Dental health plays an important role in heart health

Research also focuses on the relationship between oral hygiene and other chronic diseases, neurological disorders, pulmonary infections.

Although poor dental care does not directly cause cardiac dysfunction, periodontal disease has been associated with various cardiovascular events, including atherosclerosis, coronary heart disease, myocardial infarction, and thromboembolism.1-3 oral microbes (Table 12,4) have been found in many organs and tissues including the heart, indicating that oral health may have systemic effects on overall health and vice versa.3,5 One hypothesis suggests that gum and heart disease trigger inflammation in the artery and gingival walls as part of the body’s immune system, increasing disease potency in both.2,6

types of diseases

Gingivitis (inflammation of the gums) can progress to periodontitis (severe gum disease) when bacteria move along the roots of the teeth and into the bone structure.2 As periodontitis triggers inflammation in the oral cavity, signaling can travel to other tissues, exerting a systemic effect on the body.7,8

Infective endocarditis, or infection on the surface cells of the heart, may be associated with a bacterial process originating in the oral cavity, which induces systemic effects.2,6

Oral bacteria can also be detected for platelet aggregation in atherosclerosis and thromboembolism.2,5

In addition to periodontitis, the incidence of cardiovascular events is increased in patients with other chronic inflammatory diseases such as psoriasis, respiratory and urinary tract infections, rheumatoid arthritis and systemic lupus erythematosus.8 Microorganisms contained in biofilms growing in dental plaque can produce metabolites (i.e., immune cells, inflammatory cytokines and toxins) that have local and systemic effects throughout the body.9 As a result, in severe cases stroke-like events can begin.9

Who is susceptible?

Dental cavities and ischemic heart disease share common risk factors in the context of different populations of affected individuals. For example, diabetes and smoking both increase the risk of the disease.2,5

As a person’s risk factors increase, so does the susceptibility to disease. Lack of routine dental care increases the risk of gingivitis and periodontitis in critically ill individuals in intensive care units. Furthermore, the study results suggest that patients with acute myocardial infarction have poorer dental health.7,10

Increasing age, family history of cardiovascular and oral diseases, and lack of physical activity are risk factors for atherosclerotic disease that are common in patients with periodontitis.7 Chronic stress and obesity are also risk indicators of periodontal disease.5,8 Table 22,5,8 Lists other risk factors.

Individuals who are immigrants, low-income, or live in rural areas are at greater risk for poor dental outcomes due to lack of access to quality care and poor health literacy.6,11 The need for comprehensive health care is also important, especially for children in low-resource communities.1 1 Ethnic and racial oral health disparities are also evident among Black and Hispanic individuals.1 1 Studies show that the number of dental cavities is associated with education, income and occupation, emphasizing that there must be greater awareness of the importance of dental health in reducing potential complications.2

dental care standards

The American Dental Association (ADA) recommends brushing teeth with fluoride toothpaste for 2 minutes twice a day.5 It is important to replace the toothbrush every 3 months; Once the bristles are worn, if the toothbrush is used for too long, it can become a reservoir of bacteria.5 The ADA also recommends flossing once daily in addition to chlorhexidine gluconate or fluoride mouthwash to completely remove plaque that builds up on the surface of tooth enamel.5 In addition to regular home dental regimens, experts recommend visiting the dentist twice a year to more effectively remove bacterial biofilm and for a thorough checkup for possible gum diseases.8

conclusion

Although direct causation has not been proven, we cannot rule out shared mechanisms between cardiovascular and dental diseases. One can exacerbate the other, and taking preventive measures to ensure good oral hygiene can reduce potential risks.

While it may not be accurate to say that individuals can directly prevent heart disease by taking good dental care, dental health is recommended. It reduces the risk of possible exacerbation of other health conditions by encouraging good overall health.6

Oral health is an area of ‚Äč‚Äčinterest for its role in overall systemic health, but more research is needed to determine the extent to which it may directly lead to cardiovascular issues. Dental care is also being researched for its connection to other chronic diseases, neurological disorders, pulmonary infections, and even cancer.9

Reference

1. Periodontitis. American Dental Association. Updated June 9, 2022. Accessed October 18, 2022.

2. Gianos E, Jackson EA, Tejpal A, et al. Oral health and atherosclerotic cardio-vascular disease: a review. Am J Prev Cardiol. 2021;7:100179. doi:10.1016/jajpc.2021.100179

3. Fiorillo L, Cervino G, Laino L, et al. Porphyromonas gingivalis, peri-odontal and systemic implications: a systematic review. Dent J (Basel). 2019;7(4):114. doi:10.3390/dj7040114

4. Chang Y, Woo HG, Park J, Lee JS, Song TJ. Better oral hygiene care is associated with a reduced risk of incident atrial fibrillation and heart failure: a nationwide population-based cohort study. Eur J Prev Cardiol. 2020;27(17):1835-1845. doe:10.1177/2047487319886018

5.Sedgi L, Dimasa V, Harrington A, Lynch SV, Kapila YL. The oral micro-biome: the role of key organisms and complex networks in oral health and disease. Periodontol 2000. 2021; 87(1): 107-131. doi:10.1111/prd.12393

6. Schmerling RH. Relationship to gum disease and heart disease. Harvard Health. April 22, 2021. Accessed October 28, 2022. https://www.health.harvard.edu/diseases-and-conditions/gum-disease-and-the-connection-to-heart-disease

7. Matila KJ, Nieminen MS, Valtonen VV, et al. Association between dental health and acute myocardial infarction. BMJ. 1989;298(6676):779-781. doi:10.1136/bmj.298.6676.779

8. Friedewald VE, Kornman KS, Beck JD, et al. The American Journal of Car-Diology and Journal of Periodontology Editors’ Consensus: Periodontitis and atherosclerotic cardiovascular disease. Am J Cardiol. 2009;104(1):59-68. doi:10.1016/j.amjcard.2009.05.002

9. Liu YCG, Lan SJ, Hirano H, et al. Update and review of Gerodontology Prospect for 2020: linking oral (hypo)-function interactions to health versus systemic diseases. J Dent Sci. 2021;16(2):757-773. DOI: 10.1016/j.jds.2020.09.007

10. Naderi S, Merchant AT. The relationship between periodontitis and cardiovascular disease: an update. Curr Atherosclerol Rep 2020;22(10):52. doi:10.1007/s11883-020-00878-0

11. Northridge ME, Kumar A, Kaur RK. Inequalities in access to oral health care. Annu Rev Public Health. 2020;41:513-535. doi:10.1146/un-nurev-publhealth-040119-094318

About the Author

jessica bilicu Stores is a PharmD candidate at the University of Connecticut School of Pharmacy.

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