As the old song goes, the toe bone’s connected to the foot bone, the foot bone’s connected to the heel bone… But did you know that the heart is connected to the gums and jawbone? As the Harvard Health Letter recently explained, new research strengthens the association between dental and cardiovascular health.
The American Journal of Preventive Medicine examined health and dental insurance records from nearly 339,000 people with two distinct disorders – periodontal disease, which includes a range of mouth problems from simple gum inflammation to serious soft tissue and jawbone damage – and one of these five conditions:
- type 2 diabetes;
- cardiovascular disease;
- cerebrovascular disease (usually a stroke);
- rheumatoid arthritis; or
People with gum disease, according to the Harvard report, are almost twice as likely to have heart disease as those without it.
A study published this month in the Journal of Dental Research reinforces the Harvard information. A group of Spanish scientists showed that chronic periodontitis is closely associated to the severity of acute myocardial infarction (heart attack).
They looked at the levels of troponin I, a protein that affects heart muscle contractions, and myoglobin, a protein that carries oxygen, for 112 heart attack patients. The proteins indicate, or are biomarkers of, how much heart muscle has deteriorated from a heart attack. The patients also underwent periodontal tests.
As noted on ScienceDaily.com, the study was small and must be confirmed through additional research. But one of the study’s authors said that the results do indicate that “chronic periodontitis appears as a death risk factor and it plays an important role in the prognosis of acute myocardial infarction,” and that if subsequent research supports their study, “[C]hronic periodontitis should be considered as a predictor in the development of myocardial infarction, and be therefore included in the risk stratification scores.” Those scores are factors by which a doctor assess a patient’s chances of developing a problem.
As you’ve probably heard from your dentist, periodontal disease starts when plaque, a sticky film loaded with bacteria, builds up around your teeth. The gums pull away from the root of the tooth, leaving pockets that gradually enlarge. Infection and inflammation, which is how the body responds to infection or injury, attack tissue that holds teeth to the jawbone, and they can fall out.
If you have periodontal disease, chewing and brushing your teeth can release bacteria into your bloodstream. Several types of bacteria that cause gum disease have been found in the cholesterol-laden plaque that clogs arteries in people with heart disease.
The reasons why periodontal disease patients are more likely to have a heart condition aren’t entirely clear. People without access to good dental care also might not have the resources to protect against heart disease. Some experts suspect that inflammation, which is common to both conditions, is a factor.
The new study suggests that if you have cardiovascular disease, treating gum disease could reduce your hospital visits, and lower your health-care costs.
Except for the subjects with rheumatoid arthritis, the Harvard story summarizes, all the research participants who had at least one periodontal disease treatment had lower medical costs and fewer hospitalizations within four years of the treatment compared with people who weren’t treated. Patients with cerebrovascular or cardiovascular disease had lower health-care costs of as much as 40%.
“This is a really solid finding and a testimony to what we’ve been preaching for years,” Dr. Alpdogan Kantarci, a periodontist with the Harvard-affiliated Forsyth Institute, told the Health Letter. He explained that treating gum disease reduces the body’s burden of infection and inflammation, and that appears to help people respond better to treatments for other health conditions, like heart disease.
The take-home message here is to see your dentist regularly – your mouth is the doorway to other body systems.
Specifically, the Health Letter recommends:
- Brush and floss your teeth daily.
Most people have at least mild gingivitis, the earliest form of gum disease. But if you brush and floss daily, you can head it off, and sometimes reverse it.
- Have twice-yearly cleanings by a dentist or hygienist.
Some people need these appointments more frequently – if you have an aggressive response to bacteria and develop plaque more easily, you should have at least three or four cleanings a year. If you don’t pay attention to gingivitis, you’re likely to develop periodontal disease.
Dentists and hygienists clean teeth by scaling and root planing (deep cleaning) – that’s the use of all those sharp tools you see on the dental tray next to the chair where you sit with your mouth wide open. They also might use ultrasound devices to scrape away hardened plaque (tartar).
Scaling cleans teeth above and below the gum line. You might be given a numbing agent for your gums, or a shot of Novocain as a local anesthetic. Before treatment, make sure your dentist or hygienist knows what medications you take. Some might increase your risk of bleeding, such as warfarin, aspirin, or clopidogrel (Plavix).