Heart Disease and Oral Health

***UPDATED: August 29, 2016*** A recent report out of the Netherlands supports the growing mountain of evidence linking chronic gum disease with heart disease and stroke. An article from Medscape described the study which included more than 60,ooo dental patients, making it the largest of its kind to date. Researchers found that those with periodontitis were twice as likely to have had a heart attack, stroke or severe chest pain than those without. Even after scientists accounted for other risk factors for cardiovascular disease, like hypertension, high cholesterol, diabetes and smoking, those with periodontal disease were still 59% more likely to have a history of heart problems. “It’s clear that periodontitis is associated with chronic inflammation, so it makes sense biologically that if you have a heavy infection in your mouth, you also have a level of inflammation that will contribute to heart conditions,” said Panos Papapanou of Columbia University in New York. The research also suggested that gum disease develops first and could promote heart disease through chronic infection and bacteria in the circulatory system. Although the study doesn’t prove a causal relationship between gum disease and heart disease, Papapanou added, “Take care of your oral health for oral health itself. If you know there’s a positive association between oral health and other diseases, would you ignore it? I wouldn’t.”

A recent study confirms a close relationship between oral health and heart disease, concluding that patients being treated for heart issues who have also lost all of their natural teeth are almost twice as likely to die as those with all of their chompers. Scientists are still unclear about the specifics of the connection, but it is believed that inflammation plays a key role. According to a recent WebMD article, gum disease is the most common cause of tooth loss, which also causes inflammation that may play a role in the narrowing of arteries.

“While we can’t yet advise patients to look after their teeth to lower their cardiovascular risk, the positive effects of brushing and flossing are well established,” said the lead author of the study, Dr. Ola Vedin, a cardiologist at Uppsala University Hospital in Sweden. She added, “the potential for additional positive effects on cardiovascular health would be a bonus.”

The study involved the assessment for tooth loss, over a nearly 4 year period, of more than 15,000 heart disease patients in 39 countries. The study found that those with the fewest number of teeth were typically older, female, smokers, less active with more body fat, more likely to have diabetes and high blood pressure, and had a lower level of education. Over the course of the study, there were more than 1,500 major health events that took place, including cardiovascular death, heart attack, or stroke. The researchers considered a number of factors and were able to conclude that every increased level of tooth loss was associated with a 6% increased risk of major cardiovascular events, and a nearly 15% higher risk of cardiovascular death. When compared to patients with all of their teeth, those who were toothless had a 27% higher risk of major cardiovascular events. They also found that toothlessness was associated with an 85% higher risk of cardiovascular death, an 81% higher risk of death from any cause, and a 67% higher risk of stroke.

“The risk increase was gradual, with the highest risk in those with no remaining teeth,” Vedin stated.

It was noted that the study found a link between oral health and heart disease, but is not claiming to have established a cause-and-effect relationship.

“This was an observational study so we cannot conclude that gum disease directly causes adverse events in heart patients. But tooth loss could be an easy and inexpensive way to identify patients at higher risk who need more intense prevention efforts,” Vedin said.

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