Slots Jørgen
University of Southern California, School of Dentistry, Los Angeles 90089-0641, USA.
Int Dent J. 2003;53 Suppl 3:200-7. doi: 10.1111/j.1875-595x.2003.tb00771.x.
To review the potential of periodontal infections to cause nonoral diseases. Therapeutic recommendations are provided to help patients and dental practitioners prevent systemic complications from periodontal infections.
Systemic diseases from oral bacteria are mostly caused by transient bacteraemias, which can occur spontaneously from dental foci of infection, from mastication, brushing, flossing or other daily manipulations, or from dental treatments. Examples of systemic infections that may involve oral microorganisms include infective endocarditis, aspiration pneumonia, HIV-related disseminated candidiasis and cancrum oris, septicaemia associated with cancer chemotherapy and radiotherapy, necrotising faciitis and various other life-threatening infections. Inflamed gingiva constitutes a significant reservoir for herpes viruses, which have the potential to cause serious systemic diseases in immunocompromised patients. Periodontal disease may also aggravate chronic insulin insensitivity and thus interfere with glycaemic control in diabetic patients. Controversy surrounds the involvement of periodontal infections in coronary heart disease.
Cumulative evidence suggests that periodontal disease can be an important cause of morbidity and mortality of various systemic diseases, especially in individuals exhibiting compromised host defence. Maintaining a healthy dentition and periodontium by means of daily oral hygiene practice and regular professional care is the most effective way of preventing systemic diseases from oral infections.
回顾牙周感染引发非口腔疾病的可能性。提供治疗建议以帮助患者和牙科医生预防牙周感染导致的全身并发症。
口腔细菌引起的全身疾病大多由短暂菌血症导致，这种菌血症可自发产生于牙齿感染病灶、咀嚼、刷牙、使用牙线或其他日常操作，或牙科治疗过程中。可能涉及口腔微生物的全身感染包括感染性心内膜炎、吸入性肺炎、与HIV相关的播散性念珠菌病和坏疽性口炎、与癌症化疗和放疗相关的败血症、坏死性筋膜炎以及其他各种危及生命的感染。发炎的牙龈是疱疹病毒的重要储存库，这些病毒有可能在免疫功能低下的患者中引发严重的全身疾病。牙周病还可能加重慢性胰岛素抵抗，从而干扰糖尿病患者的血糖控制。牙周感染与冠心病之间的关系存在争议。
累积证据表明，牙周病可能是多种全身疾病发病和死亡的重要原因，尤其是在宿主防御功能受损的个体中。通过日常口腔卫生措施和定期专业护理保持牙齿和牙周组织健康，是预防口腔感染引发全身疾病的最有效方法。
