DEAR MAYO CLINIC: Will taking care of my teeth help prevent heart disease?
ANSWER: Some research suggests that heart disease, clogged arteries and stroke could be linked to the inflammations and infections that oral bacteria can cause. Based on that evidence, there appears to be an association between oral health and heart disease. But the association is not well-understood. While taking care of your teeth isn't a proven way to prevent heart disease, removing bacteria from your teeth and gums through brushing, flossing and dental checkups is a sound investment in your health.
Potential links between oral health and the health of the rest of your body has been studied for decades. Over the years, investigators have found some evidence that people who have advanced periodontal disease -- a condition that involves gum inflammation and infection -- tend to have higher rates of diseases such as diabetes, head and neck cancer, heart disease and cardiovascular (coronary artery) disease. But the research has never established a clear cause-and-effect relationship between poor oral health and any of those diseases.
One recent study found that people who said they brushed their teeth at least twice a day for two minutes or longer had a lower rate of abnormal heart rhythms and heart failure than people who did not brush that often. While again there was no evidence that poor oral health caused those heart problems -- or that good oral health habits prevented them -- it could point the way to more focused research on this topic that may help explain the link.
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For example, a bacterium called Porphyromonas gingivalis, commonly found in people with advanced periodontal disease, has been shown to raise blood cholesterol levels and affect blood pressure. This bacterium also has been linked to an increase in C-reactive protein, which rises when there's inflammation in the body and is commonly found in people who have cardiovascular disease. A well-controlled clinical study may be able to shed more light on the connection among bacteria, oral health and heart disease.
Although there is no evidence that spells out the specific link between oral health and heart disease, good oral care is important to your overall health. Oral care starts with regular self-care at home, including brushing and flossing. Brush your teeth two or three times a day for at least two minutes each time. An electric toothbrush can be particularly useful in removing plaque from the gums, which can help improve gum health.
Floss your teeth at least once a day. Daily flossing is important because it removes plaque that you can't reach with the bristles of your toothbrush, particularly plaque that builds up on the sides of the teeth and in the trough between your teeth and gums. It's in those areas that bacteria such as P. gingivalis accumulate. If left unchecked, oral bacteria can lead to chronic inflammation and potential tooth loss.
You also should get a professional dental cleaning and checkup at least once a year, including annual oral X-rays to assess the health of your teeth and the bone that supports them. An annual exam enables your dental provider to identify oral health concerns when they are still in the early stages and can be more easily managed and treated.
While there's no definitive correlation between taking care of your teeth and preventing heart disease at this point, there's no question that incorporating good oral habits into your daily routine is an integral part of a healthy lifestyle. -- Thomas Salinas, D.D.S., Dental Specialties, Mayo Clinic, Rochester, Minn.
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