial infarction."

Because it has to be assumed that there is a causal connection between periodontitis and myocardial infarction, periodontitis should be taken seriously by dentists and diagnosed and treated at an early stage. "Aggressive periodontitis has shown itself to be associated not only with the same risk factors such as smoking, but it shares, at least in parts, the same genetic predisposition with an illness that is the leading cause of death worldwide.," warned Schaefer. Knowledge of the risk of heart attacks could also induce patients with periodontitis to keep the risk factors in check and take preventive measures.

Besides Arne Schaefer, Gesa Richter, who is doing a doctorate on the subject, is also part of Professor Stefan Schreiber's working group from the Institute for Clinical Molecular Biology at Schleswig Holstein University Hospital (UK S-H), Kiel Campus. As cardiologist, Dr Nour Eddine El Mokhtari from the Kiel Heart Centre is an important partner in the group. Dental expertise came from Dr Birte Größner-Schreiber from the Hospital for Conservative Dentistry and Periodontology at the UK S-H, Dr Barbara Noack, Technische Universität Dresden, as well as Professor Søren Jepsen from Bonn University and Professor Bruno Loos, Free University Amsterdam.

Mountain Dew Mouth

2009-02-18T08:45:00.000-08:00

Dentists have known for a long time how chronic consumption of soft drinks, Mountain Dew in particular, can ravage tooth enamel. I have seen the devastating effects in my own practice. Now PepsiCo, the manufacturer of Mountain Dew, has agreed to support a dentist’s efforts in rehabilitating kids suffering from “Mountain Dew Mouth” in rural Appalachia. The story was featured on the ABC TV series 20/20. Click the link below or copy and paste it to your browser to watch a video of the 20/20 report.

http://www.abcnews.go.com/Health/story?id=6899312&page=1

Your Mouth and Heart Disease

2009-02-03T10:45:00.000-08:00

ScienceDaily (Dec. 7, 2008) — Individuals

reporting a history of periodontal disease

were more likely to have increased levels of

inflammation, a risk factor for heart

disease, compared to those who reported no

history of periodontal disease, according to

an American Journal of Cardiology report

available online.

Led by investigators from Columbia University

Medical Center and NewYork-Presbyterian

Hospital, the findings suggest persons with

increased levels of inflammatory markers

associated with a higher risk of

cardiovascular disease might be identified by

asking about oral health history. This group

might not be detected by traditional

cardiovascular risk screening.

Inflammation has been associated with

cardiovascular disease and has been suggested

to be a potential link between periodontal

disease and cardiovascular disease. To

examine whether oral health history and

inflammatory markers associated with

cardiovascular disease were linked, the

investigators followed participants in the

National Heart, Lung and Blood Institute

(NHLBI) Family Intervention Trial for Heart

Health (F.I.T. Heart), an ongoing national

trial led by principal investigator Lori

Mosca, M.D., M.P.H., Ph.D., professor of

medicine at Columbia University College of

Physicians and Surgeons and director of

preventive cardiology at NewYork-Presbyterian

Hospital/Columbia University Medical Center.

The NHLBI Family Intervention Trial for Heart

Health aims to study family members of

patients hospitalized with heart disease

because they may be at increased risk

themselves due to shared genetic and/or

lifestyle factors. Dr. Mosca and her research

team recruited family members or co-habitants

of patients hospitalized for such cardiac

events as a heart attack or narrowed arteries

that required bypass surgery or an

angioplasty procedure. Previous research has

shown that family members of cardiovascular

disease patients may be at increased risk for

the disease due to the genes and lifestyle

habits they share.

In this study, 421 individuals who were blood

related to and/or living with a person

recently hospitalized due to cardiovascular

disease were screened for traditional

cardiovascular risk factors (such as elevated

blood pressure and abnormal cholesterol

levels), inflammatory markers associated with

disease risk (high-sensitivity c-reactive

protein (hsCRP) and lipoprotein-associated

phospholipase A2 (Lp-PLA2)). They were also

asked standardized questions about their oral

health status, including whether they had

ever been diagnosed with periodontal (gum)

disease, whether they had ever been treated

for periodontal disease, whether they used

partial or complete removable dentures, and

the date of their last teeth cleaning. The

oral health history was then correlated with

standard markers of inflammation.

