Open wide. Studies show dental hygiene reduces heart disease.
Seventy percent of the U.S. population have bleeding gums, according to the American Dental Association. In addition, cardiovascular disease is the leading killer of men and women in the U.S. contributing to 2,400 deaths per day.
Research suggests managing periodontal disease may reduce the risk for cardiovascular disease.
“Over my 26 years as a practicing registered dental hygienist, many of my patients have the belief that bleeding during flossing or brushing is acceptable,” says Tammy P. Evans, RDH, Kingsgate Dental Clinic, Kirkland, Washington. “The patient’s explanation is, they always bleed when they floss. Most people would be running to their physician if they experienced bleeding while rubbing their eye or touching their skin.”
Control starts in the dental chair. Dentists are providing additional testing on all periodontal and gingivitis patients. The test is a simple pin prick done right at the dental office and could save a life. It tests C-Reactive protein (CRP) and HbA1c (blood sugar). In definition, C-Reactive protein (CRP) is a major heart marker developed by the liver in response to inflammation in the mouth and is an accurate indicator of heart attack or stroke, in fact, more accurate than high cholesterol, according to the New England Journal of Medicine.
Studies done as early as 2003 showed a simple dental cleaning to remove tartar might reduce inflammation and at the same time reduce the thickness in the lining of the carotid artery.
Evans describes bleeding gums as a sign of active disease, the same as having an infected open wound. “The infection in a patient’s mouth triggers toxins that are released and circulate in the body,” she says. “The emphasis is that the infection must be treated immediately as well as preventing future re-infections.”
According to RDH, Pennwell Dental Group, inflammation is the culprit in many diseases including heart disease, stroke and periodontal disease. The research shows a link to the major inflammatory marker, called C-Reactive protein, and bleeding gums and heart disease.
Loma Linda research shows a dramatic decrease in gingivitis with natural anti-inflammatory therapies when combined with traditional dental treatment. Research found that reducing inflammation in the mouth reduced inflammation throughout the body. Simply by treating periodontal disease and gingivitis by traditional methods, results in C-Reactive protein levels decreased by 25 percent.
This is good news for patients because typical treatment of heart disease done with statin drugs can have side effects. Statin drug treatment alone only reduced C-Reactive protein by about 30 percent. However, incorporating natural anti-inflammatory with treatment indicated C-Reactive protein levels could be reduced a whopping 50 to 90 percent within weeks.
According to RDH, Pennwell Dental Group there are three current studies that offer strong evidence about the impact of periodontal infection on the human body. These studies are from the Journal of Clinical Periodontology.
According to the Journal (Aug. 2003) researchers found that CRP values significantly decreased after periodontal treatment, meaning since the treament of periodonititis appears to be effective in reducing CRP levels, patients at risk for coronary heart disease may want to control their periodonititis.
In a second study, according to the Journal (Dec. 2003) Japanese researchers took a sampling of 7,452 men and women and examined and measured their oral health by testing their blood for 37 different items used in general blood tests. Items tested included cholesterol, C-reactive protein and diabetes. The results were then compared to the oral-health scores of the participants.
In another study, 411 of 1268 participants were selected from the prospective Inflammation and Carotid Artery Risk for Atheroslerosis Study. Dental and periodontal status and oral hygiene were evaluated at baseline measuring three World Health Organization-validated indices. The 7.5 month study was to identify patients with progressive carotid stenosis, a narrowing or constriction of the inner surface of the carotid artery, usually caused by atherosclerosis.
The results were that atherosclerosis progression was observed in 48 of the 411 or one-eighth of the patients finding significant predictors of disease progression. The conclusion of this study was that dental status,oral hygiene and particularly tooth loss are associated with the degree of carotid stenosis and predict future progression of the disease.
Parade Magazine (March 2009) in an article titled “How your gums affect your heart”, cited a recent report in the Journal of Clinical Periodontology revealing an astounding correlation: The more severe the gum disease, the thicker and harder the walls of the arteries.
In simpler terms, if blood was healthy, the oral health was healthy. If blood test detected certain “red flags” the person also had serious symptoms of periodontal diseases.
So what can be done?
The course of action is simple, start cleaning in between the teeth. Flossing is an essential part of dental care because periodontal disease and dental diseases begin between the teeth.
The reality is the number who floss daily is low. Studies reveal between five and 35 percent reported flossing when asked with accuracy depending on honesty.
Evans says, “The human mouth is a perfect incubator for bacterial growth which requires meticulous oral hygiene. Our mouth demands ongoing maintenance using simple effective brushing and cleaning between all our teeth every 24 hours with floss or dental picks. It is that simple.”
“I do see the future,” Evans continued, ”when nurses and physicians will be asking their patients during physical examinations, ‘when was the last time you had a professional dental hygiene examination and cleaning?’”
Managing heart health may reduce periodontal disease and vice versa and cooperation between cardiology and periodontal communities is an important first step in helping patients reduce their risk of these associated diseases.