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IU research team to study whether cleaning teeth reduces risk of heart disease

September 24, 2004

INDIANAPOLIS -- An Indiana University School of Dentistry researcher will study whether dental patients whose teeth are cleaned regularly may be getting far more than a sparkling white smile: they also may be reducing their chances of developing heart disease.

Leading a team of researchers from IU's schools of dentistry and medicine, Dr. Michael Kowolik will use a $1.3 million grant from the National Institutes of Health to study dental plaque accumulation as a risk factor for heart disease.

Kowolik's research comes at a time when chronic infections in the body are under increasing investigation for the role they may play in the development of a number of health problems, including heart disease.

Three years ago, Kowolik published a study showing that this same accumulation of plaque on teeth, which leads to gingivitis, produced a systemic response from the body's main line of defense to infections: the white blood cell.

"If you get an infection anywhere in the body, these cells come pouring out of your bone marrow to defend you," Kowolik said. "I had an idea that if we allowed plaque to accumulate on teeth, the white blood cells would respond. Lo and behold, they did, and we can measure this."

The new study, involving 140 Indianapolis area volunteers, takes that idea one step further. Half of the volunteers who will be recruited for the research will be African Americans, marking the first time, as far as is known, that African Americans will be included in such a study.

Cardiologists have known for 20 years that one of the principal risk factors for a heart attack is an elevated white blood cell count, Kowolik said. "We will study whether allowing plaque to accumulate is sufficient to raise the white blood cell count to the point it would become a risk factor for heart disease."

In addition to studying white blood cell counts, the research team also will look for other well-established inflammatory markers that are known to occur in people who have chronic infections and also could be related to risk of heart disease.

"We're not talking about people with advanced periodontal disease," Kowolik said. "We're talking about healthy people who simply neglect oral hygiene."

The notion that what goes on in the mouth probably affects the rest of the body isn't new, Kowolik said.

"In the early 1900s, some well-informed physicians harangued dentists for the fact that they were focused on the cosmetic repair of mouths and much less on the health of the populace," he said.

In the 1960s, dental researchers scientifically established that dental plaque causes oral inflammation, specifically gingivitis, setting the stage for later studies that have linked oral health to the health of the rest of the body, Kowolik said.

The research findings in the 1960s justified the profession of dental hygiene and the practice of preventive dentistry, he noted, because they demonstrated a definitive cause-and-effect relationship between plaque build-up and gingivitis.

This latest study will not prove definitively that neglecting oral hygiene leads to heart disease, but the body of evidence that dentistry plays an important role in a preventive health program for the rest of the body is getting stronger, Kowolik said.

Excited by the challenge the research presents, he said the work is a natural outgrowth of a dental education in which his professors took the enlightened view that "the mouth isn't just a place where you put fillings in teeth and occasionally take a tooth out, but is much more connected to the rest of the body."

A former researcher for Procter & Gamble, Kowolik received his dental and Ph.D. degrees from the University of Edinburgh, Scotland. He joined IU's full-time faculty in 1998.
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Indiana University

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