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Gum Disease Linked to Heart Attacks and Stroke

Add dentist visits to your other heart-healthy behaviors

Keeping your gums in good shape may go a long way toward protecting your heart health. Although still in the early stages, research presented at the American Heart Association Scientific Sessions 2011 in Orlando, Fla., this week shows a tantalizing link between gum disease and heart disease.

In one study, periodontist Anders Holmlund, of Gävle, Sweden, found that some types of gum disease, such as those that cause tooth loss or bleeding gums, could increase the likelihood of heart attack, stroke or heart failure.

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Holmlund and a colleague studied the records of nearly 8,000 men and women 20 to 85 years old who were treated for gum disease, also called periodontal disease, between 1976 and 2008.

They found that:

  • Adults with fewer than 21 teeth (adults normally have 32 teeth, including four wisdom teeth) had a 69 percent increased risk of heart attack compared with adults who retained most of their teeth.
  • People with more infected areas where the gums pull away from the teeth, called periodontal pockets, had a 53 percent greater risk of a heart attack than those with the fewest pockets.
  • Adults who had the fewest teeth had double the risk of developing congestive heart failure — when a weakened heart can't pump enough blood — compared with those who retained more of their teeth.
  • Men and women who suffered from bleeding gums had more than twice the risk of stroke compared with those whose gums were healthy.

"Why these different markers of periodontal disease predict different cardiovascular diseases remains unknown," says Holmlund, "but we hope that future research will answer that question."

In a separate study from Taiwan, researchers linked the frequency of trips to the dentist for teeth cleaning to a reduced risk for heart attack and stroke.

"I would advise everyone to have regular professional [cleaning]," says Chen. "Brushing can do only so much."

Brushing can help get rid of plaque, the sticky, bacteria-filled film that develops on teeth, but only professional cleaning can remove tartar, hardened plaque that brushing won't touch. In a process called scaling, a dentist or dental hygienist scrapes off the tartar from above and below the gum line.

Among more than 100,000 men and women followed for an average of seven years, those who had their teeth cleaned professionally had a 24 percent lower risk of heart attack and 13 percent lower risk of stroke overall compared with those who never had a dental cleaning. The men and women who had their teeth cleaned at least once a year had the fewest heart attacks and strokes, notes Emily Zu-Yin Chen, M.D., of the Taipei Veterans General Hospital, an author of the study.

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The study included more than 51,000 adults who had received at least one professional cleaning and a similar group matched for health conditions who had no professional cleaning. None of the participants had a history of heart attack or stroke at the beginning of the study.

"I would advise everyone to have regular professional [cleaning]," says Chen. "Brushing can do only so much."

Scientists have examined the link between gum disease and heart disease for a number of years, says cardiologist Thomas Gerber, M.D., of the Mayo Clinic in Rochester, Minn., who was not involved in either study. "Some studies found relationships between the two and others didn't." However, Gerber says, these studies have been observational.

"That means the researchers set out to look for an association between the two diseases," he says, "not to determine whether periodontal disease causes heart disease, or if treating periodontal disease reduces the risk of heart disease."

Most heart attacks and stroke are related to traditional risk factors, Gerber continues, "including high blood pressure, high cholesterol, high blood sugar, smoking, weighing too much and not exercising enough. To keep your heart healthy, you need to control these risks." Although these studies are interesting, he says, "people shouldn't come away with the impression that [just] by keeping their teeth clean they're taking a big step toward heart health."

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