Taking better care of your gums could do your heart good

Doctor listening to a patient's heart

Healthy teeth and gums can give you a great smile. Now, scientists are finding they can give you a great reason to smile, too. There's growing evidence that having a healthy mouth can help you have a healthier heart.

To understand the likely link between heart and gums, it helps to understand periodontal disease.

Periodontal disease is an infection of the gums. It is caused by a buildup of plaque on the teeth. Plaque is the film that forms on teeth when bacteria, or germs, grow on them. Regular brushing and flossing help remove the germs and film. But after plaque hardens, it takes a dental professional to remove it.

The Food and Drug Administration says about 75% of Americans older than 35 have periodontal disease. Many of us have had a mild form that causes gums to redden and swell. But that can turn into a more serious form.

The Johns Hopkins Health Alert, Healthy Teeth, Healthy Heart?, explains how that happens. When plaque builds up, the germs that live in it release toxins. These toxins cause the body's immune system to react. It sends white blood cells to fight the infection. The toxins and the substances released by the white blood cells cause problems. They break down the tissue and bones that hold teeth in place, resulting in tooth loss.

What is the connection between the heart and gums?

The germs and the toxins they make may hurt more than your teeth. They are believed to have a damaging effect on your heart and arteries as well. In fact, people with gum disease are almost twice as likely to have heart disease. The American Academy of Periodontology, or AAP, explains the possible link.

One theory is that germs from the mouth affect the heart when they enter the bloodstream. They may lead to clots in the heart's blood vessels. These clots can block blood flow and lead to a heart attack.

Another theory is that the inflammation caused by periodontal disease contributes to swelling of the arteries. This limits the path through which blood can flow. And, it makes it easier for a clot to block these already narrowed pathways.

Other studies point to a connection between periodontal disease and stroke. Many strokes are caused by a blockage of blood flow to the brain. The same germs that lead to blood clots in heart arteries might affect those in the brain.

A new study builds an even stronger case for the link

A study presented at the American Heart Association's Scientific Sessions 2011 found more evidence of a connection. It also underlined the importance of professional cleanings. More than 100,000 people in Taiwan took part in the study for seven years. Those who had professional tooth cleanings had a lower risk of heart attack and stroke. Heart attack risk was 24% lower. Stroke risk was 13% lower. That's compared to those who never had a dental cleaning. Hsin-Bang Leu, M.D., was a co-author of the study. She said professional cleanings appear to reduce the growth of germs that can lead to heart disease or stroke.

Who is at greatest risk of periodontal disease?

Anyone can get it. And many of us have had a mild form. But those at greatest risk are:

  • Smokers
  • People who chew tobacco
  • People with diabetes, osteoporosis, or autoimmune diseases. An autoimmune disease limits the body's ability to fight infections.
  • People with a family history of periodontal disease
  • You can also get the disease from someone else who has it. The germs can be spread from toothbrush to toothbrush. It is a good idea to replace yours at least every three months.

Signs of periodontal disease

Here are the warning signs to watch for:

  • Sore and receding gums that bleed easily
  • Lingering bad breath
  • A change in the way your teeth fit together
  • Loose or crooked teeth. You can, however, have periodontal disease without having tooth loss.

How to treat it

Mild periodontal disease can be treated with good dental hygiene. Germ-killing gels rubbed into the gums can be helpful, too. More serious cases may need additional care. Pulling teeth from the infected areas and getting professional cleanings can help. They can reduce the germs that end up in the bloodstream.

How to prevent it

Prevention is the best medicine. The American Dental Association, or ADA, recommends taking these basic steps:

  • Brush your teeth at least twice a day
  • Floss your teeth once daily
  • See your dentist at least twice a year for regular cleanings and oral exams

More study is needed to confirm the link between your gums and your heart. But the evidence is very strong. Good dental care may be one easy way to help lower your risk of heart attack and stroke.

The bottom line is this: Following the ADA's guidelines for preventing gum disease might also be a very heart-healthy strategy.

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