Periodontal disease, heart disease and stroke may seem unlikely bedfellows, but researchers have found that gum disease sufferers are nearly twice as likely to suffer from coronary heart disease.  In addition, oral infection is a risk factor for stroke.  People diagnosed with acute cerebrovascular ischemia were more likely to also experience some degree of periodontal disease.

Periodontal disease is a progressive condition in which the gums surrounding the teeth are infected by bacteria.  The bacteria found in plaque colonize first above, then below the gumline, causing the tissue to pull away from the teeth.  If periodontal disease is left untreated, deep pockets form between the gums and the teeth and the underlying jawbone is destroyed.  The destruction of bone tissue causes the teeth to shift, wobble or even become loose. 

Coronary artery disease occurs when the walls of the coronary arteries become progressively thicker due to the buildup of fatty proteins.  The heart then suffers from a lack of oxygen and must labor significantly harder to pump blood to the rest of the body.  Coronary artery disease sufferers sometimes experience blood clots which obstruct normal blood flow and reduce the amount of vital nutrients and oxygen the heart needs to function properly.  This phenomenon often leads to heart attacks.

Reasons for the Connection

There is little doubt that the presence of periodontal disease can exacerbate existing heart conditions.  The periodontist and cardiologist generally work as a team to treat individuals experiencing both conditions.

There are several theories which may explain the link between heart disease, stroke and periodontal disease,  including the following:

• Oral bacteria affect the heart – There are many different strains of periodontal bacteria.  Researchers assert that some of these strains of bacteria enter the bloodstream and attach to the fatty plaques in the heart blood vessels (coronary arteries).  This attachment  contributes to clot formation, causing grave danger to the individual.
  
  
• Inflammation – Periodontal disease causes severe inflammation in the gums,  elevating the white blood cell count and high sensitivity C-reactive protein levels.  Research has demonstrated a link between elevated levels of C-reactive proteins and heart disease. 
  
  
• Increased susceptibility to infection – Individuals who experience particularly high levels of oral bacteria may have weaker immune systems and an inadequate host inflammatory response.  These factors may induce specific vascular effects which have been shown to contribute to the onset of certain forms of heart disease.

Diagnosis and Treatment

Since periodontal disease appears to be a risk factor for both heart attack and stroke, it is extremely important to seek immediate treatment.  Initially, the periodontist will conduct a thorough examination of the  teeth, gums and jawbone.  X-rays can be helpful in determining the extent of bone loss in the jaws.  

The periodontist is able to conduct deep cleaning treatments such as scaling and root planing to remove hardened calculus (tartar) deposits from the gum pockets.  Antibiotics may be used topically or systemically to aid in the treatment of the infection and minimize the risk of further spread. 

 If you have  questions about periodontal disease and its relation to heart disease and stroke, please ask your periodontist.