It is about time we revisited a very popular theory from the late 1970s and early 1980s regarding the association between oral health and cardiovascular disease risk. But why now? We have just emerged from an unprecedented time where a virus held the entire world to ransom. While Covid-19 was a communicable disease, there are quite a few non-communicable diseases that are equally potent, and cardio vascular disease tops that chart. Apart from poor lifestyle choices, obesity, uncontrolled diabetes, and high cholesterol, poor oral hygiene can also impact the healthy functioning of the heart.
The oral cavity has more than 700 oral microbes. While some of them are beneficial bacteria, most other organisms are not, and when the equilibrium/balance between the good and bad microorganisms is lost, it manifests as infections in the oral cavity.
According to a recent 2021 review article in the American Journal of Preventive Cardiology, it is reported that periodontal diseases affect 47% of adults aged 30 years and older, and the infection rate only increases with age, accounting for nearly 70% of adults ages 65 and above. Patients with additional risk factors such as diabetes, obesity, and smoking are particularly prone to increased periodontal disease and Atherosclerotic Cardiovascular Diseases (ASCVD).
Periodontal disease has been estimated to have a 3.5-fold increased risk of ASVCD and a 24–35% increased risk of acute coronary heart disease events. The hypothesis of oral infection transmitting to the heart is not limited to periodontal diseases alone. It was previously thought that dental infection from infected teeth and gums could travel through the blood and become lodged in the heart valves, causing rheumatic heart disease. The practice of antibiotic prophylaxis for a dental procedure is still practised for high-risk patients. A comparison of the oral microbiome in patients with coronary artery disease (CAD) and the dental microbiome shows a similarity in the composition of the oral microbiota.
A meta-analysis of prospective and retrospective follow-up studies has also shown that periodontal disease may increase the risk of CVD by approximately 20%. So there is enough scientific evidence to show that oral health is very vital in the prevention of cardiovascular disease risks.
The only concern here is how willing we are to accept this and take adequate measures. In an effort to keep our hearts healthy, one can exercise more, reduce fat, eat less oily food, more vegetables, etc., but if the infection is already residing within the oral cavity, what good are all these measures? Heart health requires comprehensive care, including adequate attention to oral health care. Some of the preventive measures that one could take to avoid a potential impact on heart health are
As we get older, brushing our teeth twice a day is no longer enough. Additional measures such as flossing, using interdental brushes, and using water picks can provide better care.
Don’t ignore dental pain and sensitivities. Most often, these are early signs of infection, and if managed early enough, the oral structure can be preserved.
Avoid refined foods and fizzy beverages, which can weaken the structure of your teeth.
Encourage and consume a wide range of raw fruits and vegetables.
Schedule a routine checkup with your dentist every 3 to 6 months for a thorough evaluation and cleaning.
(The writer is a consultant- craniomaxillo facial surgery at a Bengaluru-based hospital.)
