Taking Oral Health to Heart

Dennis M. Abbott, D.D.S.

Dental Oncology Professionals of North Texas

February is Heart Health Awareness month.  February is also Dental Awareness month.  Coincidence?  I think not...and here’s why...

Several studies over the years have researched the correlation between oral health and heart health.  While some studies have shown that people with poor oral health have more heart attacks, we cannot be sure if this is due to a direct link between oral health and heart health or if people who take care of their teeth also tend to be more heart healthy.  Regardless, there is one underlying factor that is common to oral health and heart health and show how both may be knitted together.  That commonality is inflammation.

Inflammation is complex immune system response to infection or irritation, and although an infection may cause inflammation, inflammation itself is not necessarily indicative that an infection is present.  While acute inflammation is a normal part of the healing process and is relatively short-lived; long-term inflammation - or chronic inflammation - can result when the irritant can not be readily eliminated and the inflammatory response persists over several months or even years.  Chronic inflammation is mediated by chemical messengers in the body (known as cytokines and growth factors), enzymes that break chemical bonds, and chemically reactive molecules known as reactive oxygen species.  The outcome of this type of long-term inflammation is the destruction of tissue, thickening of connective tissue, and cellular or tissue death.  Chronic inflammation can eventually lead to several diseases and conditions, among them periodontitis (gum disease), atherosclerosis (narrowing and hardening of the arteries), and inflammatory heart disease.  Thus, while it is still unclear if gum disease and poor oral health is contributory to heart disease, the underlying cause is shared and many researchers and practitioners believe the two diseases might still somehow be related.

Other oral health situations have been definitively connected to heart health.  A dental abscess is an infection in response to a bacterial infection.  Most often, the abscess is  associated with a particular tooth and brought about by severe tooth decay or gum disease.  When pus accumulates in response to the bacterial infection, it can collect in the bone and tissue around the tooth and give rise to a boil-type lesion known as a dental abscess.  If left untreated, particularly in the lower jaw, the infection can spread down the neck (Ludwig’s angina) and lead to endocarditis (inflammation of the lining of the heart chambers and values).  In some patients, such as those with a history of rheumatic fever, artificial joints, or immunosuppression, the risk of pericarditis (inflammation of the sac around the heart) is increased.  These patients often take antibiotics before any dental procedure that might introduce bacteria into the bloodstream.

When we were kids, we learned a song that said, “the head bone’s connected to the neck bone.”  Now, as adults, we understand that  bones aren’t the only things in our bodies that share a connection.  Although we have a physician for the heart and a dentist for the mouth, we must understand that heart health and oral health together contribute to our overall health, and neither is mutually exclusive.  And so, from the dental community and the heart community...Happy February!

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This blog was originally written for My Heart Your Hands, a non-profit organization dedicated to raising awareness regarding the potential late effects of cancer among cancer survivors, healthcare providers, and the general population.

Dennis M. Abbott, D.D.S. is the founder and CEO of Dental Oncology Professionals of North Texas, an oral medicine practice dedicated to meeting the unique oral health care needs of individuals battling cancer.  Dental Oncology blog is a service of Dental Oncology Professionals of North Texas and Dr. Abbott.

Dental Oncology Professionals is proud to team up My Heart Your Hands to spread the word about the importance of oral health and how it relates to heart health.