Oral Health and Heart Disease

For World Heart Day, learn about the connection between heart and oral health

The Dental Disease-Heart Disease Connection

It seems that we learn more every day about just how much our oral health can affect our overall health. Not only are dentists often able to see early signs of illness or diseases like nutritional deficiencies, general infection, diabetes, and AIDS in the mouth, researchers are also finding that the high levels of oral bacteria can also enter other bodily systems. For example, someone with gum disease may breathe in the high levels of bacteria from their mouth, resulting in bacterial pneumonia. Similarly, inflammation caused by the body's immune response to gum disease can cause complications for those suffering from autoimmune gastrointestinal disorders.

Though researchers continue to study the link between dental disease and cardiovascular disease, some suspect that the high levels of bacteria present in mouths with gum disease can enter the blood stream, triggering inflammation, and affect the heart by increasing the risk of heart disease and stroke.

Though the idea that unchecked gum disease can cause cardiovascular disease isn't proven and research is ongoing, understanding that gum disease has been found to affect other bodily systems is a good reason to maintain good oral hygiene and dental health ‐ you might just be protecting your heart, too.

Already Diagnosed with Cardiovascular Disease?

Those who are already living with cardiovascular disease should make sure to communicate their medical history, medication list, and even their cardiologist's name/number when visiting the dentist. It is necessary for the dentist to have this information in order to develop the best treatment plan for dental work, which may include coordination with the cardiologist. Other things to consider:

• Medications ― the dentist should be made aware of all active medications and the cardiologist should be made aware of any upcoming dental treatments:
  • Blood thinners can cause excessive bleeding, so may need to be stopped prior to scheduled dental treatment
  • Patients taking antiplatelet medications should speak to their cardiologist before stopping this medication
  • A pre-procedure antibiotic might be recommended before dental treatment for those at high risk of infection
  • Calcium channel blockers taken for high blood pressure can cause dry mouth and gum overgrowth
• Endocarditis ‐ those at high risk of developing this infection of the inner lining of the heart should make every effort to maintain oral hygiene in order to prevent bacteria build up and gum disease, which can trigger this condition
  • Those at the highest risk of this condition may be prescribed a pre-procedure antibiotic by their cardiologist or dentist before any dental work is done
  • Patients may be referred to the dentist to ensure good oral health before heart valve surgery, as an unhealthy mouth is one source of bacteria that can cause endocarditis
• Heart Attack ‐ though dental cleanings should be routinely scheduled and performed after a heart attack, extensive dental treatment should be postponed until 6 months after the coronary event
  • Those who experience dental anxiety and fear and are concerned that visiting the dentist may trigger a heart attack or other event should discuss their concerns with their dentist so a plan can be developed to address the issue
  • Many dental offices keep oxygen and nitroglycerin in case of emergency for those with a history of heart attack
• Angina ‐ those with stable angina can typically undergo most dental procedures; however, those with unstable or accelerating angina should avoid pursuing elective dental procedures until they have been evaluated by their cardiologist
  • Patients with angina may also want to confirm their dental office has access to oxygen and nitroglycerin in case of emergency during a dental visit
  • Some angina patients may require dental treatment to be performed in a hospital setting so their hearts can be monitored during treatment

Proper Oral Hygiene

The best way to prevent dental disease is to practice proper oral hygiene. Follow these steps to keep your mouth healthy:

• Brush for at least two minutes, twice a day, using a soft-bristled toothbrush
• Floss at least once a day
• Visit your dentist for an exam at least once a year and a cleaning at least twice a year
• Make sure your dentures fit properly; visit the dentist for adjustments if they don't

This World Heart Day, recommit to keeping your mouth healthy ‐ your heart just might thank you!