How are Gum Disease and Heart Disease Related?

Mary McMahon

Gum disease and heart disease appear to be related, thanks to several extensive studies in the early 2000s which suggested that people with periodontal disease were twice as likely to also have coronary artery disease, along with other heart-related health conditions. A couple of theories to explain the link between gum disease and heart disease have been posited and tested with additional scientific research. While these studies have not definitively proven that gum disease causes heart disease, they have clearly shown that there is some correlation between the two.

Bacteria from the mouth may end up lining the walls of the arteries leading to the heart and cause blockage.
Bacteria from the mouth may end up lining the walls of the arteries leading to the heart and cause blockage.

Some researchers argue that the link between gum disease and heart disease has to do with bacteria in the mouth. People with severe gum disease often experience bleeding gums, and nicks and cuts in the gums can provide a way for bacteria to enter the bloodstream. If the bacteria is not attacked by the immune system in time, it can reach the heart and may cause an infection such as endocarditis or damage other organs.

Flossing can help prevent gum disease, which might be a risk factor for heart disease.
Flossing can help prevent gum disease, which might be a risk factor for heart disease.

In addition, some oral bacteria appear to secrete sticky proteins which can allow them to adhere to the walls of the arteries, rather than being swept away by the flow of blood. As the bacteria accumulate, they contribute to the narrowing of the arteries which is linked with cardiovascular disease. Bacteria can also promote the formation of blood clots which could severely damage the heart. Some scientists argued that these bacteria should be trapped by the immune system, but when doctors sampled and cultured arterial plaque, they discovered colonies of oral bacteria happily multiplying in their petri dishes, suggesting that the immune system seems to have trouble stopping oral bacteria in the bloodstream.

A woman with healthy gums.
A woman with healthy gums.

In studies which attempted to explore the link between gum disease and heart disease, researchers looked at large samples of individuals with and without heart disease and gum disease. What they discovered is that gum disease is linked with heart disease, and cultures of bacteria from the mouth can often be used as a predictor of heart disease, much in the same way that cholesterol levels are utilized.

Obviously, no one wants gum disease. Since prevention of gum disease may also lower your risk of heart disease, it's a good idea to floss and brush regularly, and to visit a dentist on a regular basis for teeth cleaning and checkups. In some cases, people may also need to take antibiotics before dental procedures, to reduce the risk of endocarditis; this is something you should discuss with your dentist.

The heart can be adversely affected by gum disease.
The heart can be adversely affected by gum disease.

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Discussion Comments


Muselover is absolutely correct. There has not been one scientific study that shows a causal relationship between gum disease and heart disease. All the studies show is that there is a correlation.

The real truth is as follows: people who are lazy and don't eat healthy meals, or exercise don't brush or floss much either.


Dear muselover, The scientist knows a thing or two more about the difference between simple correlation and causation. Although it is true that there is no definite proof that one causes the other there is many evidence that suggest it may be true.

Periodontal disease can promote inflammation of the blood vessels, an important risk factor for atherosclerosis. People with gum disease are known, for instance, to have elevated levels of C-reactive protein (CRP), a marker for inflammation that is associated with an increased risk of coronary artery disease. More recently, it has been shown that people with periodontal disease also have elevated levels of lipoprotein-associated phospholipase A2, another significant marker for inflammation that increases cardiac risk.

Furthermore, there is evidence that when people who have active periodontal disease receive good dental care and improve their own oral hygiene, their vascular function improves. And one small study has even suggested that aggressive treatment of periodontal disease can potentially result in the partial reversal of vascular disease, as determined by the carotid intimal medial thickness test. (This, interestingly, was the same test that failed to improve with Vytorin therapy in the controversial Enhance trial, suggesting that simple oral hygiene may be able to accomplish something that even some expensive cholesterol drugs cannot.)


One of the highest indicators of heart disease has been proven to be social isolation. People with bad teeth and breath are likely to also feel self conscious and have low self esteem. They may also have reduced access to dentistry due to finances. Sounds like they should look at psychoneuroimmunology.


There is no actual proof that heart disease causes gum disease or vice versa. It could be that rather than gum disease causing heart disease (or making it more likely), heart disease actually causes gum disease (or makes it more likely). Or it could be that there is a third, unknown variable involved. For instance, genetic factors could be such a third variable - the same genes that lead to heart disease might also lead to gum disease.

The inclination of humans to see patterns in data (a good, adaptive trait) can lead to problems when we make assumptions based only on studies, like these, which show correlations but cannot provide proof. The way you show proof is by controlling the variables. For instance, if you had two groups of people, and one group was never allowed to brush their teeth and the other group always had to brush their teeth, and then you compared the rate of heart disease in the two groups and found the non-brushers to have a much higher rate of heart disease, then you might be able to show proof that gum disease causes heart disease. Maybe. That's why we do experiments just like this with animals - because no one could ever ethically get away with forcing a group of people to never brush their teeth just for an experiment. It obviously is very complicated. Scientists have to be careful about how they present the results of their studies, and the media should also learn to be careful about how scientific studies are regurgitated into something that the general public can read and understand.

At any rate, there's nothing to prove or disprove that brushing your teeth more often will lead to a healthier heart. But by all means, keep brushing and flossing - please!

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