Results found that among participants who did

not have traditional cardiovascular disease

risk factors (such as high blood pressure,

high cholesterol, and overweight/obese

status), almost one in four were found to

have a personal history of periodontal

disease and higher levels of Lp-PLA2, an

inflammatory marker which has been found

present in inflamed rupture prone plaque in

heart arteries/valves.

It is important to note that it is not

possible to determine from this study that

poor oral health causes cardiovascular

disease risk or that any therapy based on

oral health status would be effective in

preventing cardiovascular disease. However,

Dr. Mosca says, "Our finding is novel because

it suggests the dentist and oral health exam

may be the latest weapon in identifying

persons at risk of cardiovascular disease,

our nation's number one killer."

"Many people don't realize how oral health is

often a predictor of one's overall health,"

says co-author John T. Grbic, DMD, MS, MMSc,

professor of clinical dental medicine at the

Columbia University College of Dental

Medicine. "Symptoms for many life-threatening

illnesses, such as diabetes and heart

disease, first appear in the mouth. For this

reason, it's vitally important for people to

have routine dental check-ups and have an

ongoing dialogue with their dentist about

their oral health. Patients may also benefit

from seeing dentists affiliated with an

academic medical center, where they are

tapped into deep referral networks to

appropriate clinicians."

The Mouth - Body Connection

2009-02-03T10:33:00.000-08:00

ScienceDaily (Sep. 11, 2008) — Heart disease is the leading cause of death worldwide. However, many people with cardiovascular disease have none of the common risk factors such as smoking, obesity and high cholesterol. Now, researchers have discovered a new link between gum disease and heart disease that may help find ways to save lives, scientists heard September 9, 2008 at the Society for General Microbiology's Autumn meeting being held at Trinity College, Dublin.

In recent years chronic infections have been associated with a disease that causes "furring" of the arteries, called atherosclerosis, which is the main cause of heart attacks. Gum disease is one of the most common infections of humans and there are now over 50 studies linking gum disease with heart disease and stroke.

"A number of theories have been put forward to explain the link between oral infection and heart disease," said Professor Greg Seymour from the University of Otago Dunedin, New Zealand. "One of these is that certain proteins from bacteria initiate atherosclerosis and help it progress. We wanted to see if this is the case, so we looked at the role of heat shock proteins."

Heat shock proteins are produced by bacteria as well as animals and plants. They are produced after cells are exposed to different kinds of stress conditions, such as inflammation, toxins, starvation and oxygen and water deprivation. Because of this, heat shock proteins are also referred to as stress proteins. They can work as chaperone molecules, stabilising other proteins, helping to fold them and transport them across cell membranes. Some also bind to foreign antigens and present them to immune cells.

Because heat shock proteins are produced by humans as well as bacteria, the immune system may not be able to differentiate between those from the body and those from invading pathogens. This can lead the immune system to launch an attack on its own proteins. "When this happens, white blood cells can build up in the tissues of the arteries, causing atherosclerosis," said Professor Seymour.

"We found white blood cells called T cells in the lesions of arteries in patients affected by atherosclerosis. These T cells were able to bind to host heat shock proteins as well as those from bacteria that cause gum disease. This suggests that the similarity between the proteins could be the link between oral infection and atherosclerosis," said Professor Seymour.

This molecular mimicry means that when the immune system reacts to oral infection, it also attacks host proteins, causing arterial disease. These findings could fundamentally change health policy, highlighting the importance of adult oral health to overall health and wellbeing: control of gum disease should be essential in reducing the risk of heart disease.

"This is a significant step towards a more complete understanding of heart disease and improving treatment and preventive therapies," said Professor Seymour. "An understanding of all the possible risk factors could help lower the risk of developing heart disease and lead to a significant change in disease burden."