How Oral Health and Your Heart are Connected

Everyday, we learn more about how things are connected. One of those critical connections is oral health and your heart. So many aspects of our lives and our bodies have a cyclical nature and if you look closely, you can follow the threads to find viable ways to keep yourself living longer and stronger into oldest age.

With the worldwide threat of cardiovascular disease – the number one killer that claims more than 17 million annually – we’re constantly searching for the connections between the disease and the foods we eat, how we sleep, the stress we're under, and our genetic predispositions.¹

The R​ole of Plaque in More than Your Smile

The type of fillings you have in your mouth are only one consideration involving oral health and your heart.

The type of fillings you have in your mouth are only one consideration involving oral health and your heart.

Endocarditis is a serious infection involving the lining of your heart (endocardium), heart valves, and blood vessels. It results in severe inflammation. It is caused by germs and bacteria from around the body that travel through your blood and lodge in your heart.²

Experts estimate that many of the 15,000 cases of endocarditis that occur annually are due to naturally occurring bacteria on your teeth dislodging. These plaques can be knocked loose during a dental procedure, brushing or flossing, or even chewing your food.³

In the mouth, they’re harmless for the most part. However, when they break free and end up in or around your heart, they present a very different set of problems. Attaching to damaged cells, they begin to multiply in an ideal environment.⁴ The bacteria form large colonies that result in infection, inflammation, and further damage.⁵

What has scientists baffled is why your body's immune response doesn't destroy the bacteria before they take root and colonize. They theorize that your immune system becomes tolerant of the infectious cells in your mouth. Studies continue to determine the process of the infection.⁶

The plaque that forms on your teeth is the same type of plaque that builds up in your cardiovascular system. One incredible example of this was exhibited during one research study where rabbits were injected with dental plaque. Within minutes, the rabbits began to present with blood clots. The case was discussed at the American Association for the Advancement of Science annual meeting.⁷

Simply put, the plaque on your teeth sloughs off and travels your bloodstream where it adheres to the arterial walls of your heart and other organs.

Scientists around the globe agree that there is a definite link between periodontal diseases and cardiovascular health. There are ways to protect yourself against the potentially harmful effects of periodontal bacteria.

7 Basic Oral Hygiene Tips

1. Brush your teeth twice every day and do it properly. Making small circles, brush for at least three minutes. Brushing before bed is especially important. Bacteria grow faster while you’re sleeping (your mouth is still) than any other time.
2. Use a soft-bristled brush. A firm toothbrush isn’t going to remove more bacteria and it can cause damage to your gums and enamel. You put small “nicks” in the surface of your teeth, providing the perfect “homes” for bacteria.
3. Replace your toothbrush three times every year. Let’s focus on bristles that wear down and no longer do their job. Focusing on the bacteria that grows on your toothbrush while it sits innocently in your bathroom is going to make both of us unhappy. Just...yuck. Toothbrushes aren’t expensive and they come in 10-packs so stock up.
4. Do not (EVER) share your toothbrush. I realized this is actually a thing people do while I was researching this report and almost fell out of my chair. No. No. No. That I even need to mention this is insane. Share a toothbrush, share all the bacteria. Gross.
5. Brush your tongue. Back when I was in elementary school, they told us to do this and I’ve always done it (along with the roof of my mouth and the inside of my cheeks). As a grownup, I discovered the level of bacteria that hang out on the bumpy surface and was so grateful for the habit.
6. Just floss already. It isn’t the nightmare people make it out to be! There are all kinds of products that make it super convenient now. I used to hate the string, too! Gross and never felt very effective (even though it was). Dental floss holders, picks, and other flossing tools get between teeth to remove plaque and bacteria that a brush can’t reach.
7. Drink more water! One of the best things you can do for your oral health and your heart, and to boost your entire body is hydrating properly. It feeds your cells, helps you process foods and nutrients more efficiently, and flushes nasty bacteria (including the ones in your mouth) from your body.

Existing Heart Disease and Dental Care

If you already have heart disease, talk to your cardiologist before undergoing any dental procedures. They may recommend you delay a treatment.

It’s also imperative that you discuss your current level of health with your dental professional. They need to be aware of your condition and informed of any medications you’re currently taking. Here are a few of the points that could make dental procedures risky for heart patients.

• Anesthesia Usage: Epinephrine (found in many anesthetics) may have an adverse effect on patients with heart conditions that include arrhythmia (rapid heartbeat), pain, high blood pressure, and increased risk of heart attack.
• Excessive Bleeding: Blood thinners are sometimes prescribed to patients recovering from a heart event. This could cause excessive bleeding during certain procedures in the dental office.
• Anticipatory Antibiotics: Patients with certain heart conditions may be required to take an oral antibiotic before you have a dental procedure to lower the risk of infection that leads to inflammation and an increased risk of a heart event.
• Calcium Channel Blockers: Prescribed for angina (chest pains) this pharmaceutical drug can cause overgrowth of the gums. A dentist or oral surgeon may need to perform surgery in order to fix the issue so they should have nitroglycerine and oxygen on hand in case there is a medical emergency.
• Unstable Angina: Patients with controlled angina should be able to undergo any dental procedure in a standard office. Patients with unstable angina, however, should only have major dental surgeries or procedures done in a hospital or in an office capable of monitoring cardiac activity during the treatment.

