Whole-Body Smile

Could oral health problems really contribute to heart attack? It may, at first, seem unlikely if you are unaware of the connection between oral and whole-body health. But researchers at Columbia University Medical Center in New York have found that people with gum disease are more likely to suffer from atherosclerosis—a narrowing of the arteries that can cause heart attack or stroke—than people with healthy mouths.

The culprit: Bacteria that form in the mouth due to gum disease can contribute to the formation of blood clots in your arteries. Not only can problems like gum disease affect your heart and arteries, but oral problems such as dry mouth are often predictors of health issues elsewhere in your body.

Dr. Patrick Lloyd, dean of the University of Minnesota’s School of Dentistry, who has been practicing dentistry for almost 30 years, confirms this. “We’re finding more and more evidence that inflammation—especially with the tissues surrounding teeth—is correlated with other types of illness, such as cardiovascular disease, low-term birth weights, and higher rates of periodontal disease in particular,” he says. “Advanced gum disease and periodontal disease can exacerbate diabetes. So the dentist can play a significant role in improving someone’s quality of life [in terms of] an underlying illness by ensuring [a patient] has little or no inflammation in their mouth tissues.”

The link between oral health and heart health begins with gingivitis, an inflammation of the mouth tissues that is not always accompanied by discomfort or pain. Perhaps that’s why, according to the Centers for Disease Control and Prevention, about 50 percent of U.S. adults have gingivitis. As gingivitis advances, it does have some telltale signs, though: red and swollen gums, bleeding during brushing or flossing, and bad breath.

What causes gingivitis? It all starts with the insidious build-up of saliva, food, and germs into a sticky film called plaque. This stuff nestles into the gum line along the tooth to make your gums red and tender. Regular brushing, flossing, and dental cleanings can reverse the effects of gingivitis.

But many cases of gingivitis progress to gum disease. Also known as periodontal disease, gum disease affects about 20 percent of adults in the United States. Symptoms of gum disease are similar to those seen in gingivitis, but more severe. Gum disease goes beyond the irritation of the gums and bad breath to infect the teeth, ligaments, and bone surrounding your teeth. The infected areas can lose tissue and bone mass and the eventual result can be tooth loss. Infected gums house pockets of bacteria that can bleed when you brush them. And when your gums bleed, the opening in the tissue allows bacteria to enter your bloodstream.

When oral bacteria leave the mouth and find damaged cells or fatty plaques near the heart, they can take several possibly damaging paths. They can multiply into bacterial colonies on the interior surface of the heart or a heart valve, triggering endocarditis, an infection-related heart attack. They can attach to fatty plaques in the arteries, contributing to plaque build-up that can cause a blockage, which in turn can lead to a heart attack. And if this blockage occurs in an artery leading to the brain, it could result in stroke.

According to the National Institute of Dental and Craniofacial Research, about 15,000 people die of endocarditis in the United States each year. Researchers believe that many of these cases are related to displaced oral bacteria that enter the bloodstream during a dental procedure, flossing, or even chewing.

The American Heart Association says people with prosthetic heart valves, a history of endocarditis, or congenital or acquired heart defects should take precautions, such as a course of antibiotics before dental work, since they are at greater risk for endocarditis than people without heart conditions.

The implications of periodontal disease are serious, but you can start protecting your mouth, your heart, and your whole body now with two trips to the dentist each year for a routine teeth cleaning, and by brushing twice and flossing once a day.