Recent research shows that treating gum disease – or avoiding it altogether with regular brushing and flossing – may improve the health of the coronary arteries. The findings add to evidence that taking care of your teeth may be one of the many ways to take care of your heart.
In most people with coronary heart disease, the underlying cause of the disease is atherosclerosis -- the buildup of deposits called plaques within the walls of the arteries. These plaques decrease the size of the artery's lumen, the channel or space through which blood flows. When atherosclerosis develops in the coronary arteries, it can decrease blood flow to the heart (causing chest pains called angina) or it can completely block blood flow (resulting in a heart attack).
Atherosclerosis doesn't develop overnight; it is a slow process that can take many years. It typically occurs after decades of lifestyle behaviors that lead to the accumulation of cells, fats, and cholesterol on the once-smooth inner lining of the arteries. This process typically starts when the endothelium (the thin layer of cells that lines the arteries) is injured, often because of exposure to toxins (such as cigarette smoke) or because of inflammation. The lining then expresses molecules that attract white blood cells and low-density lipoprotein (LDL) cholesterol. The damaged endothelium becomes permeable to these white blood cells and LDL cholesterol, which then enter the inner surface of the artery.
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Now a study published in the New England Journal of Medicine (Volume 356, page 911) confirms that aggressively treating periodontitis, a chronic bacterial infection of the gums, may not only save your teeth but also improve the health of your coronary arteries.
The study involved 120 adults with severe periodontitis who were randomly assigned to undergo routine dental cleaning or intensive periodontal therapy. Participants in the latter group received local anesthesia so the dentist could aggressively remove plaque, extract any teeth that couldn't be saved, and inject antibiotics into the infected gums to kill bacteria. Two months later, endothelial function in the coronary arteries was better in the intensively treated patients than in the comparison group -- a difference that was still apparent at the six-month mark.
Decreased function of the endothelial cells that line the walls of the coronary arteries is an early sign of the development of coronary heart disease. Researchers still need to determine whether such intensive dental treatment helps prevent coronary heart disease or heart attacks in people with existing coronary heart disease. But the findings add to evidence that taking care of your teeth may be one of many ways to take care of your heart.
