Heart Disease and Oral Health

A number of studies have shown that people with periodontitis are more likely to develop cardiovascular disease than individuals without periodontal infection. One such study suggests that the risk of fatal heart disease doubles for persons with severe periodontal disease.

Part of the link between these two diseases may be discovered through novel investigations of the opportunistic, infectious bacteria that colonize the mouth. Scientists theorize that certain types of these bacteria, which form biofilms and cause periodontal disease, also activate white blood cells in the body to release pro-inflammatory mediators that may contribute to heart disease and stroke.

To explore the underlying inflammatory responses common to both diseases, NIDCR grantees are examining periodontal disease measures (pocket depth where gingival tissues have pulled away from tooth surfaces and where there is loss of tissue) and biological responses in 14,000 people enrolled in an extensive study of heart disease sponsored by the National Heart, Lung and Blood Institute. Scientists will also analyze gingival crevicular fluid constituents that may contain pro-inflammatory mediators associated with heart disease, as well as blood samples to identify antibodies to periodontal pathogens.

The research team will compare these measures with clinical indicators of heart disease, ultrasound measures of carotid vessel thickening, and the occurrence of heart attacks, stroke, and death to determine if there is a correlation. Should the link between oral disease and heart disease be firmly established, future studies will focus on identifying the specific biological factors involved and transferring this knowledge to prevent disease.

You take pretty good care of your teeth, brushing and flossing daily. You don’t really have any major dental issues. Is it really necessary for you to schedule dental exams unless there’s a problem?

Oral health professionals point out that there are numerous reasons to keep those checkups on your calendar, even if you take good care of your teeth.

Preventive checkups provide dentists with opportunities to identify and intervene early in dental diseases. This can reduce any pain and the financial costs associated with more severe forms of dental diseases. For example, periodontal diseases that go unnoticed for lack of a checkup can progress into more serious stages possibly resulting in pain, tooth loss and other problems. If caught early, periodontal disease is easier to manage and, in some cases, reverse.

Dental professionals can use today’s dental exams to screen for oral cancers and other health issues that can be difficult to spot on your own. More than 120 diseases can cause specific signs and symptoms in and around the mouth and jaw1. Dental professionals performing checkups can spot symptoms that could indicate serious health problems elsewhere in the body that need attention.

Checkups allow your dentist to keep up with changes to your health status. Upon learning of medical conditions you’ve developed or treatments you’re receiving, your dentist can recommend strategies to help you proactively counter the negative effects the conditions and treatments would otherwise have on your oral health.

Dental health professionals can suggest the frequency that’s most appropriate for each patient. Some people don’t need to be seen twice each year, while some need to be seen more often. Consult with your dentist to determine the number of yearly visits that is right for you.

Are you among the millions who treat or manage a range of diseases with medications? If so, you should be aware of the side effects many medications can cause that negatively affect oral health.

• Xerostomia, known commonly as dry mouth, is listed as a side effect on more than 400 medications. Without adequate saliva flow, bacteria, plaque and the by-products they produce can accumulate in the mouth and make a person more vulnerable to gum disease and tooth decay.
• Gingival enlargement, a condition in which the gums become swollen and begin to grow over the teeth, is a side effect of some medications. Calcium channel blockers, sometimes used to control high blood pressure and other health issues, are just one category of medications that can cause overgrowth of gums. Eventually, this overgrowth of gum tissue can cause a severe periodontal infection. Monitoring and early intervention from dental and health professionals can reduce the likelihood of gingival enlargement in at-risk patients.
• Some oral contraceptives and blood pressure control medications have been linked to oral sores and inflammation.
• One of the agents used in tetracycline, a medication used for acne treatment, can discolor teeth and the underlying bone.
• A number of medications, ranging from certain antibiotics to ibuprofen, can produce lesions or ulcers in the mouth that often disappear after a patient stops taking the medication.
• Sugary medications, such as cough drops, liquid medications and antacid tablets can leave behind a sticky residue on teeth, making them more susceptible to decay. Sugar in medications can be particularly problematic for children on long-term therapies for chronic medical conditions. Unable to swallow pills, many children receive medications in liquid form, often sweetened to make them more palatable.
• Drugs affecting the central nervous system can negatively affect oral health. When patients experience side effects such as fatigue, lethargy and motor impairment, it becomes more difficult for them to take care of their own oral health. In fact, adults taking antidepressants and antihypertensive medications were found to have elevated levels of plaque and the clinical signs of gingivitis.

You should inform your dentist about any prescription or non-prescription drugs that you are using so they can monitor your oral health to ensure that any adverse effects are treated promptly.