In a study of more than 60,000 dental patients, those with gum
disease were twice as likely to have had a heart attack, stroke or
severe chest pain.
Previous studies have linked periodontitis and clogged arteries, but
this is the first to investigate the link in a group of people this
large, the researchers say.
At the Academic Centre for Dentistry Amsterdam, the largest dental
school in the Netherlands, investigators reviewed the medical
records of 60,174 patients age 35 and older, looking for an
association between periodontal gum disease and atherosclerotic
cardiovascular diseases such as angina, heart attack and stroke.
About 4 percent of patients with periodontitis had atherosclerotic
cardiovascular disease, compared to 2 percent without periodontitis,
the researchers found.
Even after taking other risk factors for cardiovascular disease into
account, such as high blood pressure, high cholesterol, diabetes,
and smoking, those with periodontal disease were still 59 percent
more likely to have a history of heart problems, according to a
report in the Journal of Epidemiology and Community Health.
In periodontal disease, the advanced stage of the gum disease
gingivitis, the gums pull away from the teeth and create pockets
that can become infected. Periodontitis has also been tied to other
conditions such as skin disease and dementia.
“It’s clear that periodontitis is associated with chronic
inflammation, so it makes sense biologically that if you have a
heavy infection in your mouth, you also have a level of inflammation
that will contribute to heart conditions,” said Panos Papapanou of
Columbia University in New York, who has studied the association
between gum disease and heart disease but wasn’t involved in the
The research team suggests that gum disease develops first and may
promote heart disease through chronic infection and bacteria in the
Dr. Bruno Loos, the senior author of the new report, said by email
that “plausible mechanisms to explain the relationship” may include
a common genetic background for the way the body handles
inflammation, oral bacteria and immune responses.
Still, this kind of observational study can’t prove that gum disease
causes heart problems.
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“The association … does not provide proof (of causation), even when
the results from our study corroborate findings from previous
similar research,” study coauthor Geert van der Heijden said by
Papapanou told Reuters Health that while the new findings are from
patients with a relatively high socioeconomic status, “we’re
repeatedly seeing the same conclusion.”
“It seems all over the globe we have to consider this relationship,”
In the U.S., heart disease is the leading cause of death, according
to the Centers for Disease Control and Prevention. Each year, more
than 600,000 people die from heart disease, which accounts for one
in four deaths.
Dr. Frank Scannapieco, chairman of the Department of Oral Biology at
the University at Buffalo in New York, who wasn’t involved with the
study, commented to Reuters Health that while the association of
periodontitis and coronary disease is “robust,” the strength of the
link is “moderate compared to traditional risk factors such as
Papapanou advises: “Take care of your oral health for oral health
itself. If you know there’s a positive association between oral
health and other diseases, would you ignore it? I wouldn’t.”
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