Maintaining good oral health is important to protect yourself from cavities, gum disease, tooth decay, and now potential cardiac issues.

It can be achieved by more than just brushing and flossing. Changes in your diet and consuming the proper foods at the proper times can assist in keeping your mouth healthy.

For a Healthy Mouth, Avoid These Foods!

There are foods that play a key role in keeping a healthy smile. Dentists are breaking the stereotype that it's just sugar and candy that's bad.⁸ Some of these foods are even touted as health food or certainly healthier options. These may surprise you.

• Dried Fruit: Eat fresh or frozen fruit. The more “processing” done to fruit, the less it’s a fruit and more it becomes a candy. Dried fruit is nothing more than concentrated fruit sugar and should be saved for a treat (because it isn’t a “health” food). They cling to teeth like sticky caramel and trap cavity causing bacteria against your teeth and gums.
• Garbage Beverages: You’re not going to drink water (or green tea) all the time but the trend in energy drinks, sport drinks, and “vitamin” waters is frightening. Energy drinks have been linked to an increased risk of a heart event and all of them are filled with sugar or artificial sweeteners. They are also acidic and wear away the enamel on your pearly whites. As for soda, you already know how corrosive, filled with chemicals, and all-around awful for you they are (yes, even the “diet” or “clear” ones). They offer nothing and sap your body of necessary nutrition.
• Simple Starches: This includes foods like crackers, pretzels, candies, baked goods, and potato chips. They convert almost instantly to sugar and stick to the tiny spaces between your teeth. The stickiness of them helps them accumulate throughout the day which leads to rampant bacterial growth and bad breath. For a Healthy Mouth, Pick These Instead!

There are food choices you can make that are good for oral health and your heart health. They help neutralize the acids from other foods you eat, stimulate saliva production, and provide the necessary vitamins and minerals to assist in repairing tooth enamel. You may be surprised at the last one.⁹

1. Cheese: This food is a saliva generator which helps rinse bacteria from teeth. Cheese also contains calcium and phosphates that help neutralize acids. The casein in cheese helps fortify teeth and it’s a good idea to eat a small piece of cheese following a meal to prevent tooth decay.
2. Apples and Oranges: Apples increase saliva production and prevent cavities by scrubbing teeth clean as you eat them. Any high-fiber fruits and vegetables will scrub the teeth until you can brush them properly. Despite the acid contained in oranges, they naturally cleanse your mouth. Any of the fruits in the citrus family are packed with nutrition and will help keep your teeth clean.
3. Yogurt: A probiotic and good for your oral health? Yes! Yogurt is an excellent protein and calcium source that feeds the good bacteria in your gut. Get the plain kind and mix your own fresh or frozen fruit to it.
4. Nuts: They provide essential vitamins and minerals while offering a pleasant crunch we need sometimes. There are many ways to eat them but they’re great as a portable healthy snack you can enjoy anytime, anywhere. Different nuts have different nutrients like vitamin E, potassium, zinc, iron, folic acid and fiber. Peanuts, almonds, and cashews have high levels of protein and calcium.
5. Tea: Green and black teas are high in polyphenols that can kill or suppress the bacteria causing damage to your teeth. Polyphenols also have cavity fighting properties. By now, you know that teas are an excellent option for a healthy weight, are good for the heart, and have been linked to strong anti-cancer activity.
6. Fatty Fish: Wild salmon, tuna, mackerel, and sardines are excellent sources of heart healthy omega-3s, calcium, and vitamin D. All of which are crucial to keeping your heart running at optimal levels. Most people in the United States are omega-3 and vitamin D deficient so enjoy some wild-caught fish tacos in the late-afternoon sunshine and boost your body in twenty minutes!
7. Dark Chocolate! Dark chocolate contains a compound called CBH which is proven to harden tooth enamel. Hard teeth are less susceptible to decay and cavities. Cacao also contains tannins which help prevent inflammation of the gums and aid in circulation as well as disease fighting compounds. Enjoy it in moderation.

References:

¹ World Health Organization: Cardiovascular Diseases (CVDs) 
² Mayo Clinic: Diseases and Conditions: Endocarditis 
³ Department of Endodontics, School of Dentistry: Endocarditis-associated oral streptococci promote rapid differentiation of monocytes into mature dendritic cells 
⁴ Center for Oral Health and Systemic Disease, University of Louisville Health Sciences Center: TLR2 Transmodulates Monocyte Adhesion and Transmigration via Rac1- and PI3K-Mediated Inside-Out Signaling in Response to Porphyromonas gingivalis Fimbriae 
⁵ Department of Medicine, Boston University School of Medicine: Fimbria-dependent activation of pro-inflammatory molecules in Porphyromonas gingivalis infected human aortic endothelial cells 
⁶ Discovery: How Mouth Bacteria End Up in the Heart 
⁷ Massachusetts Dental Society: A Healthy Mouth Can Mean a Healthier You 
⁸ Ask the Dentist: The 5 Worst Supermarket Foods for Your Teeth 
⁹ Precision Nutrition: The Dental Diet: 10 Nutrition Strategies for Healthy Teeth