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Healthy Mouth, Healthy Heart?

Could oral hygiene be the key to a healthy heart?

Cardiovascular disease (CVD) is the leading cause of death in Australia and one of the largest economic burdens with copious prevention methods such as medication, weight management, healthy dietary and fitness habits used to combat its onset. However, recent research proposes a simpler and a more cost efficient method to preventing CVD – a toothbrush.

Good oral hygiene is a significant factor in relation to overall health. Thus it is no surprise that a high correlation exists between periodontal diseases (gum disease) and the onset of serious conditions such as cardiovascular disease (CVD). Individuals suffering from periodontal diseases exacerbate existing heart conditions and are two times more likely to experience CVD than those with a healthy mouth. In both processes inflammation is a common factor with the treatment of periodontal diseases resulting in a reduction in overall inflammation within the body. Therefore the necessity of obtaining dental clearance and treating oral infections prior to undergoing heart surgery is evident and cannot be overemphasised.

Periodontal diseases are infections that damage the gums and bone supporting the teeth. This causes an inflammatory response which releases bacteria through the gums and into the bloodstream which experts believe causes a build-up of cholesterol-rich plaque on the artery walls. This theory is thought to increase the risk of atherosclerotic vascular disease due to a growth in cellular mediators – primarily C-reactive protein (CRP) which is the liver’s reaction to inflammation and results in inflamed arteries and blood clots.

A number of dental treatments have the potential to release bacteria into the blood stream which can then cause an infection within the heart tissues or valves. In addition to increased expenses and the need for further intervention treatments patients suffering from periodontal disease run a higher risk of developing potentially life threatening complications. Oral treatment and removal of decayed teeth before heart surgery could mean the difference between life and death. It is evident that maintaining a healthy mouth will decrease the risk of periodontal disease and in turn CDV. Therefore it is imperative that dental clearance be obtained prior to heart surgery to significantly reduce the risk of morbidity, mortality and cost.

Conquering periodontal diseases:

The most common cause of periodontal diseases is a build-up of bacterial plaque on the surface of the teeth due to poor oral hygiene. Below are a number of prevention methods:

    • Brush your teeth at least twice daily for two minutes and floss afterwards. This helps remove bacteria from food and plaque.
    • Use a good toothbrush with soft nylon bristles. This will remove food and plaque from teeth without damaging gums or wearing away tooth enamel. Natural brushes with bristles from animal hair should be avoided as they can harbor bacteria.
    • Brush your tongue to remove additional bacteria build-up.
    • Gargle with plaque reducing mouthwash to fight oral bacteria build-up.
    • Replace your toothbrush every 3 months or as soon as bristles start to wear out. Worn out bristles can harbor bacteria which will be transported to your mouth.
    • Schedule regular dental assessments. Dentists are trained to detect and treat periodontal disease.
    • Patient with heart complications are advised to see their doctor before dental treatment and take special precaution such as consuming antibiotics before and after.

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Sources:

Anwar T. Merchant, “Will periodontal treatment prevent heart disease and stroke?,” Journal of Evidence-Based Dental Practice 12, no.4, (December 2012): 212-215.

Barge, Katie, “Periodontal disease may be the heart of cardiovascular problems,” Journal of Dental Hygiene 80, no. 1, (January 2006): 1-3.
Berent, Robert and Sinzinger, Helmut “Periodontal disease and atherosclerotic cardiovascular disease,” European Journal of Vascular Medicine 42, no.1, (January 2013): 3-7.

Dajani, Adnana S. et al., “Prevention of bacterial endocarditis: recommendations by the American heart association,” Circulation 96, (1997): 358-366.

Demmer, Ryan T. and Desvarieux, Moise “Periodontal infections and cardiovascular disease: the heart of the matter,” Journal of the American Dental Association 137, no.2, (October 2006): 145.

Li, Jian-Jun and Fang, Chun-Hong., “C-reactive protein is not only an inflammatory marker but also a direct cause of cardiovascular diseases,” Medical Hypotheses 62, (December 2003): 499-506.

Lux, Judy, “Review of the oral disease-systemic disease link. Part 1: heart disease, diabetes,” Canadian Journal of Dental Hygiene (CJDH) 40, no.6, (November – December, 2006): 1-10.

Petersen, Pail Erik, The world oral health report 2003: continuous improvement of oral health in the 21st century – the approach of the WHO Global Oral Health Programme, World Health Organisation, 2003, accessed March 5 2014. http://www.who.int/oral_health/media/en/orh_report03_en.pdf?ua=1

Shah, Svati H., and Newby, Kristin L., “C-Reactive protein: a novel marker of cardiovascular risk,” Cardiology in Review 11, no. 4, (July-August 2003): 167-179.

Taylor, George W. et al., Oral and general health: exploring the connection, Delta Dental Plans Association, 2009, accessed March 6, 2014, http://www.nd.edu.au/__data/assets/pdf_file/0020/116264/Arts-Sciences-Style-and-Referencing-Guide-5th-edn.pdf.

Terezhalmy, Geza T., et al., “Oral disease burden in patients undergoing prosthetic heart valve implantation,” The Annals of Thoracic Surgery 63, no. 2, (February 1997): 402-404.

Yasny, Jeffrey S. and Herlich, Andrew., “Perioperative Dental Evaluation,” Mount Sinai Journal of Medicine 79, (2012): 34-45.

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The content on the LifeCare Dental website is provided for education and information purposes only. Information about therapy, service, product or treatment does not imply endorsement and is not intended to replace advice received from your dentist, doctor or other registered health professionals. LifeCare Dental makes no claim as to the accuracy or authenticity of this content.

Additionally, LifeCare Dental does not accept liability to any person for the information or advice provided on this website or incorporated into it by reference. Content has been prepared for Western Australian residents and wider Australian audiences, and was accurate at the time of publication. Readers should note that, over time, currency and completeness of the information may change. All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions.

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