How are Dental Health and Heart Disease Related?

Are you at risk for heart disease? It’s sometimes difficult to tell, but research beginning in the 2000s suggests that you see your dentist to find out. Several different studies conducted by cardiologists, and by periodontists (specialists in gum disease) now suggest that there are several connections between dental health and heart disease. People with gum disease, with false teeth, or with deteriorating teeth are all much more likely to have heart disease. These are correlative studies, not cause and effect studies, but further research in this area may suggest that keeping your mouth healthy is one of the keys to having a healthy heart.

One study on dental health and heart disease connects the high risk of gum disease in patients who require heart transplants. In an Australian study, 77% of a group of over 80 patients requiring heart transplant had periodontal disease. This was compared to a group not requiring transplant and with healthy hearts where only 13% had periodontal disease. This study may be slightly flawed since only 80 people requiring transplants were compared to a much larger group of people not requiring them, over 900 people. Still, combined with other studies, these findings suggest oral health and heart disease may be related.

What many similar studies reveal is that people who suffered heart attacks, who need transplants, or who need heart surgery are much more likely to have dental problems. Chief among these was periodontal or gum disease, which means a large amount of bacteria are present in the mouth. In this case, you can’t get by with brushing or flossing, since gums can bleed and thus be open to receiving bacteria into the blood stream.

It is theorized that one of the connections between dental health and heart disease is what the blood stream does with bacteria from the mouth. It may end up lining the walls of your arteries, causing atherosclerosis and artery blockage, or alternately, certain forms of strep bacteria can cause vegetative matter to grow in the valves of your heart, called bacterial endocarditis. Prevention of gum disease is important, and this means flossing regularly, and getting two teeth cleanings a year. If you have gum disease, you should check with your doctor or dentist about antibiotic mouthwashes that can help remove bacteria from your mouth prior to flossing.

Another connection between oral health and heart disease is the theory that tooth loss may actually change the diet and cause poorer cardiovascular health. Either due to missing teeth, or poorly fitting dentures, people may not eat a diet as high in fiber. Softer foods may mean more fatty foods, and a significantly unbalanced diet, which increases risk of heart disease. It’s thus important to get properly fitting replacement teeth or crowns as needed so you can consume recommended amounts of dietary fiber.

Dental health and heart disease have an even more firmly established connection that has long been known. People who have had surgeries, especially surgeries that used artificial valves, conduits or stents absolutely need antibiotic treatment prior to receiving any type of dental treatment, even a teeth cleaning. It is always important to talk to your dentist about heart conditions or surgeries you’ve had, and to ask your cardiologist if you need what are called prophylactic antibiotics prior to seeing the dentist. This large single dose of antibiotics taken an hour prior to dental work does prevent the greater risk of developing bacterial endocarditis.

Further, treatment for certain forms of heart disease may exacerbate gum disease. Certain medications like calcium channel blockers or ACE inhibitors may come in chewable form and many contain sugar. Heart disease medications may create a snowball effect that actually worsens the very diseases they are supposed to treat by causing greater dental problems. This issue might be addressed by taking pills you can swallow rather than chew so that teeth are unaffected by medications.