Although the findings indicate a strong link between gum disease and heart disease, it’s still not clear whether one actually causes the other, says the American Heart Association. The two conditions have some of the same risk factors, including smoking, poor nutrition and diabetes. Researchers believe that inflammation caused by periodontal disease may be responsible for the connection.
Oral health and heart disease are connected by the spread of bacteria – and other germs – from your mouth to other parts of your body through the bloodstream. When these bacteria reach the heart, they can attach themselves to any damaged area and cause inflammation. This can result in illnesses such as endocarditis, an infection of the inner lining of the heart, Other cardiovascular conditions such as atherosclerosis (clogged arteries) and stroke have also been linked to inflammation caused by oral bacteria.
Who is at Risk?
Patients with chronic gum conditions such as gingivitis or advanced periodontal disease have the highest risk for heart disease caused by poor oral health, particularly if it remains undiagnosed and unmanaged. The bacteria that are associated with gum infection are in the mouth and can enter the bloodstream, where they attach to the blood vessels and increase your risk to cardiovascular disease. Even if you don't have noticeable gum inflammation, however, inadequate oral hygiene and an accumulated plaque put you at risk for gum disease. The bacteria can also migrate into your bloodstream causing elevated C-reactive protein, which is a marker for inflammation in the blood vessels. This can increase your risk of heart disease and stroke.
Symptoms and Warning Signs
According to the American Association of Periodontology (AAP), you may have gum disease, even if it's in its early stages, if:
Signs and symptoms of gum disease:
- your gums are red, swollen and sore to the touch.
- your gums bleed when you eat, brush or floss.
- you see pus or other signs of infection around the gums and teeth.
- your gums look as if they are "pulling away" from the teeth.
- you frequently have bad breath or notice a bad taste in your mouth.
- or some of your teeth are loose or feel as if they are moving away from the other teeth.
Cardiovascular Diseases that require specific care
The following list contains information about some of these conditions and the proper precautions you may need to take. If you have cardiovascular disease and need oral surgery, you should talk to your dentist or surgeon about plans for pain control during and after surgery, including the use of anaesthetics and sedation.
Some people are at high risk of developing an infection of the inner lining of the heart (bacterial endocarditis). These patients must take special care to practice good oral hygiene every day. All patients scheduled for valve surgery need to have excellent oral hygiene and see a dentist before surgery because unhealthy teeth are one source of bacteria that can cause endocarditis.
It is best to wait a minimum of six months after a heart attack before undergoing any extensive dental treatments. You do not need to wait to have a dental cleaning. Ask your dentist if oxygen and nitroglycerin are available in case a medical emergency should arise during your office visit.
Anti-coagulants and Anti-platelet Medications
Be sure to tell your dentist if you are taking anticoagulants (blood-thinning drugs) such as warfarin (Coumadin).These medications could result in excessive bleeding during some oral surgery procedures.
High blood pressure (hypertension)
Some anti-hypertensive medicines can cause dry mouth or alter your sense of taste. Calcium channel blockers, in particular, may cause the gum tissue to swell and overgrow, causing problems with chewing. If you do experience gum overgrowth, your dentist will give you detailed oral hygiene instructions and might ask you to make more frequent dental visits for cleanings. A procedure called a gingivectomy can be done to remove excess gum tissue.
Patients with angina who are treated with calcium channel blockers might experience gum overgrowth. Although patients with stable angina can typically undergo many dental procedures, patients with accelerating or unstable angina should not undergo nonessential (elective) dental procedures. These patients should have their heart evaluated by their cardiologist before having such procedures.
Tell your dentist if you are taking anticoagulants (blood-thinning medications).These medications could cause excessive bleeding during some oral surgery procedures. If your stroke has resulted in an inability to produce an adequate amount of saliva, your dentist might recommend the use of artificial saliva. If your stroke has affected your face, tongue or dominant hand and arm, your dentist might also recommend the use of fluoride gels, modified brushing or flossing techniques and strategies to help you maintain good oral hygiene.
Prevention is the best medicine!
Regular healthy habits can lower your risk of both gum disease and heart disease.
Brush and floss regularly: To remove plaque-forming bacteria, brush for at least two minutes, twice a day, and don’t skip the floss.
Choose a healthy diet: A healthy diet rich in essential nutrients (especially vitamins A and C). Reduce or eliminate sugar and starches.
Avoid cigarettes and smokeless tobacco: These habits can destroy your gums and increase your chance of heart disease.
Good oral hygiene and regular dental examinations are the best way to protect yourself against the development of gum disease. You should also floss daily and visit your dentist for regular professional cleanings.
By being proactive about your oral health, you can protect yourself from developing a connection between oral health and heart disease, and keep your smile healthy, clean and beautiful throughout your life.