It has been theorized since the 1920’s that heart disease and gum disease are linked. Recent research has indicated links not only between heart disease and oral health, but between oral health and diabetes, hypertension, lung infections, and dementia. Although the links are not perfectly clear, research continues to try to narrow down specifics as to how the health of your mouth influences the overall health of your body. In today’s blog, your Lake Forest Dentist, Dr. Fondriest discusses the relevant theories along with heart disease and dental treatment.
Heart Disease and Dental Treatment are Linked
What causes heart disease? At the doctor’s office, on television, even on your breakfast cereal box, you’ve heard and read about the many risks for heart attack. For men and women, heart disease is the leading cause of death. Well known risk factors include age, genetics, smoking, high LDL cholesterol, high blood pressure, lack of exercise, diabetes, and stress. Lesser known is periodontal disease, also called gum disease, and it afflicts up to 80% of Americans. Research shows a proven link between gum disease and heart disease.
Research indicates that people who suffer chronic heart issues present with periodontal (gum) disease at an increased rate than heart healthy individuals. A recent study published in the European Journal of Preventive Cardiology included nearly 16,000 participants with chronic coronary artery disease. The participants underwent a thorough physical examination, blood testing, and were asked to complete an in-depth lifestyle questionnaire including questions regarding their dental health and tooth loss. The results of the survey showed that:
· 70% were smokers
· 41% had fewer than 15 teeth remaining
· 26% were gum bleeders
· 16% were edentulous (completely toothless)
According to the blood tests and exams, those with higher prevalence of tooth loss also had higher glucose levels, LDL cholesterol levels, higher systolic blood pressure, and were larger at the waist. Participants with a higher frequency of bleeding gums had higher LDL cholesterol levels, and higher systolic blood pressure. As the largest study to date, it clearly indicates common risks factors for dental disease and heart disease.
Gum disease showers the bloodstream with bacteria
What causes gum disease? Most often, gum disease is caused by poor dental hygiene. However, heredity, medications, other diseases, hormone fluctuations, and tobacco use also contribute to gum disease.
Theory #1: Harmful oral bacteria, particularly streptococcus mutans, are the bacteria that cause periodontal disease. One theory is that these bacteria can a) either release toxins into the bloodstream that contribute to heart disease or b) be released into the blood stream when chewing, brushing, or flossing, and clog the arteries with fatty plaque. Several species of bacteria that cause periodontitis have been found in the plaque in cardiovascular arteries as well as elsewhere in the body. Plaque deposits can cause blood clots and restrict blood flow leading to heart disease and stroke.
Theory #2: Another theory is that harmful oral bacteria cause the liver to make high levels of certain proteins resulting in inflammation of blood vessels. The inflammation can stress the blood vessels causing damage, and the immune system’s response to these toxins could result in blood clotting more easily leading to heart attack or stroke.
Theory #3: The inflammation in the oral cavity due to periodontitis, the severe form of periodontal disease, is not restricted to the mouth but spreads throughout the body putting stress on the heart.
Heart Disease and Dental Treatment
For people who suffer from heart disease, dental treatment may have to be altered due to their risk of developing endocarditis (infection of the heart). This can happen when harmful oral bacteria are released into the blood stream and attach themselves to damaged heart valves or damaged heart tissue. People with certain heart conditions were required to take antibiotics before dental treatment to prevent this from happening. However, in 2007, the guidelines were changed. Pre-dental antibiotic treatment is still recommended for:
- People who have had endocarditis in the past
- People with artificial heart valves
- People who had heart transplants and later developed heart valve problems
- People born with cyanotic heart disease that was not repaired or was repaired incompletely. This includes people with shunts and conduits
- People born with a heart defect that was completely repaired with a prosthetic material or device are required to take antibiotics for the first six months after the procedure
- People with any repaired heart defect that still has some defect at or next to the site of a prosthetic patch or device
What can you do to lower your risk for heart disease?
Gum disease begins when some of the 600 types of oral bacteria irritate gum tissue and cause infection. Lowering the amount of bacteria by reducing plaque and tartar helps reduce the risk for gum disease. You can decrease oral bacteria by brushing, flossing, and using antiseptic mouthwash daily. Also, attend six-month checkups and dental cleanings. Our hygienist will examine your gums, measure periodontal pocket depth, and remove plaque and tartar at your hygiene visit, also called a cleaning visit.
Be aware of the symptoms of gum disease: red, swollen, tender gums, bleeding while brushing teeth. Sometimes gum disease presents no symptoms. If you notice a problem with your gums, or if you’ve not had a checkup and cleaning in the past six months, call Dr. Fondriest today.