February is heart month. So this month we review current literature and research about the link between dental health and the heart and discuss tips.
Heart disease refers to conditions that involve the heart, its vessels, muscles, valves, or internal electric pathways responsible for muscular contraction. Common heart disease conditions include coronary artery disease, heart failure, cardiomyopathy, heart valve disease, and arrhythmias.
Heart disease claims around 610,000 lives each year, heart disease is the number one killer of both men and women in the United States. There is a link between this deadly disease and the health of your gums.
According to a study by the Karolinska University Hospital, Sweden, gum disease increases the risk of a first heart attack by 28%.
Periodontal diseases (gum diseases), including periodontitis, affect the surrounding tissues which support the teeth. Periodontitis, (inflammation around the teeth), is a serious gum infection that progressively damages the soft tissue and alveolar bone that supports the tooth. Microorganisms, such as bacteria, stick to the tooth surface and multiply causing an overactive immune system to react with inflammation.
Untreated periodontitis eventually results in tooth loss, increasing the risk of stroke, heart attack and other health problems. Bacterial plaque is a sticky, colorless membrane that develops over the surface of teeth. It is the most common cause of periodontal disease.
Signs of gum disease include red, swollen gums that are sore to the touch. Gums may bleed during brushing, flossing and eating. Pus is present around gums and teeth. Gums appear to pull away from the teeth. Teeth are loose or mobile.
Studies show gum disease is linked to heart disease.
By promoting systemic inflammation, periodontal disease may lead to cardiovascular disease. Treatment of periodontal disease has been reported to improve cardiovascular function in patients without overt coronary disease.
One study supported earlier findings that chronic periodontitis was associated with an incidence of coronary artery disease among men under the age of 60. Research also found a trend toward reduced periodontal risk in patients using statins. This supports findings that statin use was associated with fewer periodontal pockets.
Doctors at the University of Alabama studied the relationship between periodontal disease and stroke. Given that atherosclerosis is a systemic disease and periodontal disease may promote atherosclerosis, periodontal disease may also be associated with an increased risk of stroke. They hypothesized that tooth loss would also be associated with higher levels of inflammation and stroke. The study reinforced the association between periodontal disease, as measured by tooth loss and inflammation, and supports an association between periodontal disease and stroke.
Oral inflammation and the heart
Inflammation is part of an immune response to fight off pathogens and clear infections, protecting the body. Chronic inflammation damages the heart, even when no infection is present. This inflammation can cause structural changes to the heart, causing the muscle to become enlarged or develop fibrous tissue, impeding the heart’s ability to pump blood efficiently and leading to further deterioration.
Gum Disease and Plaque
The most common strain of bacteria in dental plaque can cause blood clots that induce heart attacks when they escape into the bloodstream. Heart disease is approximately twice as high in people with periodontal disease. Chronic inflammation of the gums due to plaque could also be involved in the inflammation of the lining of the blood vessels that is known to lead to the build-up of plaque in the arteries.
“Smoking has strong relationships to both tooth loss and heart disease,” said Dr. Catherine Okoro, an epidemiologist at the CDC. “Nonetheless, when we stratified by age group and smoking status, a significant association remained between tooth loss and heart disease among respondents aged 40 to 59 years who had never smoked.” The researchers reported the results are consistent with previous studies that link periodontal disease and tooth loss to an increased risk of atherosclerosis and heart attack.
Gum disease appears to worsen blood pressure and can interfere with medications designed to treat hypertension, high blood pressure.
Poor dental health also poses a risk to people with heart valve problems, stated Dr. Ann Bolger, a cardiologist and professor of medicine emeritus at the University of California, San Francisco. “I spend an inordinate amount of time talking to heart valve patients about their teeth because we know certain heart valve infections can be associated with poor oral health.” This latest research “is a good reminder that the mouth is an important part of a person's entire health and simple, daily behaviors that improve health are incredibly important.”
Heart disease symptoms:
- Coronary artery disease symptoms may be different for men and women. For instance, men are more likely to have chest pain. Women are more likely to have other signs and symptoms along with chest discomfort, such as shortness of breath, nausea and extreme fatigue.
- Signs and symptoms can include:
- Chest pain, chest tightness, chest pressure and chest discomfort (angina)
- Shortness of breath
- Pain, numbness, weakness or coldness in your legs or arms if the blood vessels in those parts of your body are narrowed
- Pain in the neck, jaw, throat, upper abdomen or back
- Always call 911 or emergency medical help if you think you might be having a heart attack.
What if you already have heart disease?
If you already have heart disease, be sure to follow a meticulous oral hygiene regimen. Good oral hygiene can help prevent heart infections.
Follow these easy steps to keep your heart and mouth healthy.
- Practice good oral hygiene by brushing twice a day and flossing once a day. In addition, make sure that you see your dentist regularly.
- Make sure you tell your dentist about your heart condition.
- Follow any instructions given to you by your dentist and physician. This is especially important because you may need a prescription for an antibiotic before your dental appointments.
- Prevention is the best medicine
- Avoid cigarettes and smokeless tobacco. These habits can destroy your gums and increase your chance of heart disease.
Good oral hygiene and regular dental examinations are your best protection against the development of gum disease. If you would like to schedule an appointment for an examination including oral hygiene at Pi Dental Center, give us a call at (215) 646-6334 or click the link below to fill out an online form.
- Uncovering a Link Between Inflammation and Heart Disease: Immune cells can exacerbate heart failure. A new study reveals a potential way to stop them, Laura Castañón Tufts Now, February 1, 2021.
- Higashi Y, Goto C et al. Department of Cardiovascular Physiology and Medicine, Hiroshima University, Graduate School of Biomedical Sciences, Hiroshima, Japan. 2009 Oct;206(2):604-10.
- Significant association between score of periodontal disease and coronary artery disease. Oe Y.et al. Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Honjo, Kumamoto, Japan.2009 Mar;24(2):103-7.
- Tooth loss, systemic inflammation, and prevalent stroke among participants in the reasons for geographic and racial difference in stroke study. You Z et al. Department of Biostatistics, University of Alabama at Birmingham. 2009 Apr;203(2):615-9. Epub 2008 Aug 8.
- Catherine Okoro, Ph.D., epidemiologist in the Division of Adult Community Health at the Centers for Disease Control and Prevention.
- CDC, NCHS. Underlying Cause of Death 1999-2013 on CDC WONDER Online Database, released 2015.
- Gum Disease Linked to Heart Disease, Tim Friend, USA Today.
- Rydén L, Buhlin K, Ekstrand E, et al. Periodontitis increases the risk of a first myocardial infarction: A report from the PAROKRANK study. 2016.
- Jeffcoat et al. Impact of periodontal therapy on general health: evidence from insurance data for five systemic conditions. American Journal of Preventive Medicine. 2014;47(2):166-74.
- Gum Disease and Heart Disease. American Academy of Periodontology. Dec. 2016. http://www.perio.org/consumer/heart_disease