New data supports the link between gum disease and heart disease

There is increasing evidence that gum disease is associated with an increased risk of cardiovascular events such as heart attack, stroke, atrial fibrillation, heart failure and cardiometabolic health conditions. Effective prevention and treatment of gum disease, also called periodontal disease, could potentially reduce the burden of cardiovascular disease, according to a new scientific statement published today in the flagship journal of the American Heart Association. Traffic.

The American Heart Association’s new scientific statement, Periodontal Disease and Atherosclerotic Cardiovascular Disease, includes new data supporting the association between periodontal disease and atherosclerotic cardiovascular disease (ASCVD) and updates the Association’s 2012 scientific statement. ACSVD, the leading cause of death worldwide, is caused by the accumulation of arterial plaque (fatty deposits in arteries) and refers to conditions including coronary heart disease, stroke, peripheral artery disease and aortic aneurysms.

“Your mouth and your heart are connected,” said scientific statement writing group chair Andrew H. Tran, MD, MPH, MS, FAHA, a pediatric cardiologist and director of the preventive cardiology program at Nationwide Children’s Hospital in Columbus, Ohio.

Gum disease and poor oral hygiene can allow bacteria to enter the bloodstream, causing inflammation that can damage blood vessels and increase the risk of heart disease. Brushing, flossing and regular dental checkups aren’t just about a healthy smile—they’re an important part of protecting your heart.”

Andrew H. Tran, Pediatric Cardiologist, Nationwide Children’s Hospital

Highlights of the statement include:

• Periodontal disease is a chronic inflammatory condition that affects over 40% of US adults over the age of 30. The earliest stage is gingivitis (inflammation of the gums due to oral plaque build-up). If left untreated, gingivitis can progress to periodontitis, where the gums begin to pull away from the teeth, forming small pockets that can trap bacteria and lead to infection. The most advanced stage, severe periodontitis, involves extensive damage to the bones that support the teeth. teeth can become loose and fall out. This stage often requires surgery.

• Periodontal disease is more common in people with poor oral hygiene and other risk factors for cardiovascular disease, such as high blood pressure, being overweight or obese, diabetes and smoking. The prevalence of periodontal disease is also higher among men, the elderly, people with low physical activity, and those affected by negative social determinants of health, such as lower socioeconomic status, food insecurity, and/or lack of access to health care including dental care.

• Although periodontal disease and ASCVD share common risk factors, emerging data indicate an independent association between the two conditions. Potential biological mechanisms linking periodontal disease to poor cardiovascular outcome include direct pathways such as blood bacteria and vascular infections, as well as indirect pathways such as chronic systemic inflammation.

• Numerous studies have shown that periodontal disease is associated with an increased risk of heart attack, stroke, atrial fibrillation, heart failure, peripheral artery disease, chronic kidney disease, and cardiac death. Although periodontal disease clearly contributes to the chronic inflammation associated with ASCVD, a cause-and-effect relationship has not been confirmed.

• There is also no direct evidence that periodontal treatment will help prevent cardiovascular disease. However, treatments that reduce lifetime exposure to inflammation appear to be beneficial in reducing the risk of ASCVD. Treatment and control of periodontal disease and associated inflammation may contribute to the prevention and improved management of ASCVD.

• People with one or more CVD risk factors are considered to be at higher risk and may benefit from regular dental exams and targeted periodontal care to address chronic inflammation. Previous studies have shown that more frequent tooth brushing is associated with lower 10-year ASCVD risk (13.7% for brushing once a day or less vs. 7.35% for brushing three or more times a day) and reduced markers of inflammation.

• More research, including long-term studies and randomized controlled trials, is needed to determine whether periodontal treatment can influence ASCVD progression and outcomes.

• In addition, the role of socioeconomic status, access to dental care, and other social factors negatively affecting health should be explored to develop targeted prevention and treatment strategies that can help reduce the prevalence and adverse outcomes of periodontal disease and ASCVD.