The Link between Dental Disease and Heart Disease

See your dentist to prevent a heart attack?

Recently, the research journals and popular press have been pointing to a connection between our oral health and hygiene and our cardiovascular risk.  Although there are several mediators, one stands out: periodontal or gum disease.    The Journal of Periodontology reported that inflammatory effects from periodontal disease, a chronic bacterial infection of the gums, cause oral bacterial byproducts to enter the bloodstream and trigger the liver to produce substances that increase the risk of heart disease.  This is even true in patients who are edentulous (without teeth).  Did you know that ill-fitting dentures can create infection and inflammation throughout the mouth that can trigger a systemic effect?

This inflammation is measurable! A substance produced in the body called high-sensitivity C-reactive-protein (HS-CRP) is suspected to play a role in the link between gum disease and heart disease.  This test is widely available from traditional labs.  Sometimes, CRP is measured in lieu of HS-CRP.  The difference?  CRP indicates general inflammation while HS-CRP indicates arterial inflammation and increased risk for blood clots.  Some studies estimate the HS-CRP is related to dental health over 50% of the time! For optimal health, your level should be less than 1. Initially thought to be specific to heart disease, it turns out HS-CRP is nonspecific marker of inflammation. Inflammation is bad.  Data from many studies have shown that long-standing, low levels of inflammation are at the root of most chronic diseases.  Think of it this way:  HS-CRP is the smoke…and it should put your physician on a search for the fire!

Unfortunately, many adults become lax with their oral health as they age.   Frequently, it is because there are no symptoms.  We need to think of our mouth as a car, needing frequent oil changes (dental cleanings) and scheduled maintenance (dental exams).

How do you know if you have periodontal disease?  The simplest way is to identify periodontal pockets using a periodontal probe.  Your dentist and hygienist use such a probe as part of their initial examination as well as your dental cleaning visit.  The distance that the probe goes below the gum line is a measure of periodontal damage.  A normal measurement is 3 mm. or less.  If you have pockets of 5 or more millimeters, these should be evaluated at every cleaning visit.  They will usually improve. If they don’t improve, a referral to a periodontist should be considered.

While your physician and dentist are searching for the cause, proper Omega 3 supplementation and the dietary intake of healthy fats and oils has been shown to reduce HS-CRP.   In addition, a low inflammatory diet, weight loss, exercise and other positive lifestyle changes have an impact on both HS-CRP (inflammation) and other risk factors for chronic disease.  If periodontal health is excellent, there are many other causes of elevated HS-CRP which should be investigated.  These include vasculitis, cancer, bone infections, inflammatory bowel disease, diabetes and autoimmune diseases as well as others.

Remember, we are chasing smoke.  Only by finding the fire and addressing it, can overall health be improved.

Dr. Rebecca Hunton

Dr. Lee Sheldon

Rebecca Hunton, MD has an Integrative medical practice in Viera.  She  is an expert on the successful application of lifestyle medicine to achieve optimal health and wellness. Dr. Hunton is a preferred provider to members of the NFL Players Association, a member of TEDActive and most notably, her patients have been featured on the Dr. Oz  show to demonstrate successful aging with vitality . Her website is drhunton.com

Dr. Lee Sheldon has a dental implant and periodontal practice in Melbourne. He is a featured guest on “Focus on Seniors” on WMEL radio. He also serves as vice president of the advocacy group, Helping Seniors of Brevard County. He is the author of the book, “The Ultimate Mouth Manual,” available at all book stores (also downloadable for free here)

“The material in this article is meant for overall information only. The author and publisher assumes no responsibility for the correct or incorrect use of this material, and no attempt should be made to use any of this information without the approval and guidance of your doctor.”