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Can Poor Dental Hygienie lead to Heart Disease?

Dr. Youngsoo Cho  

Youngsoo Cho, MD, is a cardiologist on staff at Banner Estrella Medical Center and Banner Good Samaritan Medical Center.

Question: A friend told me that poor dental hygiene can lead to heart problems down the road. How can tooth decay cause heart problems?

Answer: In general, it is true that poor dental hygiene and tooth decay can lead to certain heart problems. There are two specific heart conditions that have been associated with heart disease that I would like to discuss: coronary artery disease and endocarditis.

Coronary artery disease (CAD) occurs when one or more arteries that supply blood to the heart muscle itself gets blocked to varying degrees by things such as cholesterol build-up. There is evidence that CAD is an inflammatory process. 

It is thought that poor dental hygiene allows a pro-inflammatory state that is associated with CAD.  I must emphasize that this is not a proven cause but studies have shown an association with tooth decay and CAD.

Endocarditis is an uncommon but serious infection of one of the four valves in the heart.
 
Patients at most risk for this type of infection are those who have had past endocarditis, those born with complex heart defects, have had valve replacements, and in some cases, heart transplant patients. 

The link between poor dental hygiene and endocarditis is that tooth brushing, dental procedures, and mouth infections can allow bacteria that live in all of our mouths to get in the bloodstream. These bacteria can then infect the heart valves.
 
Typically, a person needs to be (a) high risk for endocarditis and (b) have bacteria enter the blood for there to be a possibility for heart valve infection. The vast majority of us are not high risk for endocarditis and any bacteria entering the bloodstream are cleared by our own healthy immune system.

Those with poor dental hygiene can allow oral bacteria more access to blood. This sets up a situation where bacteria can remain in the bloodstream, increasing risk of heart valve infection in high risk patients.

These are two good reasons to maintain good oral hygiene and have regular dental visits from a heart point of view. In addition, your dentist will be happy and you will have good breath and a nicer smile!

For more information, talk to your doctor or dentist.

Page Last Modified: 02/22/2010
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