First Posted: 3/19/2015
LIMA — If the possibility of losing your teeth wasn’t motivation enough to brush, maybe the risk of heart attack or stoke is.
Gum disease, or periodontal disease, is cause for multiple concerns — the loss of bone density or teeth, for example. But what some don’t realize is that an infected mouth could affect other parts of the body, like the heart.
For years, the correlation between oral health and heart disease has been an ongoing dispute among health care professionals. It’s been suspected, but it hasn’t been understood.
But recently, Julius Kato, an invasive cardiologist at St. Rita’s Medical Center, said the idea has been more seriously recognized by health care specialists.
“It’s changing the tables and putting dentists in the role as a health care professional that’s now helping in the process of fighting heart disease,” Kato said.
Kato said there are a few theories or possibilities as to how gum disease could lead to or worsen a pre-existing a heart condition.
With direct exposure to bacteria specific to the mouth, it is possible for bacteria causing an oral infection to make its way into the bloodstream. The process is one of the more common causes of endocarditis, an infection on a cardiac valve.
An open wound or ruptured vessel — or even bleeding from dental cleaning — could enable bacteria to enter the bloodstream. After gaining access, it’s easy for bacteria to adhere to a cardiac valve.
Once oxygenated, it’s almost nearly impossible for the body to fight it. Which is why, without treatment or antibiotics, the bacteria will continue to grow and spread. Without treatment or a valve replacement to reverse the condition, followed by a change in lifestyle, the condition could cause a stroke or serious organ damage and even heart failure.
Periodontal disease can also cause inflammation, which is a factor in heart disease. The more inflammation a body has, the more the heart is at risk. In both cases, a test to look for a certain protein can show how much inflammation is present.
In general, inflammation can lead to or worsen atherosclerotic cardiovascular disease, a condition where plaque inside the artery causes cholesterol build up. After reaching sites with atherosclerosis, inflammation disrupts cholesterol and causes it to rupture. That attracts platelets, which causes a larger clot, which can lead to a heart attack.
Even in cases where a heart condition has already been treated, Kato said gum disease can allow these issues to recur. For example, the bacteria can more easily attach to previously diseased or replaced valves.
For this reason, patients with prior heart issues, treatments or conditions should take antibiotics before visiting the dentist, even for a teeth cleaning.
“It’s these patients that are most at risk,” Kato said. “Its not likely to attack people without previous or pre-existing conditions.”
Diane Gross, a dental hygienist at Northwest Dental Center in Elida and trustee for the Northwestern Dental Hygienists’ Association, said how the bacteria actually gets into the mouth, however, is just natural occurrence.
“A baby just being born doesn’t have any bacteria in the mouth,” she said. “But in a short amount of time, it’ll form.”
Some people may have more bacteria than others, which is why others need to go to the dentist more frequently than every six months to prevent build up. Those cleanings, along with regular brushing, flossing and mouth wash use, are the best way to control or get rid of bacteria.
“It’s all one system. Each part of the body interacts with the other,” Gross said. “But a lot of stuff with the mouth is unfortunately out of sight and out of mind. If your arm starts to bleed, you freak out and go to the doctor. But if you’re brushing your teeth and your gums start to bleed, you spit it out and think nothing of it. It’s just a difference in perception.”
