The link between your mouth, strep and coronary artery disease

An estimated 45 to 50 percent of the world’s population has periodontitis (or gum disease), a serious gum infection that damages the soft tissue around the teeth. Left untreated, gum disease can destroy the bone that supports your teeth, leading to loose teeth and tooth loss.

There’s another big downside to periodontitis — its link with heart problems. Gum disease has been associated with a number of cardiovascular issues, including high blood pressure, heart disease and heart failure.

Investigators have been working to get a better understanding of this connection. And they’re getting closer to finding the root cause…

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Coronary artery disease and the oral microbiome

A team of Scandinavian researchers studied nearly 9,000 participants in SCAPIS (Swedish Cardiopulmonary Bioimage Study). The participants were aged 50 to 65 and had no overt heart disease.

They examined the participants’ coronary artery calcium scores and coronary computed tomography angiography, as well as inflammatory markers in their saliva. The researchers also assessed gut microbiota species using sequencing of fecal samples.

Results showed a correlation between the Streptococci species in saliva and worse dental health, increased C-reactive protein, and higher artery calcium scores — independent of cardiovascular risk factors. The bacteria Streptococcus anginosus (most often found in the abdominal cavity) and Streptococcus oralis (found in the mouth) had the strongest associations.

What this means is the researchers found a direct link between systemic inflammation, coronary artery disease and certain bacteria commonly found in the mouth.

The researchers say if this link is causal, these bacterial species might contribute to the process of atherosclerotic plaque formation either by direct infection or by altering host metabolism. Further studies are needed to determine whether these bacteria can be used as potential biomarkers or treatment targets.

The peril of hidden gum infection

Studies like this one, which show how the oral microbiome impacts the health of the whole body, emphasize how important it is for clinicians to address periodontitis to help reduce the risk of cardiovascular disease.

Daniel Chong, a naturopathic doctor and cardiovascular specialist with BioLounge in Portland, Ore., tells Integrative Practitioner he asks patients about their dental hygiene and dental health, including any history of gum disease or root canals.

“If necessary, I readily refer patients to dentists who are well versed in this area and have the capacity to do 3D Cone-Beam Computed Tomography and oral bacteria evaluation to better rule out subtle infections and assess the patient’s overall microbiota picture,” Chong tells Integrative Practitioner.

If you have been diagnosed with heart disease or other cardiovascular issues, it might be a good idea to ask your dentist if they can conduct these scans for you. That way, you can get a sense of the health of your oral microbiome and whether you have any nasty staph bacteria lurking deep in your gums that needs to be dealt with.

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Gut plays a role as well

This study highlights the dangers of certain oral bacteria. But research has also shown that managing the gut microbiome, which is linked with the oral microbiome, can help reduce the risk of cardiovascular disease. Chong tells Integrative Practitioner this can be done through specific probiotic strains such as Lactobacillus and Bifidobacterium in general and Lactobacillus rhamnosus in particular.

You can get probiotics from diet or supplements. Many Lactobacillus and Bifidobacterium strains can be found in fermented foods, particularly yogurt, miso and tempeh.

When shopping for probiotic supplements, check to see whether the one you have in mind contains the strains mentioned above. And it’s even better if the supplement also contains prebiotics, which give the probiotic something to feed on.

Sources:

1. More Evidence Links Oral Health and Gut Bacteria to Cardiovascular Disease — Integrative Practitioner

2. Streptococcus Species Abundance in the Gut Is Linked to Subclinical Coronary Atherosclerosis in 8973 Participants From the SCAPIS Cohort — Circulation

3. Periodontitis — Mayo Clinic