Improving oral health may be an easy way to care for your heart. The same factors that cause certain heart problems can be associated with poor oral hygiene.

Researchers are still exploring the links between oral and heart health. But most experts, including Dr. Carl Horton, a cardiologist with Texas Health Heart & Vascular Specialists, a Texas Health Physicians Group practice located in Cleburne, agree that taking care of your teeth and gums offer several heart-healthy benefits.

“When you ignore pain, particularly in your mouth, it’s a bad thing,” Dr. Horton says. “Being aware of oral and heart conditions — and taking prompt action when problems arise — are essential steps to improving your overall health.”

Why mouth health matters

Dr. Horton notes that as more research shows how important oral health is, cardiologists are taking steps to inform at-risk patients so they can tackle problems early.

“We previously thought of cardiovascular disease as an isolated phenomenon,” he explains. “All the ways heart disease is linked to other problems in the body wasn’t initially recognized. It wasn’t common to think about the disease process and the role inflammation plays in multiple conditions.”

Some studies are now suggesting that ailments in the mouth may be associated with multiple health conditions, including diabetes and stroke.

Periodontal disease, also called gum disease, is a bacterial infection involving the gums and sometimes the bone that surrounds a tooth. It ranges in severity from irritation (gingivitis) to serious infection (periodontitis).

Most of the bacteria in your mouth is harmless. But poor oral hygiene can cause bacteria to reach high levels that may cause infections, tooth decay, tooth loss and gum disease.

“The danger is that a type of bacteria from the mouth can cause clots and serious problems if it enters the bloodstream,” Dr. Horton says.

Studying the connection

Multiple studies have examined the link between oral and heart health. Two themes researchers have explored are whether periodontal disease is associated with cardiovascular disease and the influence of common risk factors, such as smoking, between the two conditions.

“As a cardiologist, we need to be having these conversations about dental health with patients,” says Dr. Horton, whose brother is a dentist. “The evidence is out there, and I know discussing oral health is something I do regularly with my patients.”

Study findings have shown there may be enough evidence to justify closely monitoring blood-pressure in patients with periodontal disease. Those diagnosed with high blood pressure, or persistently elevated blood pressure, might benefit from a referral to a dentist.

Highlights of other research from studies about heart-oral health include:

• People who said they brushed less than twice a day for less than two minutes had a three-fold increased risk of having or dying from a heart attack, heart failure or stroke.
• Two studies showed that treating gum disease, alongside other stroke risk factors, might reduce the severity of artery plaque buildup and narrowing of brain blood vessels that can lead to a new or a recurrent stroke. Further research is needed to confirm.
• People with healthier gums have lower blood pressure and responded better to blood pressure-lowering medications compared with individuals who have periodontitis, based on a review of medical and dental exam records of more than 3,600 people with high blood pressure. It found that people with periodontal disease were 20 percent less likely to reach healthy blood pressure ranges, compared with patients in good oral health.
• According to a study published in 2021, adults with severe gum disease may have higher odds of high blood pressure, independent of common cardiovascular risk factors. Individuals with gum disease were twice as likely to have high systolic blood pressure.

At-risk populations

Dr. Horton suggests that people 30 and older be even more vigilant with their oral health because their age increases the risks and complications associated with periodontal disease. A Centers for Disease Control and Prevention report found that 50 percent of adults 30 and older have some form of periodontal disease. The risk increases to 70 percent for adults 65 years and older.

It’s also essential if you who have diabetes, or are at risk for it, to monitor your oral health. “You should be extra vigilant about regular checkups, exercise and not smoking,” Dr. Horton says. 

Another concern is if you have delayed regular medical and dental screenings during the COVID-19 pandemic.

“If you are having heart problems or dental problems you shouldn’t delay getting help,” he says. “Most hospital and health care workers have been vaccinated and the risk of contracting the virus in a medical setting is lower now than ever.”

Tips to improve oral health

Much of the advice aimed at keeping the heart healthy also applies to keeping the mouth healthy.

“A lot of the basics overlap,” Dr. Horton notes. “These include focusing on eating cleaner, less processed foods, quitting smoking and not underestimating the importance of physical activity such as walking to get the heart rate up most days of the week.”

“We always tell patients they need to know their numbers,” he adds. “These include cholesterol, blood pressure, glucose and weight. It’s important to get them to normal levels, and to be aware when there are changes and seek help right away. And, just as important, is maintaining a good relationship with your dentist. You want to have regular dental visits to recognize periodontal disease as early as possible so you can get treated.”

Other oral-health recommendations from experts include:

• Brush teeth for at least two minutes twice a day with a fluoride toothpaste.
• Floss daily and use a mouthwash.
• Limit sugary beverages and snacks.
• Get dental exams regularly, usually every six to 12 months. It’s possible for gum disease to have no warning signs, which means professional cleanings and X-rays are essential.

Dr. Horton says he’s hopeful that more studies and scientific advancements will lead to increased understanding of how oral and heart health are linked.

“Until more is known, it’s important to do all you can to stay healthy and oral health is an easy fix. It’s not always the big things that matter, it’s often the little things you do for your health on a consistent basis that makes a great impact,” he concludes.

Learn more about how your heart and dental health are connected. Find a heart and vascular specialist today.

Texas Health Physicians Group providers are employed by Texas Health Physicians Group and are not employees or agents of Texas Health Resources hospitals.

Doctors on the medical staffs practice independently and are not employees or agents of Texas Health hospitals or Texas Health Resources.

This article was developed by the American Heart Association for Texas Health.