Dental Health and Heart Health . . . Is There a Connection?

Sajjad A. Sabir, MD
Clinical Cardiologist, Department of Cardiology

Did you know that there is a common household item that may play a part in preventing heart disease? It’s the simple toothbrush. It makes sense that the billions of bacteria and microbes that live in your mouth, which affect your teeth and gums, can also affect other parts of the body. While not all the research is conclusive, recent studies do suggest a strong link between dental/gum disease and heart disease.

According to the American Academy of Periodontology, people with periodontal disease are nearly twice as likely to have coronary artery disease. One study found that common dental and gum disease (also called gingivitis) was as good a predictor of heart disease as cholesterol levels.

Doctors believe that oral bacteria could also harm blood vessels and/or cause blood clots by releasing certain toxins that resemble proteins found in artery walls and thus the blood stream. These proteins can cause plaque (not the plaque associated with gum disease) to stick to the walls of the arteries. It is also possible that the inflammation that comes as a side effect of dental disease (infection) can also cause inflammation in other parts of the body, namely the heart and surrounding blood vessels.

The American Heart Association published a statement in April 2012 supporting an association between gum disease and heart disease. The article noted that current scientific data do not indicate if regular brushing and flossing or treatment of gum disease will decrease the incidence, rate or severity of the narrowing of the arteries (called atherosclerosis) that can lead to heart attacks and strokes. However, many studies show an as-yet-unexplained association between gum disease and several serious health conditions, including heart disease.

Patients with certain heart conditions have a higher risk of endocarditis. This is an infection of the heart. It can be life threatening. It happens when bacteria in the bloodstream attach to damaged heart valves or other damaged heart tissue.

Pre-treatment with antibiotics is still recommended for people who have had endocarditis in the past. It is also recommended for people with artificial heart valves, and people who had heart transplants and later developed heart valve problems.

Pre-treatment with antibiotics also is recommended for people with certain heart conditions that were present at birth:

  • Cyanotic heart disease that has not been repaired or was repaired incompletely. This includes people with shunts and conduits.
  • A heart defect that was completely repaired with a prosthetic material or device. In this case, antibiotics are advised only for the first six months after the procedure.
  • Any repaired heart defect that still has some defect at or next to the site of a prosthetic patch or device.
  • People with certain heart conditions may need antibiotics before they have particular dental procedures. Make sure to inform your dentist of any heart issues.

Gum disease is an infection of the tissues that support the teeth and is a major cause of tooth loss in adults. The American Dental Association believes that the most important thing you can do to avoid gum disease and maintain good oral health (including prevention of tooth decay or cavities) is:

  • Brush teeth twice a day with an ADA-accepted fluoride toothpaste.
  • Clean between teeth daily with floss or an interdental cleaner.
  • Eat a balanced diet and limit between-meal snacks.
  • Visit your dentist regularly for oral examinations and professional cleanings.

While the research is not conclusive in support of the connection between dental disease and heart disease and not all professionals agree, the common sense, low cost, simple thing to do is to maintain good dental health, regardless of your age.

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