How Periodontitis Can Damage Your Heart
Periodontitis is a serious infection of the gum tissue, but what you might not know is that periodontitis and heart health are linked. The infection gradually breaks down the gum tissue that supports your teeth, as well as the bone that anchors your teeth. Periodontitis can range from gingivitis, which primarily affects the gum tissue, to severe periodontitis, which affects both gums and bones.
Bone loss from periodontitis can be seen on X-rays. Many people have periodontitis, especially those over 75. As the disease advances, your gums may swell and become bright red or purplish and tender, bleed easily, and start to pull back from your teeth.
Your mouth is your first line of defense against many germs that can harm you. When mouth tissue becomes diseased, the bacteria in the mouth can invade your body and cause further infection, including in your heart tissue and valves. Gum infection may also raise inflammation throughout your body. As the infection advances inside the mouth, you may notice a bad taste or difficult-to-treat bad breath.
The biggest risk factor for periodontitis is poor oral hygiene. This means not doing one or more of the following: brushing your teeth twice daily, flossing daily, and getting regular dental checkups.
Other risk factors for periodontitis are not so obvious but important to consider, including:
- Poor nutrition
- Clenching or grinding your teeth
- Certain prescription drugs
- Stress and how you respond to stress
- Smoking
- Hormonal changes with pregnancy or menopause
- Genetics (unfortunately gum disease can run in families)
Complications of Periodontitis for Your Heart
As a cardiologist, I unfortunately see one of the most severe complications of periodontitis as it relates to the heart: endocarditis. It’s often caused by a bacterial infection that invades the heart valves and causes them to break down. Most people with endocarditis need heart surgery to remove the infected valve and any diseased tissue around the valve. Because the heart pumps blood throughout the body, a heart valve infection can spread to all organs and cause catastrophic problems like stroke, heart attack, and kidney and bowel injury.
Fortunately, although periodontitis is common, endocarditis is rare. Other forms of heart disease are much more common, including heart attacks, coronary artery disease, and heart failure. Since periodontitis raises inflammation, it can injure blood vessels and make cholesterol plaques unstable. It may also raise the risks of coronary artery disease and heart attacks.
The possible links between periodontitis and risk for coronary artery disease and heart attack were the focus of a study published in January 2016 in Circulation. The study was dubbed PAROKRANK — periodontitis and its relation to coronary artery disease — and included 1,610 patients. Their oral health was divided into three categories based on dental examinations and X-rays: healthy, mild-moderate periodontitis, and severe periodontitis. People with periodontitis were more likely to be smokers, have high cholesterol, and have family members with heart disease. On average, people who had periodontitis had one less tooth compared to those without the condition.
When the authors compared the groups, they found a 49 percent increased risk of heart attack in those with severe periodontitis. Even when the authors accounted for known heart disease risk factors (smoking, abnormal cholesterol, high blood pressure, diabetes, and obesity), there was still a 28 percent increased risk of heart attack linked to periodontitis.
Treating Periodontitis and Heart Health
We don’t know yet if treating periodontitis will reduce your risk for heart attack. But a number of studies suggest that treatment does lower heart disease risk factors overall.
Treating periodontitis can:
- Lower the amount of inflammationin your body, which is measured by a blood test called C-reactive protein (CRP)
- Raise high-density lipoprotein (HDL), your good cholesterol levels
- Lower low-density lipoprotein (LDL) cholesterol, the “bad” cholesterol that leads to coronary artery plaque buildup and instability
- Improve your small blood vessel health, which is vital to keeping organs like the heart, brain, kidneys, and pancreas healthy
The first step in gingivitis or periodontitis prevention and treatment is to brush your teeth twice a day and to floss daily. And be sure to visit your dentist regularly and set up follow-up visits as needed. Scraping off tarter and plaque helps the gums heal and stay close to the bone, providing a valuable defense for your body.
