The possible link between gum disease and heart disease has been the subject of clinical study for decades. We know that nearly half of American adults have some degree of gum disease, also known as periodontal disease. We also know that there’s a definite correlation between gum disease and heart disease, especially in individuals with heart valve disease. But does correlation equal causation?
Does Gum Disease Cause Heart Disease?
Scientists don’t know for sure if gum disease causes heart disease directly. What they do know is that people with poor oral health are up to three times more likely to have a heart attack, stroke, or other cardiovascular event, but researchers are still trying to determine the reason for this correlation.
Not everyone with periodontal disease will develop heart disease, and not all heart disease sufferers have problems with their gums. In addition, treating gum disease does not appear to prevent or mitigate the effects of heart disease in a significant way.
Possible Link Between Gum & Heart Health
Plaque is one common denominator between gum disease and heart disease. Gum disease takes hold when this sticky, bacteria-rich film accumulates around the teeth and gums.
Plaque is also at the center of cardiovascular disease, though this type of plaque consists of fat, cholesterol, and other blood-based substances.
While these two types of plaque don’t commonly overlap, they’re commonly associated with the same types of lifestyle and risk factors.
Inflammation
If there is a direct link between gum disease and heart disease, inflammation may be a prime trigger. Inflammation occurs when immune cells flood the system to attack irritants such as viruses and bacteria. Acute inflammation is a short-term response that addresses immediate threats. But chronic (long-term) inflammation can trigger conditions like atherosclerosis, plaque accumulation in the arteries.
Gum disease is a major cause of chronic inflammation. So by extension, gum disease may trigger the kind of long-term immune response that can take a toll on the arteries and ultimately the heart.
Bacterial Contamination
The bacteria—and not just the inflammation associated with the bacteria—present another possible link. Bacteria from inside the mouth can enter the heart via the bloodstream and infect the heart valves, particularly artificial heart valves. This may explain why people with heart valve disease have an especially high gum disease correlation, though more research is needed.
Researchers have actually found traces of oral bacteria in the bloodstreams of people with atherosclerosis. The only question is whether these bacteria are able to trigger or exacerbate the coronary artery disease in a significant way.
Lifestyle Factors
The most likely—or at least the most significant—link between periodontal disease and heart disease is lifestyle. In other words, many of the same risk factors associated with periodontitis are also present with heart disease, which may explain why so many people live with both conditions.
For example, poor diet and smoking can contribute to both conditions. Other shared risk factors include stress and age (people over 65 are at the greatest risk for both conditions).
For people who live with diabetes, the risk is especially high. Diabetes can result in thickened blood vessels, which in turn reduces blood flow and weakens the gum and bones, leaving them more vulnerable to bacterial infection. And for diabetes sufferers already living with periodontal disease, gum infections can cause dangerous blood sugar spikes, increasing the risk of heart attack and stroke. Anyone living with diabetes should undergo regular dental checkups to prevent oral infections.
Gum Disease & Heart Disease Symptoms
You can identify early warning signs and take necessary preventative actions if you know the symptoms of periodontal disease and heart disease.
Gum Disease Symptoms
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Swollen or bleeding gums
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Extreme tooth sensitivity
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Chronic bad breath
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Loose teeth
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Receding gum line
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Pain when chewing
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Changes in bite
Heart Disease Symptoms
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Chest pain (angina)
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Irregular heartbeat (arrhythmia)
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Swelling from fluid buildup (edema)
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Shortness of breath
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Confusion, dizziness, or lightheadedness
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Unexplained fatigue
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Heart attack
If you notice any of the above signs or any combination of gum disease and heart disease symptoms, speak to your healthcare provider right away.
Other Health Issues Linked to Gum Disease
Periodontal disease isn’t just correlated with poor heart health. It has also been associated with a number of other conditions, including:
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Cancer: There is a smaller but still significant correlation between gum disease and cancer, particular kidney cancer, pancreatic cancer, and certain blood cancers. This may once again relate to lifestyle factors or chronic inflammation (as cancer has its own inflammatory triggers), but more research is still needed.
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Pneumonia: Just as bacteria can travel from the gums to the heart via the bloodstream, these same bacteria can also travel to the lungs, potentially contributing to respiratory conditions.
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Rheumatoid arthritis (RA): Though research is still in its infancy, preliminary studies have revealed a possible correlation between RA and gum disease.
These are just a few more reasons why it’s so important to keep your gums healthy with proper oral care and the help of an experienced periodontist.
Gum Disease Prevention Tips
Whether or not there’s a causal link between gum disease and heart disease, it’s important to maintain good gum health. A good smile is a terrible thing to waste, and the bacteria in your mouth does have the potential to affect other systems in your body.
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Visit your dentist every six months for checkups and cleanings.
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Visit your dentist as soon as you notice any potential trouble signs (cavities, toothaches, unexplained tooth sensitivity, swollen gums, etc…)
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Brush your teeth after every meal using a fluoride toothpaste approved by the American Dental Association.
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Floss at least once a day.
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Use mouthwash every day to kill the lingering bacteria in your mouth.
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Refrain from all forms of tobacco use.
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Maintain a nutritious, heart-healthy diet rich in lean protein, vegetables, and complex carbohydrates.
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Keep sugar consumption to a minimum.
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Keep your diabetes under control if you live with this condition; follow all of your doctor’s health recommendations, take any prescribed medications, monitor your blood sugar every day, and keep your blood sugar within the optimal range.
If you have mild gum disease (gingivitis), you may be able to treat it at home by focusing on the lifestyle habits listed above. If your condition has advanced to a more severe form of gum disease (periodontitis), you’ll need to control the condition with the help of an experienced periodontist.
The dentist will ask about your health history and other conditions. Then they may check your gums for inflammation, examine any pockets surrounding your teeth, and take X-rays. Depending on the severity of the condition, the dentist may recommend a course of treatment that includes scaling and root planing or surgical intervention.
Gum Disease and Heart Disease in Summary
We know that gum disease sufferers are at a two-to-three-times higher risk of heart disease. But if you’re still trying to make sense of the connection, remember the following:
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We don’t know the extent to which poor oral health directly causes heart problems
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We do know that gum disease can trigger inflammation, and chronic inflammation can lead to plaque accumulation in the arteries over time
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We also know that the bacteria associated with gum disease can travel through the bloodstream to the heart
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Gum disease and heart disease share similar lifestyle risk factors (like diet, smoking, etc), and this may also account for the correlation
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Because gum disease may be associated with heart disease and numerous other health conditions, everyone should be diligent about taking care of their gums and teeth
Regardless of whether there’s a causal link, one thing is for certain. We must all be diligent about maintaining proper oral care and heart-healthy living.
