Teeth and Heart Disease: What’s the Connection?

Research has shown that periodontal, or gum, disease can increase the risk of heart disease. A build-up of plaque, a sticky film that contains bacteria, on and around the teeth causes this infection and inflammation of the gums, or the tissues that hold your teeth together.

Chronic inflammation has been shown to increase the risk of heart disease. It’s important to brush your teeth for at least two minutes twice per day. Regular dental cleanings have been shown to help prevent more significant and costly health challenges for those with heart disease.

The link between gum disease and heart disease isn’t entirely clear. Research has shown that oral bacteria that cause gum disease can spread beyond the mouth and contribute to other health issues.

The spread of this bacteria may increase inflammation throughout the body. Chronic low-grade inflammation has been shown to increase the risk of many health conditions, including heart disease.

Some evidence suggests that gum disease can also negatively affect blood pressure. Gum disease can also interact with medications that treat hypertension (high blood pressure).

High blood pressure can increase the likelihood of atherosclerosis, or a build-up of plaque in the arteries. Atherosclerosis is a risk factor for heart attack and stroke.

Risk Factors

Gum disease significantly increases the risk of heart disease caused by poor oral health. Hygiene can also impact your risk, even if you don’t have gum disease. Some evidence suggests that people who brush their teeth less than two times per day or for less than two minutes have a higher risk of heart disease.

The risk of oral health issues also increases with age. Many medications reduce saliva flow, contributing to dry mouth and tooth decay. Aging also comes with a higher risk of gum disease.

Poor oral health has also been linked to numerous other conditions, such as:

• Alzheimer’s disease: Gum disease has been linked to Alzheimer’s disease, which is the most common type of dementia. Research has shown that the oral bacteria may travel into the blood and spread to the brain.
• Diabetes: Oral bacteria can increase blood sugar and make it harder to manage diabetes. Uncontrolled diabetes, in turn, can worsen oral health.
• Cancer: Inflammation caused by oral bacteria has been shown to increase the risk of oral, head and neck, lung, and pancreatic cancers.
• Endocarditis: This is inflammation and infection of the tissue that lines the inside of the heart. Oral bacteria that spread into the blood can reach the heart and cause endocarditis.
• Pneumonia: Oral bacteria can spread to the respiratory system and cause pneumonia, which is inflammation and infection of the lungs. Gum disease can also negatively affect the immune system and raise the risk of infections that cause pneumonia.
• Rheumatoid arthritis: Gum disease can increase inflammation in the body, which may trigger rheumatoid arthritis. Poor oral health can also worsen this inflammatory condition, which causes painful, stiff, and swollen joints.

A build-up of plaque on and around the teeth causes gum disease. There are two stages of gum disease: gingivitis and periodontitis. Gingivitis causes the bleeding of the gums, which also often appear red and swollen. If untreated, gum disease can progress to periodontitis.

Periodontitis symptoms include:

• Bad breath
• Bleeding of the gums
• Gaps between the gums and teeth
• Gums that are bright red or reddish-purple, shiny, swollen, or tender to the touch
• Hard deposits on the teeth that are brown, green, white, or yellow
• Loose teeth
• Receding gums
• Shifting teeth
• Tooth sensitivity

A study published in 2022 looked at how preventative oral care impacts the costs of diabetes and heart disease. The researchers recruited 11,734 people who had either diabetes, coronary artery disease, or both.

The participants were enrolled in a healthcare plan in Arkansas that included dental care coverage for at least one year between 2014 and 2018. The researchers compared the total healthcare costs of those who had gone to at least one preventive dental visit to those who didn’t.

People with diabetes who received preventive dental care saved, on average, $549. Those with coronary artery disease who visited the dentist saved $548. People with both conditions who visited a dentist saved about $866.

These findings don’t confirm that preventive dental visits can reduce healthcare costs. The significant savings among people with diabetes or coronary artery disease who regularly made preventive dental visits compared to those who didn’t may suggest better health outcomes.

Having private dental insurance opens access to care, but there are other ways to find affordable dental care. Solutions may include:

• Dental schools host clinics where dental students can treat people at reduced prices
• Faith-based groups and charities that donate dental services
• Federally qualified health clinics that offer sliding fee scales where people pay what they can afford

Cost is quite often a barrier to dental care. Most insurance plans, including Medicare, don’t include dental care. As a result, many people avoid regular teeth cleanings and exams.

Many people opt out of dental care coverage because it’s an added expense. Data from the Centers for Disease Control and Prevention (CDC) shows that 50% of adults aged 18 to 64 in the U.S. don’t have dental care. About 22% of those with dental care coverage didn’t see a dentist within the past year.

People also lose dental insurance when they retire. Medicare doesn’t include dental care coverage, meaning it becomes an out-of-pocket expense. Only 30% of people aged 65 and older had dental insurance as of 2017.

The American Dental Association (ADA) recommends people visit a dentist at least once per year, if not twice per year or quarterly, depending on their overall health. Preventative dental care removes harmful bacteria that may worsen other conditions.

Postponing care means oral conditions can worsen, become more expensive, and impact nutrition, socialization, and quality of life. Dental cleanings can also prevent complications in people with conditions like diabetes and heart disease.

Oral bacteria that cause gum disease can spread from the mouth and into the blood, resulting in inflammation. This inflammation has been shown to increase the risk of heart disease. Other conditions that may be related to gum disease include cancer, dementia, diabetes, and rheumatoid arthritis.

Remember to brush your teeth for at least two minutes twice per day to prevent gum disease. It’s also important to visit the dentist regularly for dental cleanings, which may reduce heart disease risk.