Research suggests that periodontal bacteria in the blood stream can:

  • Contribute to the development of heart disease
  • Increase the risk of stroke
  • Compromise the health of those that have diabetes or respiratory diseases
  • Increase a woman’s risk of having a preterm, low-birth weight baby

So, what is Periodontal Disease?

Periodontal disease is defined as a bacterial infection, and in its earliest stages, it is called gingivitis. It begins with plaque buildup between the teeth and the gums consisting of a colony of bacteria, food debris, and saliva that typically isn’t removed properly from the gums and teeth regularly without a dental cleaning. The bacteria in plaque produce toxins or acids that irritate and infect the gums, eventually destroying the jaw bone that supports the teeth. When periodontal disease is not treated it can eventually lead to tooth loss and in the worst case, even heart disease.

What does the research say?

Some recent research studies show a correlation between gum disease and heart disease. In one study from 2014, researchers looked at people who had both gum disease and heart disease. 

The findings pointed to gum disease contributing to the potential increase and the risk of heart disease because inflammation in the gums and bacteria may eventually lead to narrowing of important arteries. Given this evidence, the American Dental Association and American Heart Association have acknowledged the relationship between gum disease and heart disease. 

Gum diseases leading to other diseases

Gum disease and oral health may be related to other conditions, as well, such as:

  • Osteoporosis: Some research suggests that lower bone density leads to bone loss in the jaw. This may eventually lead to tooth loss due to a weaker underlying bone. 
  • Respiratory disease: Bacteria in the mouth can move to the lungs and cause infections such as pneumonia. This is more common for people with periodontal disease. 
  • Cancer: Some research suggests that gum disease may increase the risk of certain forms of cancer, such as kidney, pancreatic, and blood cancers. However, more research is needed in this area.
  • Rheumatoid arthritis (RA): Early research shows an association between RA and gum disease. 

There are also some conditions that may increase your risk of developing gum disease. Research indicates that people with diabetes are at increased risk of developing gum disease. This is likely due to increased inflammation and greater risk of infections in general. The risk lowers if you manage your diabetes. 

Pregnant women are also at increased risk of gum disease due to hormonal changes and increased blood flow. 

What cardiovascular diseases require specific care?

The following list contains information about some of these conditions and the proper precautions you may need to take prior to any dental work. 


Some people are at high risk of developing an infection of the inner lining of the heart. These patients must take special care to practice good oral hygiene every day. 

Your doctor can tell you if you fall into the high-risk group. All patients scheduled for valve surgery need to have excellent oral hygiene and see a dentist before surgery because unhealthy teeth are one source of bacteria that can cause endocarditis.

Heart attack (myocardial infarction)

It is best to wait a minimum of six months after a heart attack before undergoing any extensive dental treatments. You do not need to wait to have a dental cleaning. 

Anticoagulants and Antiplatelet Medications

Be sure to tell your dentist if you are taking anticoagulants (blood-thinning drugs) such as warfarin (Coumadin). These medications could result in excessive bleeding during some oral surgery procedures. Many patients with cardiovascular disease take an antiplatelet medication called clopidogrel (Plavix), particularly patients with drug-eluting stents. Never stop taking Plavix without talking to your cardiologist.

High blood pressure (hypertension)

Some antihypertensive medicines can cause dry mouth or alter your sense of taste. Calcium channel blockers, in particular, may cause the gum tissue to swell and overgrow, causing problems with chewing. If you do experience gum overgrowth, your dentist will give you detailed oral hygiene instructions and might ask you to make more frequent dental visits for cleanings. Although rare, gum surgery is sometimes needed.


Patients with angina who are treated with calcium cannel blockers might experience gum overgrowth. In some cases, gum surgery might be required (see above. Although patients with stable angina can typically undergo many dental procedures, patients with accelerating or unstable angina should not undergo nonessential (elective) dental procedures. We recommend that you should have your heart evaluated by your cardiologist before having such procedures. 


Tell your dentist if you are taking anticoagulants (blood-thinning medications). These medications could cause excessive bleeding during some oral surgery procedures. If your stroke has resulted in an inability to produce an adequate amount of saliva, your dentist might recommend the use of artificial saliva. 

Is there something you can do?

There are many healthy lifestyle habits you can use to maintain good oral hygiene and reduce your risk of gum and heart diseases. 

  • Brush your teeth and tongue at least twice per day with a fluoride toothpaste. Ask your dentist to demonstrate the correct technique for brushing.
  • Floss between your teeth and gums at least once per day.
  • Use mouthwash regularly. 
  • Only use teeth cleaning products that have the Dentist Association’s seal of approval. 
  • Refrain from smoking or chewing tobacco. 
  • Drink water that contains fluoride. 
  • Eat a diet high in vegetables, high-fiber foods, low-sugar fruits, and vegetable-based proteins.
  • Maintain healthy levels of blood sugar, especially if you have diabetes.
  • See a dentist twice per year for regular cleanings and checkups.
  • Be mindful of early signs of gum disease, such as bleeding gums and constant bad breath. Let your dentist know if you have any of these symptoms.

At German Heart Centre we care!

We are committed to our patients and even something as seemingly trivial as dental hygiene that can affect your greater health is our concern. Contact our clinic for more information and scheduling information for the next possible consultations with any of our qualified and experienced cardiologists.

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