Does having bad gums affect my heart?
There is a plausible association between severe gum disease and heart problems, but no proven causal relationship. Good oral care is sensible, but whether treating gum disease lowers your cardiac risk has not yet been demonstrated.
Poor gum health is associated with an increased risk of cardiovascular disease, but whether one causes the other has not yet been proven. Multiple systematic reviews and a meta-analysis point to a link between severe gum inflammation (periodontitis) and a range of cardiovascular conditions, including coronary artery disease, strokes and heart failure. These are consistently associations, not an established causal chain.
How large is that association in practice? A large cohort study (more than 8,000 participants, followed over several years) put the risk of coronary artery disease in people with periodontitis at a hazard ratio of 1.14, and at 1.05 for milder gum inflammation. Neither was statistically significant after correction for known risk factors such as smoking and high blood pressure. In other words, that study was unable to demonstrate an independently elevated risk.
Other studies found larger associations. A small study of 103 cardiac patients found that a specific form of tooth root inflammation was associated with an almost three times higher likelihood of coronary artery disease. A Finnish cohort study found that bacterial substances from gum pockets that enter the bloodstream were independently associated with a doubled risk of stable coronary artery disease. These studies are, however, too small and too observational to draw firm conclusions from.
There are plausible biological mechanisms. Bacteria from the gums can enter the bloodstream and trigger a body-wide inflammatory response. Certain inflammatory substances that are elevated in saliva during periodontitis are also elevated in cardiovascular disease. This suggests shared biological processes, but does not yet prove cause and effect. Whether treating periodontitis reduces cardiac risk has not been demonstrated through intervention research.
The cautious practical lesson: taking good care of your gums has its own benefits regardless, and a link with cardiovascular disease is plausible enough to take seriously. If you already have known cardiac risk factors, regular gum check-ups are an additional reason not to neglect your oral care.
Based on one meta-analysis/review combination (PMID 29903685), four individual reviews (PMID 12694425, 14621450, 16298220, 29972696) and three studies not further indexed (PMID 10989403, 24461397, 28556187). All associations are observational; intervention research is lacking.
What is the link between gum disease and heart disease?
The link between gum disease and heart disease has been found consistently across dozens of studies, but whether it is truly causal has not yet been established. Even so, good oral care is worthwhile in its own right, regardless of the question about the heart.
Is a high homocysteine level bad for my heart?
Elevated homocysteine is associated with a higher risk of cardiovascular disease, but whether you can reduce that risk by lowering homocysteine with folic acid has not been proven on the basis of these studies. Have an elevated value discussed with your general practitioner.
How harmful is prolonged stress really for my heart?
Long-term stress measurably increases your risk of cardiovascular disease, particularly through work-related stress (10-40% extra risk in large population studies). The effect is real, but smaller than that of smoking or high blood pressure.
Is the Mediterranean diet really good for your heart, and why?
For people with an elevated cardiovascular risk, the Mediterranean diet is the best-supported dietary choice currently available. Both large trials and dozens of population studies confirm a lower risk of heart attack and stroke.
Is a calcium score of my heart worth doing?
For people aged 40 to 75 in a grey zone regarding statins, a calcium score is a well-supported tool for making a considered decision about medication together with your doctor.
Is coffee good or bad for your heart?
For most healthy adults, three to four filtered cups per day are associated with a beneficial effect on the heart and blood vessels. Pregnant women are an important exception: for them, the maximum is one to two cups per day.