The Sneaky Heart Disease Risk Factor Doctors Want You to Know

“We’ ve known for quite some time that periodontal disease is a risk factor for cardiovascular disease,” says Yu-Ming Ni, M.D., a cardiologist and lipidologist at MemorialCare Heart and Vascular Institute at Orange Coast Medical Center in Fountain Valley, CA. “It’s just not a relationship that we commonly discuss.”

Meet the experts: Yu-Ming Ni, M.D., is a cardiologist and lipidologist at MemorialCare Heart and Vascular Institute at Orange Coast Medical Center in Fountain Valley, CA; Hosam Hmoud, M.D., is a cardiology fellow at Northwell’s Lenox Hill Hospital; Justin Zachariah, M.D., M.P.H., is a statement co-author and director of research, Pediatric Cardiology at Texas Children’s Hospital Heart Center; Stephanie Saucier, M.D., is a cardiologist at Hartford HealthCare; Hsun-Liang Chan, D.D.S., is a professor and chair of the Division of Periodontology at The Ohio State University College of Dentistry

The link between dental and heart health seems random, but there are a few things to consider. Here’s what doctors want you to keep in mind.

There are a few reasons why your dental health may impact your risk of cardiovascular disease. Gum disease and poor oral hygiene allow bacteria to enter the bloodstream, which may cause inflammation that can lead to the buildup of plaque and, ultimately, heart disease, says Hosam Hmoud, M.D., a cardiology fellow at Northwell’s Lenox Hill Hospital.

Gum disease itself causes inflammation, and that’s something the body reacts to, Dr. Ni says. “That inflammation can stress the arteries of your heart, simply by nature of that chronic inflammatory response,” he says. Inflammation also seems to make plaque that may build up in the arteries more vulnerable to rupture, which may lead to heart attack and stroke, Dr. Ni says.

Still, “the exact mechanisms with which gum disease is linked to heart diseases are not fully known,” says Hsun-Liang Chan, D.D.S., professor and chair of the Division of Periodontology at The Ohio State University College of Dentistry. But because of this association, “maintaining good dental hygiene, coupled with regularly scheduled dental visits, can mitigate those risks,” Dr. Hmoud says.

This isn’t a new concept, by the way. Several studies have linked periodontal disease with a higher risk for heart attack, stroke, atrial fibrillation, heart failure, dying from a cardiac event, and more. “Overall, periodontal disease should be viewed as one of many modifiable risk factors,” says Stephanie Saucier, M.D., a cardiologist at Hartford HealthCare.

The AHA stresses that while periodontal disease contributes to chronic inflammation that’s linked to heart disease, a cause-and-effect relationship hasn’t been determined. So, while someone with periodontal disease may be at a higher risk of having a heart attack and other heart events, it’s not clear if the periodontal disease directly causes that.

Still, cardiologists say there seems to be some benefit in staying on top of your dental health to support your heart. “It wouldn’t completely turn things around, but it would certainly be additive in terms of risk factor modification for heart disease,” Dr. Hmoud says.

Dr. Ni agrees. “This can definitely influence your risk of heart disease, but it’s one of many risk factors,” he says. “It’s not like having perfect dental health will eliminate your risk for heart disease, but it certainly helps.”

Justin Zachariah, M.D., M.P.H., statement co-author and director of research, Pediatric Cardiology at Texas Children’s Hospital Heart Center, stresses the importance of staying on top of your dental health. “Managing gum disease through direct oral hygiene treatments, like flossing, can reduce inflammation in the whole body and change the microorganisms that camp out locally in the mouth, the oral microbiome,” he says. “Inflammation related to gum disease appears to be associated with worse heart disease risk factors like diabetes, high blood pressure, and cholesterol.”

The American Dental Association (ADA) recommends seeing your dentist “regularly” to lower the risk of developing cavities and periodontal disease. “For individuals without a diagnosis of gum disease, two times a year should be sufficient,” Dr. Chan says. “For those with a prior diagnosis of gum disease, since their risk of getting gum disease is elevated, three to four cleanings per year is recommended.”

Of course, if you’re having a dental issue or dental pain, it’s important to see a dentist sooner rather than later.

If you really want to maximize your heart health, Dr. Ni recommends following the AHA’s Life’s Essential Eight, which breaks down lifestyle habits that are good for your heart. Those include:

• Eating an overall healthy diet that includes whole foods, fruits and vegetables, lean protein, nuts, seeds, and cooking in non-tropical oils like olive and canola.
• Doing at least 2.5 hours per week of moderate-intensity exercise.
• Avoiding tobacco.
• Getting seven to nine hours of sleep each night.
• Doing your best to maintain a healthy weight.
• Controlling your cholesterol, focusing on lowering levels of LDL, or “bad,” cholesterol.
• Managing your blood sugar.
• Managing your blood pressure, doing your best to keep it below 120/80 mm Hg.

If you have concerns about your heart health, check in with your healthcare provider. They should be able to go over your individual risk factors and make personalized recommendations from there. “Each thing we can do to help our heart health is of benefit,” Dr. Zachariah says.