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Gum Disease and Oral Hygiene May Be Connected to Heart Disease and Stroke

Risks Associated With Gum Disease, Cardiovascular Disease, and Stroke

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Updated January 23, 2011

Gum Disease and Oral Hygiene May Be Connected to Heart Disease and Stroke
Photo © A.D.A.M.
Gum disease exists in about 75% of Americans, and many do not realize that risk factors associated with serious health concerns such as heart disease and stroke have been associated with gum disease.

Heart Disease

There are various types of heart disease, all with various risk factors.

Researchers have found that people with gum disease are almost twice as likely to suffer from coronary artery disease. This type of heart disease occurs when plaques (deposits of fat, cholesterol, calcium and other material) form in the walls of the coronary arteries, causing the walls to become thicker. That essentially makes it harder for the blood to flow through, limiting the amount of oxygen and nutrients that are necessary for proper heart function.

One theory suggests that bacteria from gum disease enters the bloodstream and connect to the plaques in the coronary arteries, possibly contributing to the formation of blood clots. How does bacteria in the mouth enter the bloodstream? One of the first signs of gum disease most people notice is bleeding gums, especially when brushing and flossing. When the gum tissue has been compromised, the bacteria is able to enter the blood directly in the mouth. Gum disease also causes the inflammation of the gum tissue, another noticeable sign of an oral infection. Theories linking gum disease and heart disease to one another note a possible connection between the inflammation of the gums and the increased production of arterial plaque. The swelling of the arteries may be related to this type of inflammatory response.

Identifying the Cause

Researchers have identified two oral pathogens associated with gum disease, known as Tannerella Forsynthesis and Preventella Intermedia, that may be associated with an increased risk of having a heart attack. Although these pathogens have been identified, the findings of this study suggest the total count of bacteria -- regardless of its type -- has a greater impact on the health of the heart. And that's another reason to prevent gum disease and the amount of bacteria in the mouth.

Existing Heart Disease

Patients with existing heart ailments need to prepare for dental appointments unlike the average person. Bacterial endocarditis is a dangerous infection that involves the lining of the heart and is commonly caused when bacteria enters the blood during medical procedures. During dental treatment, a common organism found in the mouth known as Streptococcus Viridan may enter the bloodstream and travel to the heart. This may cause infected blood clot formations that are able to travel to the brain, lungs, kidney, and spleen. Dangerous medical conditions that may result from bacterial endocarditis include:
  • Blood clots in the brain, kidneys, lungs, or abdomen
  • Stroke
  • Damage to the heart, specifically valve damage
  • Irregular heart beats and arterial fibrillation

Fifty percent of bacterial endocarditis cases are caused by Streptococcus Viridans.
Prophylactic antibiotics, also known as pre-medications, are prescribed to prevent bacterial endocarditis for people with:

  • Artificial heart valves, palliative shunts and conduits, or prosthetic material and devices used to repair congenital heart defects
  • Congenital heart defects present from birth
  • Previous history of infected endocarditis
  • Cardiac transplant that develops a problem in the heart valve
It is critical that any current or previous heart ailments are reported to your dentist prior to any dental treatment. If your dentist feels you are in need of pre-medication, a prescription will be given to you prior to the appointment with strict instructions for its use.

The Key to Successful Transplant

Medications synonymous with transplant surgery, known as immunosuppressants, may cause xerostomia, an oral condition that causes a reduction in the the flow of saliva, thus creating a dry environment in the mouth. This is a concern for heart transplant patients because a dry mouth is the perfect breeding ground for oral infection. According researchers, organ failure and transplant complications are associated frequently with an active viral infection possibly similar to those found breeding in the mouth. Aside from medication, poor oral hygiene resulting in the accumulation of plaque may also cause oral infections, again, increasing the risk of rejection or serious complication.

When a child requires a transplant, different complications arise, due to oral infection. Systemic problems may affect tooth development, resulting in compromised enamel, likely affecting the formation of the teeth. Similar to adults, the medications necessary to help prevent the rejection of an organ, create the same dry environment in a child's mouth and the same oral infection. Gum disease, oral thrush, herpes and various aggressive types of bacteria were all listed as possible infections with gum disease noted as quite severe in children with compromised immune systems.

Stroke

A stroke is classified as an interruption of blood flow to the brain. In the United States alone, someone suffers a stroke every 40 seconds.

Researchers have found that those diagnosed with acute cerebrovascular ischemia were more than likely to have an oral infection, compared to the other participants in the study.

Prevention and Treatment

Preventing gum disease is achievable by brushing and flossing twice daily, and keeping regular dental visits for examinations and professional cleanings. If you have questions about gum disease and the connection to heart disease and stroke, book an appointment with your dentist to evaluate your situation.

Sources:

A.D.A.M. Infectious Endocarditis

A.D.A.M. Stroke

A.D.A.M. Stroke Secondary to Atherosclerosis

American Academy of Periodontology. "Gum Disease Links to Heart Disease and Stroke"

Pussinen, Pirkko J. PhD; Alfthan, Georg PhD; Rissanen, Harri MSc; Reunanen, Antti MD; Asikainen, Sirkka DDS; Knekt, Paul PhD. Antibodies to Periodontal Pathogens and Stroke Risk. Stroke. 35(9):2020-2023 September 2004.

University at Buffalo. "The More Oral Bacteria, the Higher the Risk of Heart Attack, UB study shows" April 1, 2009.

University of Southern California. Oral Care Key to Successful Organ Transplants. April 1, 2009.

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