The heart and mouth connection: How heart disease and oral health link

According to the Centers for Disease Control and Prevention (CDC), heart disease will claim an estimated 600,000 lives this year, making it America's number one killer.

Did you know that heart disease and oral health are linked? There are two different connections between heart disease and your oral health:

  1. Studies have shown that people with moderate or advanced gum (periodontal) disease are more likely to have heart disease than those with healthy gums.
  2. Oral health holds clues to overall health. Studies have shown that oral health can provide warning signs for other diseases or conditions, including heart disease.

Link #1: How gum disease increases risk of heart attacks

Because the mouth is a pathway to the body, people who have chronic gum disease are at a higher risk for heart attack, according to the Academy of General Dentistry (AGD). Gum disease (called gingivitis in its early stages and periodontal disease in the late stages) is caused by plaque buildup.

Some researchers have suggested that gum disease may contribute to heart disease because bacteria from infected gums can dislodge, enter the bloodstream, attach to blood vessels and increase clot formation. It has also been suggested that inflammation caused by gum disease may also trigger clot formation. Clots decrease blood flow to the heart, thereby causing an elevation in blood pressure and increasing the risk of a heart attack.

Risk factors

Studies have not established that either heart disease or gum disease actually causes the other. This is a difficult task because many of the risk factors for gum disease are the same as those for heart disease:

  • Cigarette smoking
  • Poor nutrition
  • Diabetes
  • Being male

Link #2: How oral health warns about heart disease

More than 90 percent of all systemic diseases — including heart disease — have oral symptoms, research suggests. In addition, dentists can help patients with a history of heart disease by examining them for any signs of oral pain, infection or inflammation. According to the AGD, proper diagnosis and treatment of tooth and gum infections in some of these patients have led to a decrease in blood pressure medications and improved overall health.

Warning signs for gum disease

Gum disease affects 80 percent of American adults, according to the AGD. Warning signs that you may have gum disease include:

  • Red, tender or swollen gums
  • Bleeding gums while brushing or flossing
  • Gums that seem to be pulling away from your teeth
  • Chronic bad breath or a bad taste in your mouth
  • Teeth that are loose or are separating from each other

Prevention is the best medicine

Although gum disease seems to be associated with heart disease, more studies are needed before we can say with certainty what the relationship is. Research has not shown that treatment for one of these diseases will help control the other, but we do know that regular dental checkups, professional cleanings and good oral hygiene practices can improve oral health and that good oral health contributes to good overall health.

While regular dental exams and cleanings are necessary to remove bacteria, plaque and tartar and detect early signs of gum disease, you can play a major role in preventing gum disease:

  • Brush for two to three minutes, twice a day, with fluoridated toothpaste. Be sure to brush along the gumline.
  • Floss daily to remove plaque from places your toothbrush can’t reach.
  • Use a mouth rinse to reduce plaque up to 20 percent.
  • Eat a healthy diet to provide essential nutrients (vitamins A and C, in particular).
  • Avoid cigarettes and smokeless tobacco.

If you have heart disease...

  • Establish and maintain a healthy mouth. This means brushing and flossing daily and visiting your dentist regularly.
  • Make sure your dentist knows you have a heart problem, and share your complete medical history, including any medications you are currently taking.
  • Carefully follow your physician's and dentist's instructions about health care, including using prescription medications, such as antibiotics, as directed.
Some information courtesy of the Academy of General Dentistry.
The Third National Health and Nutrition Examination Survey (NHANES III).
Centers for Disease Control and Prevention.
Last updated: May 2011
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