Heart Disease and Stroke: The Oral Systemic Link

A number of studies now support the fact that there is a very strong link between poor oral health, particularly periodontal disease, and heart disease and stroke. This link is important to know about, because approximately 36% of all deaths in America are caused by cardiovascular disease.

Some research indicates that controlling periodontal disease can lower the risk of stroke by half, and heart disease by two-thirds. If this research is confirmed by further studies, it will represent the greatest breakthrough yet in the prevention of cardiovascular disease.

No one is sure exactly why cardiovascular disease is so strongly linked to periodontal disease. There are several theories, though. One of the leading theories is that periodontal disease, which is America’s most common inflammatory disease, increases the level of inflammation throughout the body, including inflammation in blood vessels. Inflammation is now known to be a primary cause of heart disease and stroke.

Many researchers and clinicians think that inflammation is even more harmful to the cardiovascular system than the most established, classic risk factors, such as high LDL cholesterol. The link between inflammation and heart disease helps explain why almost half of all people who develop heart disease do not have any of the well-known risk factors for the disease, other than high levels of inflammation.

Besides inflammation, other theories say that small blood clots that form in the oral cavity as a result of periodontal disease sometimes enter the bloodstream, and can contribute to heart attacks and stroke. Another theory is that periodontal disease reduces the blood supply to the brain, by thickening the primary artery that brings blood to the brain, the carotid artery. Also, the bacteria from periodontal disease has been shown to contribute to hardening of the arteries, or atherosclerosis.

It has not yet been proven to a degree of absolute certainty that periodontal disease is a primary causative factor, instead of just a coincidence. However, one of the most persuasive indicators is a studying showing that 25% of people who had heart attacks had periodontal disease, but did not have any other of the common problems associated with heart disease, including high blood pressure, high cholesterol, or obesity.

Studies show that the degree of severity of periodontal disease is directly related to the severity of coronary artery disease. In one study of people with coronary atherolsclerotic heart disease, known as CAD, almost 85% had periodontal disease, compared to only about 22% of people who did not have CAD.

There is also evidence that cumulative tooth loss, which is a good indicator of severe periodontal disease, is closely related to peripheral artery disease, or PAD, particularly in men.

Other research shows that periodontal disease is closely associated with high blood pressure, which is often regarded as the main cause of heart attack or myocardial infarction. Therefore, it’s possible that periodontal disease may be an indirect cause of heart disease, as well as, in some cases, a direct cause.

Therefore, it makes abundant sense for people who are worried about cardiovascular disease to control their periodontal disease. This may be just one way to prevent cardiovascular disease, but it appears to be a very important way. Besides, it is not as demanding as other preventive measures, such as losing weight or exercising, and can therefore be a good way to kick-start a comprehensive program for heart-health.