The strong link between gum disease and heart failure

It’s pretty shocking to discover just how much the health of your mouth can impact your overall health.

For instance, periodontal (or gum) disease can lead to inflammation and degeneration in the brain.

It can trigger inflammatory bowel diseases like ulcerative colitis and Crohn’s disease.

It can increase your risk of developing type 2 diabetes.

It can make you more likely to contract severe COVID-19 or die from the illness.

And it’s even been linked to rheumatoid arthritis, lung infections, obesity, prostate inflammation and erectile dysfunction.

Gum disease also can influence cardiovascular health. Studies have linked gum disease to heart disease. And research shows people with periodontitis, a severe gum infection, are more likely to have high blood pressure.

Now, there’s new research that expands the list of ways gum disease may influence the heart….

Heart failure and your gums

A team of U.S.-based researchers analyzed long-term data from the Atherosclerosis Risk in Communities (ARIC) study that included 7,514 people who averaged 63 years of age.

Periodontal disease was found in 59 percent of the participants, while 23 percent had healthy gums. Another 18 percent were in edentulism, meaning they no longer had their natural teeth.

While there have been many studies that found links between periodontal status and coronary artery disease, stroke or diabetes, few have focused on heart failure.

Among the participants, those with periodontal disease were much more likely to experience heart failure with reduced ejection fraction (HFrEF) over an estimated 13 years of follow-up. In this type of heart failure, the left ventricle isn’t pumping blood to the body as well as it should.

There was also a nonsignificant trend of excess heart failure with preserved ejection fraction (HFpEF) in those with periodontal disease. In HFpEF, ejection fraction may be within a normal range, but often the heart muscle has thickened or stiffened to the point where the ventricle holds a smaller amount of blood than usual — meaning there’s not enough blood being pumped to meet the body’s needs.

But the people whose gum health had deteriorated to the point of edentulism had roughly double the risk of both HFrEF and HFpEF.

All of these results remained significant even after adjusting for sociodemographic, behavioral and heart failure risk biomarkers, as well as other pre-existing health conditions and coronary heart disease.

Gum disease is triggered by an inflammatory response to bacteria under the gums. Chronic systemic inflammation is also believed to be directly related to heart failure’s pathogenesis.

Some scientists believe the link between the two could be because periodontitis influences the amount of inflammation in the membrane lining the inside of the heart and blood vessels.

Previous research suggests acute heart failure patients could benefit from intravenous corticosteroids if they have elevated levels of C-reactive protein (CRP), a biomarker of systemic inflammation.

It takes more than brushing

The investigators say these findings support the need for more research exploring the potential for using anti-infective periodontal therapies to minimize heart failure burden.

While they work on that, there are a few things you can do…

If you’re a smoker or have diabetes, you’re at increased risk for periodontal disease. That means quitting the habit and staying on top of diabetes management.

And of course, the best defense against gum disease is a good offense. To start with, make sure your oral hygiene is impeccable. To avoid heart failure, it’s worth the time and effort.

But when it comes to the health of your mouth, good oral hygiene is really only half the battle. Like your gut, your mouth has its own microbiome. And just skipping brushing for one day has been shown to promote changes in the oral microbiome that kick off periodontitis.

As for supplements that might help, one study suggests that melatonin may help reduce gum tissue inflammation. Another links low levels of vitamin D3 to periodontitis, which is not surprising for several reasons…

• Of all the vitamins, it’s probably the strongest at quelling inflammation
• A study published in the Frontiers of Immunology confirmed that vitamin D3 could balance people’s immune systems and help strengthen defenses against infections. The same could not be said for vitamin D2.

And my colleague, Margaret Cantwell, recommends these four supplements specifically that fight aging and gum disease.

If you’re already dealing with HFpEF, find out why you should add olive oil to your diet, pronto, here.

Sources:

People With Gum Disease Are More Prone to Heart Failure — MedPage Today

Periodontal Status, C-Reactive Protein, NT-proBNP, and Incident Heart Failure: The ARIC Study — JACC: Heart Failure

Heart Failure With Reduced Ejection Fraction (Systolic Heart Failure) — MyHealth.Alberta.ca

Ejection Fraction Heart Failure Measurement — American Heart Association