The connection between oral hygiene and heart problems

Oral hygiene is a vital aspect of overall health, often emphasized for its role in preventing cavities, gum disease, and bad breath. However, emerging research has highlighted a fascinating and potentially life-saving link between oral hygiene and heart health. This connection suggests that the health of your mouth may have a significant impact on the health of your heart. In particular, poor oral hygiene and untreated gum disease have been found to contribute to an increased risk of cardiovascular problems.

It is estimated that nearly half of all American adults older than 30 have gum disease - in almost 8% this is severe periodontal disease. It is important to note that the older you are, the higher the risk of gum disease. Almost 60% of American adults who are 65 or older have some form of gum disease. Furthermore, men are at higher risk of periodontal disease than women (risk for men: 50%, risk for women: 35%).

This article delves into the relationship between oral hygiene and heart health, exploring the mechanisms behind this connection, the evidence supporting it, and ways to maintain both a healthy mouth and a healthy heart.

The role of oral hygiene in preventing gum disease

The first step in understanding the connection between oral hygiene and heart problems is recognizing the importance of gum health. Gum disease, also known as periodontal disease, begins with the accumulation of plaque - a sticky film of microorganisms - on the teeth. If not removed through regular brushing and flossing, plaque can irritate the gums, causing gingivitis, the earliest stage of gum disease. Gingivitis is characterised by red, swollen, and bleeding gums, but it is usually reversible with correct oral care.

If gingivitis is left untreated, it can progress to a more severe form of gum disease known as periodontitis. Periodontitis is characterised by more intensive inflammation and infection that can lead to the destruction of the bone and tissue that support the teeth. This condition not only compromises oral health but can also contribute to systemic health problems, including heart disease.

Mechanisms linking oral health to heart disease

1. Inflammation and its role in both conditions

One of the key factors linking oral health and heart disease is inflammation. Chronic inflammation plays a central role in both periodontal disease and cardiovascular disease. When the gums become infected and inflamed due to the presence of harmful bacteria, this inflammation can spread throughout the body, contributing to atherosclerosis - a condition in which plaque builds up in the arteries, narrowing them and increasing the risk of heart attack and stroke.

In periodontal disease, bacteria from the infected gums can enter the bloodstream, triggering an inflammatory response in the body. This response may cause the blood vessels to become inflamed and more prone to damage, which is a major contributor to heart disease. Research has shown that people with gum disease tend to have higher levels of C-reactive protein (CRP), a marker of inflammation that is also linked to an increased risk of heart disease.

1. Bacterial translocation and its impact on the heart

Another way oral health impacts heart health is through bacterial translocation. The mouth is home to millions of bacteria, many of which are harmless when kept in check with appropriate oral hygiene. However, when gum disease occurs, harmful bacteria can enter the bloodstream through the inflamed gums. Once in the bloodstream, these bacteria can travel to other parts of the body, including the heart.

Certain species of bacteria, such as Porphyromonas gingivalis, have been identified in the arterial plaques of people with heart disease. These bacteria may contribute to the development of atherosclerosis by triggering the formation of blood clots and promoting the growth of arterial plaque. Over time, the presence of these bacteria in the bloodstream can exacerbate the process of plaque buildup in the arteries, leading to a higher risk of heart attack, stroke, and other cardiovascular complications. Whilst this article is focused on the link between oral hygiene and heart disease, it is important to note that there may also be a link between P. gingivalis and rheumatoid arthritis, the risk of suffering a stroke, diabetes, problems during pregnancy and many other health issues.

1. The impact of oral health on blood vessels

In addition to inflammation and bacterial translocation, poor oral hygiene can also directly affect blood vessels. Studies have shown that individuals with gum disease may have impaired endothelial function. The endothelium is a layer of cells lining the blood vessels, and its proper function is essential for maintaining healthy blood flow and preventing the formation of blood clots. When the endothelium is damaged due to inflammation or the presence of bacteria, the risk of heart disease increases significantly.

1. Shared risk factors between gum disease and heart disease

There are several shared risk factors between gum disease and heart disease, including smoking, diabetes, and poor diet. Smoking is a well-known risk factor for both cardiovascular disease and gum disease, as it impairs blood flow to the gums and promotes inflammation. Similarly, people with diabetes are at an increased risk of both heart disease and periodontal disease due to the effects of high blood sugar on the body's ability to fight infection and heal. Additionally, a diet high in sugar and processed foods can contribute to the development of both gum disease and heart disease, as it promotes inflammation and plaque buildup.

