Does a Healthy Smile = A Healthy Heart?

Studies show that people with gum disease-a condition technically known as periodontal disease-are also more likely to have heart disease. According to Harvard Health, people with gum disease have two to three times the risk of having a heart attack, stroke, or other serious cardiovascular event than people without the condition.¹  And that’s a problem since one out of every two men and one out of every three women over the age of 30 has some degree of periodontal disease.²

What Causes Gum Disease?

Periodontal disease is an infection of the tissues that hold your teeth in place (aka, your gums). It’s typically caused by poor brushing and flossing habits that allow plaque—a sticky film of bacteria—to build up on your teeth and harden into tartar. Without treatment, periodontal disease can destroy the bone that supports your teeth. This can cause your teeth to loosen and may even lead to tooth loss.³ It can also increase your risk of developing cardiovascular disease.

The biggest risk factor for periodontal disease is poor dental hygiene. Without routine brushing and flossing, plaque can go unchecked, increasing the odds of developing gum disease as much as five-fold.⁴  Other risk factors include hormonal changes during puberty and menopause, certain health conditions such as AIDS or diabetes, some medications like contraceptives or steroids, and the genes you inherit.⁵

Symptoms of periodontal disease include:

• Red, swollen, or tender gums
• Bleeding gums
• The buildup of tartar along the gum line
• Gums that pull away from teeth
• Loose or sensitive teeth.
• Pain while chewing
• Persistent bad breath ⁵

If you have any of these symptoms, run-don’t walk-to your dentist. That’s because treatment, which includes the removal of plaque and tartar, can help to reverse periodontal disease at every level.

The Gum Disease-Heart Disease Connection

How does what’s happening in your mouth affect your heart? It’s all about the bacteria. Just like your gut, your mouth has its own unique microbiome. Scientists have discovered a link between a bacterial imbalance in your oral microbiome, known as dysbiosis, and several types of cardiovascular disease, including atherosclerosis, heart failure, and infective endocarditis (an infection of the inner lining of the heart).⁶

Here’s what happens: the bacteria that infects your gums sparks inflammation. This bacteria, along with the inflammation, then travel to the bloodstream and eventually to your gut where they trigger an immune response and body-wide inflammation. These actions can then set the stage for vascular damage, the buildup of arterial plaque, and reduced blood flow. ^6,7,8

How to Prevent Gum Disease for a Healthier Heart

Since nearly half of adults already have some form of periodontal disease, here are some tips that can help improve the condition. As a bonus, these tips can also help prevent the cardiovascular consequences of poor periodontal health.

• Brusha, brusha, brusha.Brush your teeth for two minutes at least twice a day—once in the morning and just before going to bed. And don’t forget to brush your molars and the backside of teeth where bacteria can hide. It’s also smart to replace your toothbrush every three months, or more often if the bristles are matted or frayed.
• Don’t forget to floss. Flossing before you brush allows you to clean away any loosened food bits and bacteria. According to researchers at the University of North Carolina at Chapel Hill, flossing is a particularly effective way to prevent periodontal disease in older adults.⁹
• Ditch the mouthwash. New research in the Journal of Medical Microbiology reports that commonly-used alcohol-based mouthwashes disrupt the oral microbiome and can lead to an uptick in the number of harmful bacteria present in the mouth.¹⁰
• Make regular dental visits.See your dentist regularly for cleanings, usually every 6 to 12 months. If you have risk factors that increase your chance of developing periodontitis—such as having dry mouth, taking certain medicines or smoking—you may need professional cleaning more often.
• Fortify your gut. Since the bacteria from your mouth, along with factors that promote inflammation, travel to your gut and then to other parts of the body, it’s a good idea to fortify the “good” bacteria in your intestinal tract. One of the easiest ways to improve your gut microbiome is with a daily probiotic. According to a recent study in the Brazilian Journal of Microbiology, several strains of Lactobacillus bacteria, including acidophilus, L. plantarum, B. breve, B, infantisand L. rhamnosus, can discourage inflammation and strengthen the intestinal barrier.¹¹
• Support a healthier mouth and heart. Periodontal disease, especially mild periodontal disease, may seem unavoidable. But you can get some extra protection with Aged Garlic Extract (AGE). Rich in antioxidants and anti-inflammatory properties, AGE has been shown to reduce both the incidence and the symptoms of periodontal disease.¹² One 2023 study review published in the Journal of Indian Association of Public Health Dentistry found that AGE inhibits the buildup of plaque and improves gum healing.¹³ As a bonus, AGE also helps to keep your entire cardiovascular system in top form. Studies show that a daily dose of AGE can effectively reduce your blood pressure, cholesterol, and the buildup of plaque and calcium deposits in arteries, making it a win-win for both your heart and your oral health.^14,15

