Gum Disease and Heart Disease

Good diet and body exercise may not be enough for preventing heart diseases. Many researchers advise that you should also add tooth brushing and flossing.

The first study (Finland, 1989) noted that patients who had heart attacks had more severe oral conditions including periodontal disease and tooth decay, indicating a link between oral health and heart disease. Since then, several studies suggest that pre-existing gum disease could be a significant risk factor for heart disease, comparable to smoking, family history and elevated cholesterol, increasing the risk of heart attack or stroke.

Although the exact way that gum disease is contributing to heart disease is not yet absolutely clear, researchers suggest several possible ways of action:

• Atherosclerosis - Bacteria from diseased gums may enter and travel through the bloodstream, attaching to fatty plaques in the coronary arteries (heart blood vessels) and contributing to the formation of artery-clogging plaques (atherosclerosis).

  Coronary artery disease is characterized by a thickening of the walls of the coronary arteries due to the build-up of fatty proteins that causes a narrowing of the arteries. Blood clots can obstruct normal blood flow, restricting the amount of nutrients and oxygen required for the heart to function properly. If the blood flow gets completely blocked, this may lead to heart attacks. Atherosclerosis in the carotid artery in the neck can lead to stroke.

• Inflammatory response - Gum disease bacteria that have entered the bloodstream may trigger an inflammatory response to blood cells causing swelling. Researchers found diseased gums released significantly higher levels of bacterial pro-inflammatory components, such as endotoxins, into the bloodstream in patients with severe periodontal disease compared to healthy patients. If it happens in an artery that could cause blockage and heart attack. If the gum disease bacteria have reached the heart or other organs the body’s immune response may damage these organs.

  Another study found that gum disease bacteria trigger the liver to make C-reactive proteins, which is an indicator for increased risk for cardiovascular disease. C-reactive proteins interfere with the process that inhibits blood clots which can predispose one to a sudden heart attack or stroke. A CRP value of under 1 mg/lt is considered normal, a value of 2-3 triples the risk of heart attack and higher values can increase the risk up to 7½ times.

• Endocarditis - Researchers also believe that gum disease may contribute to infective endocarditis, a condition in which the interior lining of the heart and heart valves become inflamed, possibly due to a bacterial infection. If left untreated, this condition could lead to a fatal infection.

  Bacteria have shown a tendency to collect at previously-damaged sites within the heart. Such a damage may be caused from rheumatic fever, congenital defects, and other conditions. The fact that many patients might be unaware of this pre-existing damage that puts them in a high risk group increases the importance of gum disease prevention and early treatment.

Studies have shown that effective treatment of periodontal disease have led to improvement of the cardiovascular health. Preventing heart disease can help to decrease the risk of developing heart disease and having a heart attack or stroke.

Everyone but especially patients belonging to high risk groups or with a history of heart problems must take good care of their dental health. Regular periodontal evaluations are recommended so that any signs of gum disease are detected at an early stage, and the condition treated before it develops to the more risky stage of periodontitis.

Patients who have heart problems or recently had heart surgery may need to take antibiotics before having any dental procedures in order to prevent the risk of mouth bacteria reaching the heart through the bloodstream, especially in the existence of periodontal disease.