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Healthy teeth, healthy heart?

Paying attention to your dental hygiene and health -- especially your

gums -- may pay you back with more than a gleaming, healthy smile and manageable dental bills. It may keep your heart healthy too.However, the keyword is may. Cardiologists and dentists who treat gum disease have long debated the link between dental health and heart disease, but the issue still is not completely resolved. While there are several theories, it is not clear whether gum disease actually has a direct link to heart disease. If it's true that people with poor oral health have more heart attacks, it doesn't necessarily mean that poor oral health causes them. People with good oral hygiene may just be taking better care of themselves. In other words, people who floss and brush their teeth may also exercise regularly and have other heart-healthy habits.

Gum disease and heart disease: How could they be linked?

Experts do agree that there are plausible reasons why dental health and heart health may be linked. For example, inflammation is a common problem in both diseases. Hardening of the arteries or atherosclerosis, is associated with inflammation. Much of the build up of fatty plaque, also called atheroma (not the same as dental plaque) in the arteries is an inflammatory process. Inflammation is also associated with gum disease. Gingivitis (the early stages of gum disease) occurs when gums become inflamed and bacteria invade the tissues.

 

What research shows about gum disease and the heart

Experts in periodontology and cardiology recently reviewed more than 120 published medical studies, position papers and other data on the heart and a possible dental health link. They developed a consensus report, published simultaneously in the Journal of Periodontology and the American Journal of Cardiology.
The aim of the paper was to give cardiologists, periodontists and other health professionals a better understanding of the links between gum disease and heart disease, but much of the information is also helpful to consumers. The report makes these points:

• A review of several published studies finds that gum disease is in itself a risk factor for coronary artery disease.
• Analysis of the large National Health and Nutrition Examination Survey (NHANES) in the US found that gum disease is an important risk factor for diseases of the blood vessels and the arteries that supply the brain, especially strokes that involve insufficient blood or oxygen reaching the brain. Data from another study of more than 50,000 people found that those with fewer teeth and more gum disease had a higher risk of stroke. However, other studies have not shown an obvious association between gum disease and stroke.

Other research found a direct link between clogged arteries in the legs (peripheral vascular disease) and gum disease.

 

The consensus: No consensus

Although the report was a consensus of sorts, the link is far from definitive, experts say. There is no solid science to demonstrate a direct link between heart health and oral health. However, in two areas experts generally agree:

• Bacteria found in both health problems are similar. The bacteria found in gum disease are also found in blood vessels undergoing atherosclerosis.
• Inflammation is another common denominator for both diseases. When people have moderate to severe gum disease, their levels of C-reactive protein (CRP), a protein that rises during whole-body inflammation, increase. CRP levels are also used to assess a person's risk of a heart attack. 

 

Advice for a healthy heart and gums

The joint report also made these recommendations:

• Dentists should tell patients with moderate to severe gum disease that they may have an increased risk of heart and blood vessel problems. People who have moderate to severe gum disease and a known risk factor for heart disease, such as smoking or a raised blood pressure, should consider having a medical check-up if it has been one year or more since their last one.
• Doctors and dentists should work together to focus on reducing heart disease risk and ensuring good periodontal care for patients with heart disease and gum disease.

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