Bad Teeth, Bad Heart?

By:
Karen Leckey

Reviewed By:
Andrew M. Sicklick, D.D.S.

You may know the lyrics to the healthy heart song: eat right, exercise, lose weight, quit smoking. Ever heard the verse that goes "brush and floss regularly?"

For years, researchers have been studying the connections between oral health and cardiac health. They've known that bacteria from the mouth can get into the bloodstream during dental procedures and cause serious heart infections in people with heart defects or artificial valves.  

More recently, multiple studies have shown connections between periodontal (gum) disease and heart disease. They include links between higher rates of periodontitis, tooth loss and other oral problems to increased risk factors for coronary artery disease, thickened carotid arteries and other types of cardiovascular disease. Despite the numerous connections and multiple studies, cause and effect relationships are harder to identify. Can gum disease give you a heart attack? Tough to say.

Research: What it says and what it means

The studies relating heart disease and gum disease are varied. Here are the conclusions found by three separate studies:

• The rate of heart disease increases with the number of teeth patients were missing.
  
  
• Intensive treatment of periodontal disease may reverse atherosclerosis, or hardening of the arteries.
  
  
• People exposed to certain bacteria associated with gum disease also have increased risk for cardiovascular disease.
  

In addition, many of these studies are retrospective studies. This means that researchers reviewed the data from other large, general health studies and then analyzed the rates of oral health and heart disease looking for connections. Identifying cause and effect in these cases can be a "chicken and egg" situation. Does gum disease give you heart disease? Or, does gum disease lead to less heart-healthy diet choices? For instance, loose teeth could lead you to avoid healthy, hard-to-chew food like fruits and vegetables and instead favor soft, high-fat, high-cholesterol foods like cakes and cheeses.

So, which causes clogged arteries: The bad teeth or the behaviors they may cause? There may be no absolute answers. The lesson to take from here is that one body system easily affects the others.

5 ways your teeth can help your heart

So how can you help yourself if the doctors can't even explain the connections? Start with the basics for good oral hygiene, including these five steps:

1. Brush your teeth twice a day, every day, more if your dentist tells you to. Use fluoride toothpaste. Change your toothbrush or brush head every three or four months.
   
   
2. Floss your teeth once a day to keep gums healthy and free of periodontal disease. You already may have gingivitis, a milder form of gum disease that includes bleeding or reddened gums. If gingivitis is left untreated, it can develop into the more severe periodontitis. If you brush and floss regularly and still have gum disease, ask your dentist for other options.
   
   
3. Make that appointment. Brushing and flossing should be supported with regular professional dental cleanings twice a year. Your dentist can clean your teeth better than you can and can tell when other conditions such as dry mouth affect your teeth. If needed, your dentist can bring in the big guns, like prescription mouthwash or scaling and root planing, a deep cleaning of the gums.
   
   
4. Quit smoking. Double or triple points for this one. Quitting smoking can help reduce your risk for heart disease, periodontal disease and oral cancers. If you smoke and have periodontal disease, it takes longer to heal after getting the disease treated.
   
   
5. Keep bacteria under control. Some of the recent studies have connected higher levels of bacteria or signs of bacterial exposure with heart disease. When you get a prescription for antibiotics, finish it. Don't stop the drugs when you feel better. People with some heart conditions or artificial valves may need antibiotics before dental cleanings and some other dental procedures to prevent infection. Guidelines for this type of antibiotic prophylaxis changed in 2007, so check with your dentist or physician if you are not sure if you still need antibiotics.
   

Heart disease has numerous risk factors, some of which (gender and family history) are not in your control. Your dental health is. Following these steps will definitely help your teeth and gums and may help your heart. But remember, being rigorous with dental hygiene doesn't give you a free pass to ignore your heart health. For that, eat well, exercise regularly, get your weight under control and get your cholesterol and blood pressure checked regularly.