Evidence supporting the connection between oral hygiene and heart disease

Numerous studies exploring the relationship between oral hygiene and heart health have found that individuals with severe gum disease are nearly twice as likely to develop heart disease as those with healthy gums. A recent study conducted by researchers at the Harvard School of Public Health concluded that periodontal disease was associated with an increased risk of coronary artery disease.

In addition to these studies, a review published in the American Journal of Preventive Medicine found a clear correlation between tooth loss and risk of heart disease.

While the evidence is compelling, it is important to note that a definitive cause-and-effect relationship between oral hygiene and heart disease has not yet been established. Many of the studies on this topic are observational, meaning that they can show an association but cannot yet prove that poor oral hygiene directly causes heart disease. However, the body of evidence supporting the connection continues to grow, and many health professionals now believe that maintaining good oral hygiene is an important factor in reducing the risk of cardiovascular disease.

How to improve oral hygiene and protect heart health

In view of the probable link between oral hygiene and heart disease, it is crucial to maintain good oral health. Here are some tips to improve oral hygiene and protect both your mouth and your heart:

1. Brush your teeth regularly

Brushing your teeth at least twice a day is the foundation of good oral hygiene. Use a soft-bristled toothbrush and quality toothpaste to remove plaque and prevent the buildup of harmful bacteria. Make sure to brush for at least two minutes, paying attention to all surfaces of the teeth and gums.

1. Replace your toothbrush regularly

Advertisements tell us to “change the toothbrush at least every three months”. Three months is, however, a long time for an item with lots of little bristles that not only collect tiny pieces of food from our teeth, but also harbour germs and bacteria. Our toothbrushes sit around for hours in between use, and during this time, the bugs can multiply extensively. However, your body’s natural defences make it highly unlikely for you to catch an infection simply by brushing your teeth, as the human body is usually able to defend itself from such bacteria. It is nevertheless worth thinking about where your toothbrush resides when not in use. Right next to the lavatory is perhaps not the best of places, as every time you flush, a fine mist - containing bacteria - is released into the surrounding air.

1. Floss daily

Flossing helps remove plaque and food particles from between your teeth and along the gumline - areas that your toothbrush may miss. Daily flossing is essential for preventing gum disease and maintaining good oral health.

1. Visit your dentist regularly

Regular dental checkups are essential for detecting and treating gum disease early. Your dentist can monitor your oral health and provide professional cleanings to remove plaque and tartar buildup, which can contribute to gum disease.

1. Quit smoking

Smoking is a major risk factor for both gum disease and heart disease. If you smoke, quitting can significantly improve your oral and cardiovascular health. Your dentist and doctor can offer support and resources to help you quit.

1. Manage chronic conditions

Conditions such as diabetes and high blood pressure can increase your risk of both gum disease and heart disease. Managing these conditions with the help of your doctor can help reduce your risk of developing serious health problems.

1. Eat a heart-healthy diet

A diet rich in fruits, vegetables, whole grains, and lean proteins can promote both oral and cardiovascular health. Avoid sugary snacks and drinks, which can contribute to tooth decay and inflammation. By the way: Links to websites with information on heart-healthy living and eating can be found below in the “References” section.

1. Reduce stress

Chronic stress has been linked to both gum disease and heart disease. Finding ways to manage stress, such as through exercise, meditation, or deep breathing, can help improve both your oral and cardiovascular health.

Conclusion

The connection between oral hygiene and heart disease is a growing area of research that spotlights the importance of maintaining good oral health. Gum disease, chronic inflammation, and bacterial translocation can all contribute to an increased risk of heart disease and other severe health problems. Whilst more research is needed to establish a definitive cause-and-effect relationship, the evidence supporting the link between oral health and heart health is compelling. By practicing good oral hygiene, quitting smoking, managing chronic conditions, and following a heart-healthy lifestyle, you can reduce your risk of both gum disease and cardiovascular problems. The health of your mouth and the health of your heart are more closely connected than you might think, and taking care of one can help protect the other.

References:

Data and insights from MedlinePlus

Plaque and tooth decay

Periodontal disease and inflammation study

Immune response in periodontal disease

University research on gum disease

Diet and lifestyle guidelines