Periodontal Disease and Heart Health

Is There a Link?

Does a healthy mouth equal a healthy heart? More and more, the research says "yes." Doctors have been talking about the potential link for nearly two decades and with good reason. Heart disease is a serious problem around the world. So is poor oral health. Could better brushing and flossing give you a healthier heart? And could dentists take a peek inside your mouth and see if you're at risk for heart disease?

Doctors say maybe.

"For the most part, the data is circumstantial. It's hard to prove cause and effect," says Thomas Boyden, Jr., MD. He's the medical director of preventive cardiology at Spectrum Health Medical Group Cardiovascular Services in Grand Rapids, MI. "However, I think the data is pretty strong and there is definitely a link."

Scott Merritt, DMD, founder and partner of Bridgemill Dentistry in Canton, GA, agrees. "I absolutely believe there is a strong correlation between oral disease and heart function."

So, What's the Link?

What's the link? In a word, inflammation, or swelling. Scientists know that it leads to hardened arteries, also called atherosclerosis. That's a condition that makes it hard for blood to flow to your heart. It puts you at greater risk for heart attack and stroke.

Inflammation is also a sure sign of gum disease. Sore, swollen gums are the main symptom. There are two main types: gingivitis, which causes red, painful, tender gums, and periodontitis, which leads to infected pockets of germy pus. That's the type that raises the worry for heart problems. It allows bacteria and other toxins to spread below the gum line.

"Your gums are very vascular, meaning they're full of blood vessels. And, your mouth is full of bacteria. If you disrupt the gum layer even a little bit, you're going to get bacteria in your bloodstream, which can go anywhere and trigger inflammation throughout the body," Boyden says. "Inflammation is one of the main things that cause damage to blood vessels, including those of the heart."

Studies show that the bacteria found in periodontal disease -- including Streptococcus sanguis, which plays a role in strokes-- spreads to the heart. "The two appear to go hand-in-hand," Merritt says. "In the absence of gum disease, there is significantly less of these bacteria in the heart."


Some research suggests that the more bacteria you have from gum-disease, the thicker your carotid arteries may be. If they're too thick, blood can't flow to your brain. That can cause a stroke.

"Quite simply, the more bacteria you have in your body, the more the heart will be affected," Merritt says. "If we can reduce the long-term bacteria present in our bodies, I believe it will lower the risk factor to heart disease."

But both experts warn this doesn't mean you need to rush out for antibiotics before your next dental visit. Guidelines for antibiotic use before dental procedures have changed in recent years. If you take them when it's not necessary, you might find they don't work when you do need them. Ask your doctor if you need to take them.

Another Link to Consider

While bacteria likely play a role in dental heart health, doctors say your lifestyle choices are a factor, too.

"People with bad periodontal disease tend to have bad health habits in general," Boyden says. "They aren't taking care of themselves. Many are smokers. They probably aren't exercising; they may not be eating well. We know all of those things are some of the strongest predictors of heart disease."

A lot of people with periodontal disease also have diabetes, which is another strong risk factor for heart disease, he adds.

Brush Your Teeth, Boost Your Heart?

The American Heart Association says there's no evidence that you can prevent heart disease by preventing gum disease.

But it's important to get regular dental checkups -- including dental X-rays. You should also be sure to treat any gum disease early if you want to save your choppers and stay healthy. "If you are aggressive about treating your mouth health, your overall health gets better, too," Boyden says. So go ahead -- brush your teeth a bit longer or floss a little more often. Everyone likes a clean and healthy mouth, and maybe your heart just might love it, too.

WebMD Feature Reviewed by James Beckerman, MD, FACC on December 15, 2015



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Scott V. Merritt, MD, founder and partner of Bridgemill Dentistry, Canton, GA.

Thomas Boyden, Jr, MD, medical director, preventive cardiology, Spectrum Health Medical Group Cardiovascular Services, Grand Rapids, MI.

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