For many years, the connection between gum disease and heart disease has been investigated. Research has suggested that people with poor oral health such as those with gum disease are at risk of developing valve or coronary heart disease or making their cardiovascular condition worse.

What is gum disease?

With gum disease (also referred to as periodontal disease), up to 100 million bacteria can live on a single tooth. It can cause gaps to form next to teeth which allow bacteria to easily enter the bloodstream.

Gum disease is known as gingivitis in its early stage. This is an inflammation of the gums, or gingival, the part of the gum around the teeth. The inflamed gum is a result of bacteria that builds up in the mouth due to consistent poor oral health hygiene. Although the gums are irritated, the teeth are left intact in their sockets, and no irreversible bone or tissue damage occurs at this stage.

However, when left untreated, gingivitis causes red, swollen gums that bleed while brushing and flossing, and can eventually develop into gum disease. Even in the early stages of gum disease, bleeding gums can allow an open doorway that allows harmful bacteria to enter your bloodstream.

Bacteria that has been allowed to accumulate on the teeth and gums results in the inner layer of the gum and bone pulling away from the teeth to form pockets. Over time, these pockets will become deeper, fill with more bacteria, and more gum tissue and bones will be destroyed. When this happens, the teeth are not held in place, meaning they become loose and tooth loss occurs.

Symptoms of gum disease

• Bad breath that won’t go away
• Bleeding gums, especially when brushing or flossing
• Painful chewing
• Swollen or red gums
• Loose teeth
• Pus between teeth and gum
• Noticeable changes in the way teeth fit together when you bite
• New spaces developing between teeth
• Receding teeth that make teeth look longer than normal

What causes gum disease?

Our mouths are full of bacteria – gum disease occurs when bacteria in the mouth infects the tissue around the teeth over time. This bacteria allows plaque, a sticky, colorless film, to form on the teeth and cause inflammation of the surrounding gum tissues. Plaque is formed when starchy and sugary food interacts with the bacteria within our mouths. As they reform quickly, plaques are required to be removed daily through good brushing and flossing habits. When not removed adequately, plaque can harden into calculus or tartar at the base of the teeth or near the gums, which all contribute to the development of gingivitis.

Certain factors exist that can increase your chances of developing gum disease:

• Poor oral hygiene
• Tobacco chewing or smoking
• Obesity
• Poor nutrition, including having a vitamin C deficiency
• An underlying medical condition such as diabetes
• An underlying medical condition that decreases or compromises your immunity
• Dry mouth
• Genetics
• Substance abuse
• Certain medications such as oral contraceptives, steroids, channel blockers, and chemotherapy
• Hormonal changes, including those related to pregnancy or a person’s menstrual cycle
• Age

How is gum disease related to heart disease?

Our gums have plenty of blood vessels and have high blood supply, which makes gums perfect channels for the bacteria to enter into the blood.

Researchers have found such bacteria in arteries and valves in the heart and can cause inflammation, which is a natural response to infection. When this goes on for too long, this can lead to the build-up of fatty deposits and the formation of blood clots that can block your arteries and even trigger a heart attack.

Inflammation in the body, particularly long-lasting inflammation, can have severe consequences, including the narrowing of major blood arteries and the development of a condition known as atherosclerosis. This condition can ultimately lead to a heart attack. Inflamed and swollen gums can be particularly problematic, as they tend to break down easily. This breakdown opens the door for bacteria residing in the gums to access the bloodstream. Over time, these bacteria accumulate within the heart’s valves, resulting in an inflammatory heart disease called bacterial endocarditis, which can also contribute to heart attacks.

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Fatty deposits can also build up in the carotid arteries within your neck. In serious cases, if these fatty deposits break apart and are carried away in the bloodstream, they can lodge in the brain, block a blood vessel, and cause a stroke.

Additionally, some studies have shown that when plaque bacteria enter the bloodstream through infected gums, a condition called infective endocarditic can occur. This is a potentially fatal bacterial infection that inflames the sac around the heart, the valves of the heart, and the heart muscle itself. Those with a heart valve problem are at a higher risk of developing endocarditic.

With this all being said, there is not yet a direct proven link between gum disease and heart disease. This is because many people with heart disease have healthy gums, and not every person who has gum disease develops cardiovascular problems. While there is still a growing debate that gum disease is a singular risk factor for heart disease, there are also many other risk factors to take into account. You may be more at risk of developing heart disease because of:

• Smoking
• Substance abuse
• Lifestyle
• Diet
• Obesity
• Uncontrolled diabetes
• High blood pressure
• High blood cholesterol levels
• Age

How do I prevent gum disease?

In the UK, more than 45% of adults suffer from gum disease. Keeping good oral health on a daily basis is vital for your overall health as well as your oral health. Remember to brush your teeth for two minutes twice a day with fluoride toothpaste, floss daily, and make regular appointments with your dentist.

If you see blood on your toothbrush, or your gums are bleeding after you brush, you may have gum disease. In this case, ensure to see your dentist as soon as possible to identify any issues and treat them promptly. In making a diagnosis, your dentist will review your medical history to identify any factors that may be contributing to your symptoms, such as smoking and taking certain medications.

Remember, gum disease can be successfully reversed if diagnosis is made early and treatment is prompt and proper.