New Study Confirms Periodontal Disease Linked To Heart Disease

Mounting evidence shows a link between periodontal disease — chronic infection of the gums and bone — and a host of serious and sometimes life-threatening medical problems, from heart disease and stroke to diabetes and respiratory disease.

Although family history, diet, weight and exercise are very important factors in heart health, scientific data collected over the last few years is showing there is some sort of relationship between dental health and heart health. The evidence for this connection is so strong that in 1998 the National Institutes of Health awarded a $1.3 million grant for research studies about the link between periodontal disease and cardiovascular diseases.

Heart health describes the health status of the heart muscle, the lining of the heart, heart valves, heart arteries and blood vessel throughout the body - the cardiovascular system. If this system is affected by disease, a person can suffer high blood pressure, heart rhythm disorder, blocked or hardening of the arteries, high blood cholesterol levels - all of which lead to strokes, angina or heart attack.

Several theories exist to explain the link between periodontal disease and heart disease. One theory is that oral bacteria can affect the heart when they enter the blood stream, attaching to fatty plaques in the coronary arteries (heart blood vessels) and contributing to clot formation. Coronary Artery Disease (CAD) is characterized by a thickening of the walls of the coronary arteries due to the buildup of fatty proteins. Blood clots can obstruct normal blood flow, restricting the amount of nutrients and oxygen required for the heart to function properly. This may lead to heart attacks. Another possibility is that the inflammation caused by periodontal disease increases plaque build up, which may contribute to swelling of the arteries.

Researchers have found that people with periodontal disease are almost twice as likely to suffer from coronary artery disease as those without periodontal disease.

Periodontal disease can also exacerbate existing heart conditions. Patients at risk for infective endocarditis may require antibiotics prior to dental procedures. Your dentist and cardiologist will be able to determine if your heart condition requires use of antibiotics prior to dental procedures.

Next time you're evaluated for the risk of heart disease, don't be surprised if the doctor pulls out a tongue depressor and says, "Say 'ah.'"

"If you want to assess a person's general health," says James R. Orcutt, a dentist in Ithaca, N.Y., and a former president of the New York State Dental Society, "look first in their mouth."

Some researchers believe that the bacteria shed by chronic oral infections can spread through the bloodstream and contribute to disease in the heart and other parts of the body. Other researchers believe that chronic gum infections may trigger a chain of chemical events that causes inflammation—swelling—throughout the body. When plaque lining the arteries becomes inflamed, blood clots can form, leading to heart attack or stroke.

The downside of poor oral health doesn't end there. Researchers have also found that periodontal disease may make it more difficult for people with diabetes to control their blood sugar. Despite the consequences of poor oral health, says Linda Niessen, a professor of geriatric dentistry at Baylor College of Dentistry in Dallas, dental care remains "the poor relation in the nation's health care system."

The frail elderly are particularly at risk for tooth decay and gum disease, Folse says. "Dry mouth"—one side effect of many medications—inhibits saliva's ability to restore tooth enamel, contributing to decay. And arthritis, stroke and other conditions can make brushing uncomfortable, difficult or even impossible.

Periodontal disease is preventable. If you have already been diagnosed with periodontal disease, it can be controlled and in some cases, reversed. It starts with taking proper care of your teeth and gums, especially if you are susceptible to heart or respiratory diseases. In fact, improving your oral health could halt the progression of respiratory system diseases.

Dr. Aschacher makes the following recommendations, “To prevent periodontal disease you do not want to smoke. You need to have a regimented hygiene program that includes professional cleanings every three months, brushing 3 times a day, and flossing daily. You should use an approved rinse like Crest or Listerine, or even the prescription brand, Peridex.” Call the office and schedule a screening to see if you are at risk for periodontal disease.