20th March is world oral health day. Dr Tilak Suvarna, Senior Interventional Cardiologist at the Asian Heart Institute talks about how the ‘plaque’ on your teeth may be connected to plaque in your arteries.
The first kind of plaque is related to ‘gum disease’- the sticky, bacteria-laden film dentists refer to as plaque builds up around teeth due to poor dental hygiene. A completely different type of plaque — made of fat, cholesterol, calcium, and other substances found in blood — can build up inside arteries. Known as atherosclerosis, this fatty plaque is the hallmark of coronary artery disease.
Researchers have proved time and again that people with gum disease (also known as periodontal disease) have two to three times the risk of having a heart attack, stroke, or other serious cardiovascular event. This link needs to be understood clearly because many people with heart disease have healthy gums, and not everyone with gum disease develops heart problems. Shared risk factors, such as smoking or an unhealthy diet, may explain the association. Still there’s a growing argument that gum disease may be an independent risk factor for heart disease.
There are three possible links-
- The bacteria that infect the gums and cause gingivitis and periodontitis also travel to blood vessels elsewhere in the body where they cause blood vessel inflammation and damage; tiny blood clots, heart attack and stroke may follow. Supporting this idea is the finding of remnants of oral bacteria within atherosclerotic blood vessels far from the mouth. Then again, antibiotic treatment has not proven effective at reducing cardiovascular risk.
- Rather than bacteria causing the problem, it’s the body’s immune response – inflammation – that sets off a cascade of vascular damage throughout the body, including the heart and brain.
- There may be no direct connection between gum disease and cardiovascular disease; the reason they may occur together is that there is a 3rd factor (such as smoking) that’s a risk factor for both conditions. Other potential “confounders” include poor access to healthcare and lack of exercise – perhaps people without health insurance or who don’t take good care of their overall health are more likely to have poor oral health and heart disease.
How to know signs of gum disease
Any of these signs can be a clue that you have periodontal disease:
swollen, red, or tender gums
gums that bleed easily
pus between the teeth and gums
bad breath
buildup of hard brown deposits along the gum line
loose teeth or teeth that are moving apart
changes in the way dental appliances fit.
Prevention
Daily toothbrushing and flossing can prevent and even reverse an early stage of gum disease, known as gingivitis. If your dentist says you have gingivitis, ask for a brushing and flossing demonstration to make sure you’re doing both correctly. Flossing sweeps away the sticky film between teeth that leads to plaque buildup. Twice-yearly cleanings by a dentist or hygienist are also advisable.
However, it is important to note that there’s no proof that treating gum disease will prevent cardiovascular disease or its complications. But the connection is compelling enough that dentists (and many doctors) say it’s yet another reason to be vigilant about preventing gum disease in the first place.