Maintaining healthy teeth and gums is an important way to protect your heart health. But how are they connected? We asked Dr. Aviv Ouanounou, a dentist and associate professor at the University of Toronto Faculty of Dentistry, and Kelly Van Heugten, a registered nurse and manager of the heart program with Heart & Stroke’s health systems team. Here’s what we learned.
The oral health link
“There is a lot of research to show that there is a connection between heart disease and oral health problems,” says Dr. Ouanounou. In particular, bacteria from your mouth can travel through the bloodstream to other parts of your body.
If these bacteria reach the heart, they can cause damage and inflammation, in some cases leading to serious problems including heart attack and stroke.
Who’s at risk of oral health problems?
We all have bacteria in our mouths. But they can become a problem if you have untreated cavities, or gum disease such as gingivitis, resulting from buildup of plaque on your teeth.
Smoking increases your risk of these conditions, as does poor nutrition and lack of regular dental care. People with diabetes are more likely to experience gum disease.
How do I know if I have gum disease?
You might see redness in your gums or a little bleeding when you brush. If it progresses to more serious periodontitis, you’re likely to see more bleeding along with other signs including sore, puffy gums, sensitive teeth and chronic bad breath.
What could tooth or gum problems do to my heart?
Over time, bacteria from your mouth can contribute to atherosclerosis, the fatty buildup that clogs arteries and can lead to heart attack. “Research has shown that the same bacteria from common oral infections have been found in blockages in heart arteries,” says Dr. Ouanounou.
A more acute problem linked to these bacteria is infective endocarditis, inflammation of the inner lining of your heart (endocardium). It can be very serious, and can cause clots to form, potentially leading to heart attack or stroke. Endocarditis requires prompt treatment with antibiotics.
What if I have an existing heart condition?
People with congenital heart disease or valve disease are at higher risk for endocarditis. Heart surgery also increases your risk, says Kelly Van Heugten. It’s not something many people think about, but the heart and mouth are interconnected. Her cardiac patients would be sent to see their dentist before surgery; some needed extensive dental work to clean up problems that could put their hearts at risk.
After heart surgery, Kelly says, it’s crucial to commit to good oral health habits (see below). This is especially true if you have a prosthetic implant such as a valve replacement, which can attract bacteria.
How can I protect my heart?
Good oral hygiene is the foundation, says Dr. Ouanounou. That means thorough brushing twice daily, flossing daily, and seeing a dental professional on a regular schedule. “Keep your mouth healthy and clean. And that will prevent other problems.”
It’s important to tell your dental professional about any changes to your health, says Kelly Van Heugten. Depending on your situation, you may need to take preventive antibiotics before any dental procedure that could cause bleeding. Your dentist should use their clinical judgment, along with these guidelines from the Canadian Dental Association, to determine the right course for you.
It can also be helpful to connect your dentist to your other healthcare providers, Kelly adds. “You need to make sure that the dentist can potentially interact with your cardiologist, or possibly your pharmacist.
What if I don’t have a dentist?
Many people in Canada face challenges accessing dental care. While dentists are the most common practitioner we think of when it comes to oral health, there are other options. Some community health clinics provide links to regional dental services. Some procedures may be provided by professionals other than a dentist; for example, cleaning by a dental hygienist.
The new Canadian Dental Care Plan is currently enrolling seniors and children under 18 to provide coverage for dental care.
Where can I learn more?
- More about gum disease
- The Canadian Dental Association Position on Prevention of Infective Endocarditis
- Information on the Canadian Dental Care Plan
- Find an independent dental hygienist
