The Relationship Between Oral Health and Heart Disease

***UPDATED: April 21, 2015*** Heart disease is the leading cause of death worldwide. And because oral infections are a key risk factor (and the most common diseases of humankind), scientists are always exploring this connection, attempting to better understand it. Recently, researchers summarized the latest evidence supporting the link in the journal, Trends in Endocrinology and Metabolism, which was later detailed in a Science Daily article. According to Thomas Van Dyke, senior author of the review, “Give the high prevalence of oral infections, any risk they contribute to future cardiovascular disease is important to public health.” Inflammation is key commonality between oral infections, like periodontitis,and cardiovascular disease. But taking a simple over-the-counter anti-inflammatory drug (ie, ibuprofen) isn’t a viable treatment as it can produce significant cardiovascular side effects. It has been found that high doses of atorvastatin, a cholesterol-lowering medication, can prevent both periodontal and cardiovascular inflammation and actually reverses the existing disease.  Van Dyke admitted that further research is needed to further understand the relationship and explore possible treatment plans. In the mean time, he recommends that everyone take better care of their teeth to potentially lower their risk of developing cardiovascular disease and other health problems.

***UPDATED: December 3, 2013*** Oral health experts are calling for additional public health policies targeting the consumption of junk food after a clear connection between oral health and heart health has been established.  According to a recent Science Daily article, authors writing of the need for more public awareness state that poor oral hygiene and excess sugar consumption often leads to periodontal disease, destroying the supporting bone around teeth.  Because chronic gum disease has been found to trigger an inflammatory response (atherosclerosis), which often leads to heart disease, they believe that the sugar found in most junk foods and consumed in mass quantities through soda, should be significantly limited.  The authors also referred to the infamous NYC soda ban controversy, claiming the issue is responsible for bringing public awareness of the dangers of sugar consumption to a new level.  Still, experts agree that more needs to be done to reduce sugar consumption in order to prevent future heart-related health problems.

It has been acknowledged and greatly accepted that poor oral health is related to several chronic health conditions, such as dementia, diabetes, and heart disease.  While several studies have shown a definite correlation between the two aspects of health, it has proven very difficult to determine how exactly they are related.  Does poor oral health lead to one of these often fatal diseases or vice versa? Does brushing your teeth really reduce your risk of developing a health condition? Scientists are one step closer to answering these questions and more after researchers at Columbia University in New York conclude that improving dental care actually does slow down the speed in which plaque builds up in arteries, therefore reducing the risk of heart disease.

A recent Medical News Today article described the study which was published online in an issue of the Journal of the American Heart Association.  Researchers followed 420 adults between the ages of 60 and 76 located in northern Manhattan who were participating in the Oral Infections and Vascular Disease Epidemiology Study (INVEST). Individuals took part in oral infection and artery thickness exams both at the beginning and end of the study, a span of about 3 years.  Samples of oral plaque were analyzed for the presence of 11 strains of bacteria known to play a role in the development of periodontal disease and seven control bacteria.  Fluids from around the gums were also examined for levels of Interleukin, a marker of inflammation.  Atherosclerosis, the process where plaque builds up in arteries, putting a person at risk of heart disease, stroke, and death, was measured using high-resolution ultrasound scans in both carotid arteries.  The results showed that the progression of atherosclerosis slowed significantly with improved gum health and a reduction in the proportion of bacteria linked to periodontal disease.  Furthermore, after adjusting results for factors that could influence them, like body mass index, diabetes, smoking, or cholesterol levels, few changes were observed in the results.

Lead author and associate professor of Epidemiology at Columbia’s Mailman School of Health, Moïse Desvarieux, believes the study is the “most direct evidence yet that modifying the periodontal bacterial profile could play a role in preventing or slowing both diseases.” Similarly, co-author, Panos N Papapanou, professor at Columbia’s College of Dental Medicine said that “results show a clear relationship between what is happening in the mouth and thickening of the carotid artery, even before the onset of full-fledged periodontal disease.  This suggests that incipient periodontal disease should not be ignored.” As scientists continue to work towards fully understanding the relationship between oral health and overall wellness, one thing is known as certain.  The connection is very real, and ignoring oral health issues does, in fact, contribute to a number of chronic, sometimes fatal, health conditions.

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