Tooth Decay, Periodontal Disease Linked to Heart Disease

Research from around the world is confirming that tooth decay and periodontal disease are associated with heart disease. We’re not just talking about the heart here either: Rather, a number of cardiovascular disorders, from coronary artery disease and atherosclerosis to heart valve problems.

Coronary heart disease linked with periodontitis

Coronary artery disease is one of the leading causes of cardiovascular death. A 2018 study from the University of Eastern Finland and the University of Helinski tested 505 Finnish coronary patients.

Of these, 152 had stenosis, 184 had coronary artery disease, and 169 had acute coronary heart disease. The researchers tested each patient for their levels of oral bacteria burden.

The researchers found that those with higher levels of gingivitis-causing bacteria also had the greatest risk of acute coronary heart disease.

The researchers also found that people with these higher levels of gingivitis bacteria also had greater levels of inflammation markers in their blood.

Heart valve problems linked to oral bacteria

A 2017 study from Spain’s University of Valencia tested 60 people with an average age of 71. 30 were patients with heart valve problems, who were preparing to undergo heart valve surgery. Another 30 were healthy people who were matched in age with the heart valve group.

The researchers tested all the subjects for periodontal disease and tooth decay. The researchers found that the heart valve patients were significantly more likely to have periodontal disease and tooth decay compared to the healthy control group.

Atherosclerosis and dental caries

A 2013 study from Austria confirmed that dental caries are specifically linked with atherosclerosis – the hardening of the arteries – a major component of most heart diseases.

The researchers – from Austria’s Innsbruck Medical University – utilized computed tomography along with standard dental instrumentation to analyze 292 patients: 137 women and 155 men. The patients had an average age of 54 years old.

The researchers counted the number of cavities and decaying teeth surfaces among the patients. They also measured their progression of gingivitis and periodontal disease – gum disease – in addition to measuring the amount of jaw bone loss.

Jawbone loss is linked specifically to periodontal disease because bacteria that infect the gums and their waste products destroy bone material the roots of the teeth.

Using a calculation method called logistical regression, it was determined that those patients with less than one tooth cavity – had significantly less incidence of atherosclerosis compared to those patients with multiple dental caries.

The researchers also determined that those with greater levels of periodontitis and a greater incidence of atherosclerosis – the hardening of the arteries – compared to those with lower levels of periodontitis or none at all.

These factors were multiplied by the age of the patient. The older the patient, the greater the atherosclerosis, but again this was also related to the number of dental caries and restorations that patient had.

The researchers concluded:

“Dental caries, pulpal caries, and chronic apical periodontitis are associated positively, while restorations are associated inversely, with aortic atherosclerotic burden.”

How does this happen?

Pathogenic bacteria leak their waste into the bloodstream, which can damage the walls of the blood vessels. This blood vessel wall damage, along with the pollution of the bloodstream, produces the scarring and plaque formation referred to as atherosclerosis.

Oral bacteria that produce this scarring and plaque include the following species:

• Porphyromonas gingivalis
• Porphyromonas endodontalis
• Aggregatibacter actinomycetemcomitans
• Prevotella intermedia
• Fusobacterium nucleatum
• Tannerella forsythia
• Campylobacter rectus

The buildup of these species eventually leak into the bloodstream as either the bacteria themselves or their byproducts. This produces plaque on the walls of the blood vessels, which gradually clogs the arteries. Pieces of plaque can also break off and block the smaller blood vessels that feed the heart muscles. This can cause a heart attack. When pieces of plaque break off and clog the blood vessels in or leading to the brain this can cause a stroke.

REFERENCES:
Liljestrand JM, Paju S, Pietiäinen M, Buhlin K, Persson GR, Nieminen MS, Sinisalo J, Mäntylä P, Pussinen PJ. Immunologic burden links periodontitis to acute coronary syndrome. Atherosclerosis. 2018 Jan;268:177-184. doi: 10.1016/j.atherosclerosis.2017.12.007.

Silvestre FJ, Gil-Raga I, Martinez-Herrera M, Lauritano D, Silvestre-Rangil J. Prior oral conditions in patients undergoing heart valve surgery. J Clin Exp Dent. 2017 Nov 1;9(11):e1287-e1291. doi: 10.4317/jced.53902.

Glodny B, Nasseri P, Crismani A, Schoenherr E, Luger AK, Bertl K, Petersen J. The occurrence of dental caries is associated with atherosclerosis. Clinics (Sao Paulo). 2013 Jul;68(7):946-53.

Adams C. Oral Probiotics: Fighting Tooth Decay, Periodontal Disease and Airway Infections Using Nature’s Friendly Bacteria. Logical Books, 2015.