Preventing gum disease before it starts is always the ideal scenario. But if you’re at risk of periodontal disease or if you’ve already got the condition, the above tips can keep you- and your heart-smiling!

1. Gum disease and heart disease: The common thread. Harvard Health. 2021. https://www.health.harvard.edu/heart-health/gum-disease-and-heart-disease-the-common-thread#:~:text=People%20with%20gum%20disease%20(also,gum%20disease%20develops%20heart%20problems.
2. Eke PI, Thornton-Evans GO, Wei L, et al. Periodontitis in U.S. adults: National Health and Nutrition Examination Survey 2009–2014. Journal of the American Dental  2018;149(7):576–88.
3. Gasner NS, Schure RS. Periodontal Disease. [Updated 2023 Apr 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK554590/
4. Lertpimonchai A, Rattanasiri S, Arj-Ong Vallibhakara S, et al. The association between oral hygiene and periodontitis: a systematic review and meta-analysis. International Dental Journal. 2017;67(6):332-343.
5. Periodontal (gum) disease. National Institute of Dental and Craniofacial Research. 2024. https://www.nidcr.nih.gov/health-info/gum-disease#:~:text=Periodontal%20(gum)%20disease%20is%20an,%2C%20red%2C%20and%20bleeding%20gums.
6. Tonelli A, Lumngwena EN, Ntusi NAB. The oral microbiome in the pathophysiology of cardiovascular disease. Nature Reviews Cardiology. 2023;20(6):386-403.
7. Gianos E, Jackson EA, Tejpal A, et al. Oral health and atherosclerotic cardiovascular disease: A review. American Journal of Preventive Cardiology. 2021;7:100179.
8. Chopra A, Franco-Duarte R, Rajagopal A, et al. Exploring the presence of oral bacteria in non-oral sites of patients with cardiovascular diseases using whole metagenomic data. Science Reports. 2024;14(1):1476.
9. Marchesan JT, Byrd KM, Moss K, et al. Flossing is associated with improved oral health in older adults. Journal of Dental Research. 2020;99(9):1047-1053.
10. Laumen JGE, Van Dijck C, Manoharan-Basil SS, et al. The effect of daily usage of Listerine Cool Mint mouthwash on the oropharyngeal microbiome: a substudy of the PReGo trial. Journal of Medical Microbiology. 2024;73(6).
11. Li, C., Peng, K., Xiao, S. et al.The role of Lactobacillus in inflammatory bowel disease: from actualities to prospects. Cell Death Discovery. 2023;9:361.
12. Zini A, Mann J, Mazor S, et al. Beneficial effect of aged garlic extract on periodontitis: a randomized controlled double-blind clinical study. Journal of Clinical Biochemistry and Nutrition. 2020;67(3):297-301.
13. Kataria S, Sahoo S, Marya CM, et al. Aged garlic extract as a wonder herb in medicine and oral care: A comprehensive review. Journal of Indian Association of Public Health Dentistry. 2023;21(4):288-93.
14. Vila-Nova TMS, Barbosa KBF, Freire ARS, et al. Effect of aged garlic extract on blood pressure and other cardiovascular markers in hypertensive patients and its relationship with dietary intake. Journal of Functional Foods. 2024;112:105931.
15. Shaikh K, Kinninger A, Cherukuri L, et al. Aged garlic extract reduces low attenuation plaque in coronary arteries of patients with diabetes: A randomized, double-blind, placebo-controlled study. Experimental Therapies Medicine. 2020;19(2):1457-61.

This article is for informational purposes only. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment and should never be relied upon for specific medical advice.