Happy Teeth and Gums = Happy Heart: The undeniable link between oral health and heart health

From early childhood, we’re taught about the importance of preventing cavities through regular brushing and flossing of our teeth – but good oral health is about much more than cavity prevention. What most people don’t know is that numerous studies have shown that oral health can actually be a good indicator of overall health. In fact, problems, such as gum disease have been linked to heart disease and countless other health conditions, including diabetes, cancer, Alzheimer’s, rheumatoid arthritis and more.

“There is a well-established correlation between these two seemingly unrelated areas of the body [the mouth and the heart],” explains Dr. Stephen Boateng, WakeMed Heart & Vascular - Cardiology. “We know that poor oral health can lead to poor cardiovascular health, and research shows that having gum disease can actually double or triple your risk of suffering a heart attack, stroke or other serious cardiovascular event. While we don’t fully understand how these risks are connected, it’s clear that they are undeniably linked. By taking steps to improve oral health, patients can help reduce their overall risk of cardiovascular disease.”

Plaque Is Plaque

In the world of oral health, plaque is a buildup of bacteria, saliva and food particles that adhere to the surface of the teeth. While everyone has plaque on their teeth, it can be removed by practicing good oral hygiene and routine dental care. But, when it builds up over time, it can lead to tartar formation – which is calcified plaque that can lead to gum disease. Gum disease, also known as gingivitis (early stage) or periodontal disease (advanced gum disease), affects more than 40 percent of U.S. adults. If left untreated, the gums around your teeth may loosen – creating ‘pockets’ in the gums that make it easier for infection and inflammation to take hold. Teeth may continue to loosen, or even fall out.

On the other hand, plaque in the cardiovascular system is made up of cholesterol, fatty substances, calcium and other organic matter. Over time, this plaque can build up, at which point it’s called atherosclerosis – which is a hardening of the arteries caused by plaque that thickens artery walls and restricts the flow of blood and oxygen throughout the body. This can lead to serious problems, including heart attack, stroke or even death. In many cases, atherosclerosis can be prevented or treated with a healthy lifestyle and/or medical intervention.

Here, our experts weigh in on what we need to know – and how to keep both our mouths and hearts healthy.

Stephen Boateng, DO

Q: How do you explain the link between oral health and heart health?

A: There are a couple of ways gum disease may lead to heart disease. The first is inflammation. Your gums are highly vascular, making it easy for the bacteria to travel from your gums throughout your blood stream. This activates an immune system response that triggers inflammation throughout the body. Over time, this inflammation can lead to other problems such as heart disease, diabetes and arthritis, among others.

The second way gum disease can lead to heart problems is through direct infection. Bacteria in the bloodstream can lead to problems such as endocarditis - which is inflammation of the inner lining of the heart valves and chambers. While relatively rare, this serious infection is more likely to affect those with artificial heart valves, damaged heart valves or other defects.

Q: What are some lifestyle factors that can affect both oral health and heart health?

A: The first and most important is smoking or tobacco use. Tobacco use weakens your immune system, making it harder to prevent gum infection or heart disease. Smoking specifically is linked to a two-fold increase in risk for gum disease when compared to non-smokers. At the same time, cigarette smokers are 2 to 4 times more likely to develop heart disease. Other ways to keep your mouth and heart healthy include: practicing good oral hygiene, avoiding sugary foods and drinks, and taking other steps to reduce inflammation – such as getting enough sleep, exercising regularly, and adding rich, anti-inflammatory foods into your diet.

Tim Barlow, DDS

Q: How do you know if you have gum disease?

A: Signs of early gum disease include swollen, tender gums that bleed, bad breath, and/or an unpleasant taste in the mouth. Symptoms of later stage disease include gums that are pulling away from the teeth (known as receding gums), pain while chewing or loose teeth. Your dentist can diagnose gum disease and provide strategies for treatment and preventing further disease progression.

Q: Can gum disease be reversed?

A: In its early stages, gum disease can be reversed with good home care that includes brushing, and especially flossing. But, once gingivitis transitions to advanced periodontal disease, we start seeing bone loss in the teeth. Once bone loss has occurred, you can’t get it back. What most people don’t know is that more people lose teeth due to gum disease than they do to cavities, which are much easier to treat.

Q: What are best practices for good oral health?

A: Brushing twice a day is the basis for maintaining good oral health – and each brushing session should last two full minutes. For the prevention of gum disease, flossing is the gold standard because brushing alone can’t get in between your teeth the way flossing does. Next, it’s important to see your dentist at least twice a year for routine cleanings and to identify gum disease early when
it’s easier to treat. Lastly, using an antiseptic mouthwash for at least 30 seconds can be a great adjunct strategy for good oral health. For patients with advanced gum disease, cleanings can be performed every 3-6 months. There are also treatments for gum disease, such as scaling or root planing – these deep cleaning treatments involve scraping plaque and tartar, and smoothing out the rough surfaces on your teeth to help gums reattach. Clorohexadine mouth rinse can also help kill the bacteria that contributes to gum disease.

This blog is adapted from Heart to Heart Magazine. Subscribe today.