Connecting the dots: your gums, your arteries, and your heart

Here is another lifestyle tip for 2009: To prevent heart disease, visit your dentist.

Now, you’d ask what does your dental hygiene have to do with your cardiovascular health? Well, it has something to do with two seeming different but apparently related health conditions: periodontal or gum disease and atherosclerosis.

Periodontal or gum diseases, also known as periodontitis range from “simple gum inflammation [gingivitis] to serious disease that results in major damage to the soft tissue and bone that support the teeth. In the worst cases, teeth are lost.”

Atherosclerosis is defined as “the progressive narrowing and hardening of the arteries over time.” When this happens to the coronary arteries supplying the heart, it leads to coronary artery disease (CAD). CAD causes angina (chest pains) and heart attacks when blood clots form in the narrowed arteries, thereby blocking blood supply to the heart. CAD can also weaken the heart muscles and can cause abnormal hearth rhythms (arrhythmias) and heart failure.

Atherosclerosis can also lead to blockage of arteries supplying the brain, causing stroke.

So where is the link?

The link is in the systematic inflammation that is characteristic of the two diseases. In particular, the bacteria Porphyromonas gingivalis that cause gum lesions are also associated with the development of atherosclerotic plaques.

A recent study by Italian researchers showed that a simple dental workup could lead to lower risk for atherosclerosis, and thus cardiovascular diseases. The researchers enrolled 35 healthy adults with mild to moderate periodontal disease. They underwent periodontal treatment which involved “removal of tartar and cleaning the gums, and that’s it-no surgery and no antibiotics-just your basic dental hygiene.” The intima media thickness (IMT) of the carotid artery was regularly checked as well as inflammation biomarkers for cardiovascular risk. The results of the study can be summarized as:

• Periodontal treatment resulted in a significant decrease in the total oral bacterial load.
• The treatment also led to decreased levels of inflammation biomarkers as well as adhesion and activation proteins.
• The carotid IMT was significantly reduced starting 6 months after periodontal treatment and persisted even up to 12 months or longer.

This is the first study to demonstrate that dental hygiene can actually prevent, even reverse atherosclerosis. However, a more comprehensive study involving more participants is on the way to confirm the results.

The authors give us the following take-home message:

“By taking good care of your teeth and gums, you can not only prevent the development of atherosclerosis, you can also reduce your risk of developing cardiovascular disease.”

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