Dental

The Link Between Dental Health and Heart Disease: Truth?


Amid the COVID-19 pandemic that continues to burn through the U.S., dental health may rank low on your list of things to worry about. Still, there are interesting studies on oral health’s role in disease prevention. At first blush, avoiding gum disease has more impact than mitigating the ick factor of inhaling one’s own trapped breath while wearing a face covering. But is there a link between dental health and heart disease?

Consider heart health, whose importance to quality of life will remain long after COVID-19 has been reduced from public health emergency to an intense lessons-learned bad memory. I’ve read several articles declaring that gum disease is associated with an increased risk of developing heart disease. Yet, as a former journalist I’m skeptical of practically everything I read. So I dug deeper.

I located a study that focused on dental hygiene practices, whose researchers looked for a correlation between inadequate toothbrushing and cardiovascular disease.1 They wanted to know if poor brushing habits were associated with a risk of having a heart attack, heart failure or stroke. The study’s data seemed to put some teeth into the theory that oral health is a factor in cardiovascular health. Study participants who reported brushing less than twice a day (and for fewer than two minutes each session) had a three-fold increased risk of a heart attack or stroke compared to those who brushed at least two minutes twice a day.

Yikes, I thought.

Harvard Medical School also presented these theories2:

  • The bacteria that causes gum inflammation (also known as gingivitis) and severe periodontis can travel to blood vessels elsewhere in the body, triggering inflammation and damage, which may lead to blood clots, heart attack or stroke.
  • It’s the body’s actual immune response to the bacteria (inflammation) that can cause vascular damage elsewhere in the body, including in the heart and brain.

In another study, the gum disease known as periodontis was cited as one of many conditions that can cause ongoing inflammation in the body. In a report published in the AHA journal Hypertension, scientists said gum disease appeared to increase blood pressure and interfere with medications to treat it.3 While the researchers reported no direct connection between gum disease and cardiovascular disease, they postulated that the conditions may occur together if a third risk factor (such as smoking) is also present.

DENTAL HEALTH & HEART DISEASE
Poor dental health has been debated as a possible cause of heart disease for years.4

According to the Mayo Clinic, the American Heart Association reviewed available scientific evidence and concluded that poor oral health has not yet been proven to cause heart disease.

On the Mayo Clinic  website, Thomas J. Salinas, D.D.S. writes, “Taking care of your teeth isn’t a proven way to prevent heart disease. While there appears to be some connection between oral health and heart disease, more research is needed to understand it.”

The Cleveland Clinic website sticks another pin in it: “There is research to both support and refute the possible link between periodontal disease and cardiovascular disease, and more studies are needed to see how the two may be linked.”5

So what now?

Even though the link between oral health and heart health appears less than definitive, it’s still important to take care of teeth, gums…and yes, the cardiovascular system.

Regarding oral health, the Centers for Disease Control and Prevention (CDC) says:6
The three oral conditions that most affect overall health and quality of life are cavities, severe gum disease and severe tooth loss.

By age 8, 52% of kids have had a cavity in their baby teeth.

Low-income children are twice as likely to have cavities as higher-income children.

One in four adults aged 20 to 64 currently have cavities.

The CDC recommends:

  • Brushing twice a day, preferably with a fluoride toothpaste
  • Cleaning between teeth daily with floss or interdental cleaner
  • Eating nutritious and balanced meals and limit snacking
  • Visiting the dentist regularly for professional cleanings and oral examination
  • Checking with a dentist about using supplemental fluoride
  • Checking with a dentist about dental sealants, a plastic protective coating that’s applied to the chewing surfaces of the back teeth to protect them from decay

Is it safe to get dental care during the pandemic?

The CDC provided safety protocols for dental practices7.  WebMD posted this useful article, , that discusses dental office safety during the pandemic. The article advises readers to call the dentist with questions about oral care and whether it’s appropriate to come in for an appointment or wait until later. If you have a urgent dental emergency, such as a broken tooth, serious pain, bleeding, swelling, etc., contact your dentist. In the meantime, keep brushing!

As for heart disease, what are the known risks?

Several health conditions, as well as lifestyle, age and family history can increase the risk for heart disease. While you can’t change your blood relatives or your age (unless you’re like me and you lie about it), 47% of Americans have at least one of three key risk factors for heart disease that can be controlled: high blood pressure, high cholesterol and smoking.8 Additionally, stroke and heart attack are threatening younger adults.

If you have risk factors and are concerned about heart disease, ask your doctor about proven ways to reduce the threats to your health, such as stopping smoking, exercising regularly and maintaining a healthy weight. Check out my article on disease prevention, 10 Ways to Take Charge of Your Health.

Bottom line: while the link between dental health and heart disease is not completely clear, experts say it’s important to take care of both.

1American Heart Association, “Bad Toothbrushing Habits Tied to Higher Heart Risk”
2Harvard Health Publishing, “Gum Disease and the Connection to Heart Disease”
3Hypertension, “Poor Oral Health and Blood Pressure Control Among U.S. Hypertensive Adults”
4Mayo Clinic, “Will Taking Care of My Teeth Help Prevent Heart Disease?”
5Cleveland Clinic, “Is there a link between periodontal disease and cardiovascular disease?”
6CDC, “Oral Health Fast Facts”
7CDC, “Guidance for Dental Settings”
8CDC, “What Health Conditions Increase the Risk of Heart Disease?”
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