Real Connection Between Oral Health And Heart Disease

January 22, 1999

ANAHEIM, Calif.-- Reports over the past five years have suggested a link between periodontal (gum) disease and cardiovascular disease. But so far, no clear cause-and-effect relationship has been found. In a presentation at the annual meeting of the American Association for the Advancement of Science, University of Michigan dentistry Prof. Walter Loesche suggested several possibilities. Loesche spoke during a symposium titled "The Link Between Systemic Conditions and Diseases and Oral Health."

Because evidence of the link has come to light only recently, few studies have looked directly at the mechanisms by which periodontal disease might contribute to cardiovascular disease. But by reviewing the literature on both types of disease, Loesche has found intriguing connections that suggest possible mechanisms:

Blood vessels damaged by periodontal bacteria or their products. One possibility is that bacteria from the mouth -- or products released by these bacteria -- travel through the bloodstream to other parts of the body, where they damage the linings of blood vessels. In his own research, Loesche has found that patients with coronary artery disease have elevated levels of certain periodontal bacteria. These bacteria contain lipopolysaccharides, toxins that can cause illness when released into the body.

Other lines of research suggest that lipopolysaccharides may damage the cells that line blood vessels, as measured by the release of a substance called von Willebrand factor. Researchers have found that levels of von Willebrand factor are elevated in people with periodontal disease. This observation suggests that lipopolysaccharides produced by periodontal bacteria might travel through the bloodstream to blood vessel walls, where they cause damage.

A similar relationship appears to exist with a group of proteins called acute phase response proteins. Levels of these proteins increase in the bloodstream in response to chronic infection, injuries, or other physical trauma. Researchers at Harvard University have found that one of these proteins, C-reactive protein, is a good predictor of second heart attacks in cardiovascular patients. Interestingly, other studies show that patients with periodontal disease have increased levels of C-reactive protein, and that the levels drop when the periodontal disease is treated.

Researchers also have started looking for evidence of oral bacteria themselves in blood vessel linings. Using DNA probes, researchers at the State University of New York, Buffalo, have indeed found DNA from three and possibly four types of periodontal bacteria in the vessel walls. University of Michigan researchers are also finding the DNA of periodontal bacteria in atheromas (fatty deposits on blood vessel linings that are a hallmark of cardiovascular disease).

Inflammatory responses involving cytokines. When gum tissue becomes inflamed, white blood cells in the tissue respond by producing cytokines, (small, protein-like signaling molecules). If the cytokines leak into the bloodstream, they too might alter blood vessel linings in ways that make it easier for a type of white blood cell, called a monocyte, to attach to and penetrate vessel walls, said Loesche. This is the first step in the process by which fatty deposits accumulate on blood vessel walls.

Smoking. Smoking is a risk factor for both heart disease and periodontal disease, and it could serve as a link between the two, Loesche speculates. By increasing the disease-causing bacteria in the mouth, smoking may increase the odds that these bacteria or their products will get into the bloodstream. Smoking also makes blood vessel linings stickier, which might make it easier for bacteria and bacterial products to attach to vessel walls and cause damage.

Much more research is needed before researchers will know exactly how periodontal disease and cardiovascular disease are related. But what's exciting, said Loesche, is that periodontal disease is both preventable and treatable. That could mean that preventing stroke and heart attack will someday be as simple as practicing good oral hygiene and treating gum infections promptly.

University of Michigan

Related Heart Disease Articles from Brightsurf:

Cellular pathway of genetic heart disease similar to neurodegenerative disease
Research on a genetic heart disease has uncovered a new and unexpected mechanism for heart failure.

Mechanism linking gum disease to heart disease, other inflammatory conditions discovered
The link between periodontal (gum) disease and other inflammatory conditions such as heart disease and diabetes has long been established, but the mechanism behind that association has, until now, remained a mystery.

New 'atlas' of human heart cells first step toward precision treatments for heart disease
Scientists have for the first time documented all of the different cell types and genes expressed in the healthy human heart, in research published in the journal Nature.

With a heavy heart: How men and women develop heart disease differently
A new study by researchers from McGill University has uncovered that minerals causing aortic heart valve blockage in men and women are different, a discovery that could change how heart disease is diagnosed and treated.

Heart-healthy diets are naturally low in dietary cholesterol and can help to reduce the risk of heart disease and stroke
Eating a heart-healthy dietary pattern rich in vegetables, fruits, whole grains, low-fat dairy products, poultry, fish, legumes, vegetable oils and nuts, which is also limits salt, red and processed meats, refined-carbohydrates and added sugars, is relatively low in dietary cholesterol and supports healthy levels of artery-clogging LDL cholesterol.

Pacemakers can improve heart function in patients with chemotherapy-induced heart disease
Research has shown that treating chemotherapy-induced cardiomyopathy with commercially available cardiac resynchronization therapy (CRT) delivered through a surgically implanted defibrillator or pacemaker can significantly improve patient outcomes.

Arsenic in drinking water may change heart structure raising risk of heart disease
Drinking water that is contaminated with arsenic may lead to thickening of the heart's main pumping chamber in young adults, according to a new study by researchers at Columbia University Mailman School of Public Health.

New health calculator can help predict heart disease risk, estimate heart age
A new online health calculator can help people determine their risk of heart disease, as well as their heart age, accounting for sociodemographic factors such as ethnicity, sense of belonging and education, as well as health status and lifestyle behaviors.

Wide variation in rate of death between VA hospitals for patients with heart disease, heart failure
Death rates for veterans with ischemic heart disease and chronic heart failure varied widely across the Veterans Affairs (VA) health care system from 2010 to 2014, which could suggest differences in the quality of cardiovascular health care provided by VA medical centers.

Heart failure: The Alzheimer's disease of the heart?
Similar to how protein clumps build up in the brain in people with some neurodegenerative diseases such as Alzheimer's and Parkinson's diseases, protein clumps appear to accumulate in the diseased hearts of mice and people with heart failure, according to a team led by Johns Hopkins University researchers.

Read More: Heart Disease News and Heart Disease Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to