Prevent Heart Attacks by Keeping Your Gums Healthy | Consumer Health Information Corporation

Prevent Heart Attacks by Keeping Your Gums Healthy

Tran Nguyen
Doctor of Pharmacy Candidate, 2002
Virginia Commonwealth University/Medical College of Virginia

How many times have you heard in the news that heart disease is the number one cause of death in the United States? Well, it's true and now researchers are trying to determine if there is a link between gum disease and an increased risk of heart attacks. According to some research studies, periodontal disease (also called gum disease) might be an important risk factor for developing a heart attack.

What is gum disease and how do people get it?
Gum disease is caused by germs (bacteria) that infect the tissues surrounding and supporting your teeth. The early stage of gum disease is called gingivitis. During this stage, the gums become red, swollen, and may bleed easily. But gingivitis can be easily treated by brushing the teeth and gums, and flossing daily. If not treated, the disease can become worse and this is could lead to periodontitis. During this stage, gums and bones that support the teeth can become seriously damaged. Your teeth can become loose and you may need oral surgery or even have teeth pulled. Brushing and flossing alone cannot cure periodontitis.

Gum disease is caused by dental plaques (a sticky film containing bacteria, food particles and mucus) that build up in the pockets between your teeth and gums. It can also run in the family.

Medicines that cause dry mouth are another cause of gum disease. This is because your body needs saliva to keep your mouth moist. Saliva also contains proteins that help protect your mouth from harmful bacteria. Examples of some medicines that can cause dry mouth are: medicines used to treat allergies, depression and high blood pressure. If you get dry mouth from taking medicines, there are steps you can take to keep the mouth moist and prevent gum disease.

How can gum disease have any connection to heart disease?
When bacteria infect your gums, your gums and the tissues around it swell. The swelling stretches the gum tissue allowing bacteria from your mouth and food to get through more easily. There are many tiny blood vessels in the gums around teeth that carry blood to and from your heart. The walls of these blood vessels also become stretched. So it is much easier for bacteria to enter these blood vessels in your gums and go into your blood when you have gum disease.

Some experts have also suggested that when these bacteria get into your blood, they can cause your body to make and release chemicals that can damage your heart. The bacteria may also cause plaques to form on the walls of your blood vessels. Plaques found on walls of blood vessels are different from dental plaques. These plaques are made of fatty substances that can narrow the opening of the blood vessels. The effect is similar to how large pieces of food can clog the kitchen drain. In addition, these bacteria can also cause your blood to form small clots. Narrower blood vessels and blood clots can block the normal flow of blood to your heart. When your heart does not receive enough blood, you can have a heart attack.

Does having gum disease mean you will get heart disease?
Currently, we do not know. Some researchers found that having gum disease does increase the chance of getting heart disease. Others found that the chance of getting heart disease is the same whether people have gum disease or not. But, researchers seem to agree that people who have heart disease also tend to have gum disease. Whether having gum disease causes people to develop heart disease is still uncertain. However, new studies are underway to clarify this link between gum disease and heart disease.

In the meantime, we do know that heart disease and gum disease are both very common. According to the Center for Disease Control, an estimated 21 million Americans have heart disease and the American Dental Association estimates at least 60 percent of adults have gum disease. We also know that heart disease is the number one cause of death in the United States. Since gum disease can be easily prevented, isn't it best that we protect ourselves first?

Protect yourself from losing your teeth and possibly your life.
Gum disease can only be stopped if it is diagnosed early. Once there is bone loss in the teeth, it may be too late. So it's important to know the early signs of gum disease. According to the American Dental Association, the following are signs that require an immediate visit to the dentist:

Gums that bleed when you brush your teeth
Red, swollen, or tender gums
Gums that have pulled away from the teeth
Bad breath that doesn't go away
Pus between your teeth and gums
Loose or separating teeth
A change in the way your teeth fit together when you bite
A change in the fit of partial dentures

It's good to be able to recognize if you are developing gum disease. But isn't it even better if you know how to protect yourself from getting it. To help prevent gum disease, the American Dental Association urges people to follow these general recommendations.

Brush your teeth well at least twice a day.
- Place your toothbrush at a 45-degree angle against the gums.
- Move the brush back and forth gently in short strokes.
- Brush the outer tooth surfaces, the inner tooth surfaces, and the chewing surfaces of the teeth.
- Use the tip of the brush to clean the inside surfaces of the front teeth, using a gentle up-and-down stroke.
- Brush your tongue to remove bacteria and freshen your breath.
Use a soft-bristled toothbrush to prevent scraping your gums. The size and shape of the toothbrush should fit your mouth so that it can reach all areas of your mouth easily. There are many different types of toothbrushes available. Your dentist and pharmacist can help you select the best toothbrush for your use.
Clean between your teeth every day with floss or other between-the-teeth cleaners.
Use toothpastes and mouthwashes that contain fluoride. Fluoride has been proven to prevent cavities. Children less than 8 years old should not swallow because too much fluoride can damage the clear protective surface of their teeth.
Eat a diet balanced in fruits, vegetables, meats, dairy and breads.
Try to limit snacking between meals.
Chew gums that contain xylitol. Xylitol is a sweetener that has been found to kill bacteria that decay teeth.
Avoid cigarette smoking.
Visit your dentist every six months or whenever recommended by your dentist, for checkups and professional cleaning.

Because certain medicines have side effects that can lead to gum disease, it is important to know if the medicine that you are taking is one of them. Your pharmacist can help you identify these medicines. Your pharmacist can also help you select the best dental product for you from the pharmacy. So, to protect yourself, the next time you go to the pharmacy:

Ask your pharmacist if any of the medicines that you are taking can cause dry mouth.
If you need to be on medicine that causes dry mouth, ask your pharmacist for over-the-counter products to help treat your dry mouth.
Ask your pharmacist if you have any questions about selecting toothbrushes, toothpastes, or mouthwashes that are best for you.

If you think you might have gum disease, it is important that you set up an appointment with your dentist as soon as possible. Before you go in for a dental procedure, you should know that certain dental procedures could cause infections. Protect yourself by letting your dentist know the following information:

Tell your dentist if you have a heart condition or any medical condition. Certain illnesses increase your chance of getting an infection from dental procedures.
Tell your dentist if there are certain antibiotics that you can't take because your dentist may have you take antibiotics.
Tell your dentist all the medicines that you are taking. This will help your dentist decide which dental procedures you may need.

The Bottom Line ...
Research is ongoing to determine the link between gum disease and heart disease. But regardless of what some current studies conclude and even what future studies may conclude, we still need to save our teeth. Isn't the agony and pain of tooth decay and being toothless enough of a motivation for us to simply brush and floss regularly? It would just be a bonus if we can floss away heart disease.

Protect yourself! Be aware that gum disease may increase your chance of getting heart disease. Learn the early signs of gum disease and how to prevent it. Help your dentist and pharmacist help you by asking them the right questions and giving them the right information.