There is a link between dental hygiene and a healthy heart, according to recent research. Although it is not clear that heart disease is actually caused by poor dental health, evidence points to an association between the two.

“Mounting evidence over the past few years points to a possible link between chronic inflammatory conditions, including gum disease and cardiovascular disease,” says Dr. George Honos, a cardiologist in Montreal and a spokesman for the Heart and Stroke Foundation.

Only about 50% of coronary artery disease can be explained by traditional risk factors such as smoking, diabetes, inactivity, high cholesterol and elevated blood pressure. Scientists are pointing to gum disease as another culprit.

“Bacteria originating in the oral cavity may explain some of these other cases,” Honos says.

What happens is this: when we don’t brush our teeth properly and floss regularly, plaque may form on the teeth and irritate the gums. The bacteria that live in plaque release toxins, provoking the immune system to mount an attack. To fight infection, the body bombards the gums with white blood cells, which can eventually break down the tissue surrounding the teeth and also the bones that hold teeth in place.

Researchers believe oral bacteria can also enter the bloodstream and attach themselves to the blood vessels in the heart, contributing to clotting. Gums that bleed easily, are sore to the touch and look as if they are receding are signs that you may have periodontal disease.

The early stage of gum disease, called gingivitis, is very common, affecting about 53% of young adults and 98% of those over age 60, according to a paper prepared by the Canadian Task Force on Preventive Health Care. Advanced gum disease is much less common, occurring in approximately 7% of young adults and 34% of elderly North Americans.

A glimpse of international medical literature shows a link between dental health and heart health.

> A national study of Canadians aged 36 to 69 found those with severe gum disease had between three and seven times the risk of developing fatal heart disease.

> A Finnish study found men who had suffered an acute myocardial infarction (AMI), a kind of heart attack, had a significantly higher presence of recent bacterial infection.

> Researchers in Australia recently reviewed the medical literature on cardiovascular and oral disease links, and found reducing mouth infections could significantly benefit cardiovascular health.

> A recent study of 500 people in Goa, India, found that poor oral hygiene, decayed teeth and bleeding gums were significantly associated with AMI.

> A study of 171 middle-aged men in Northern Ireland found poor periodontal status was significantly associated with coronary heart disease.

> A large study conducted in Ger-many concluded that high levels of periodontal bacteria were related to a higher incidence of heart disease among 789 people studied.

> In a U.S. study of 1,056 patients, a team of doctors and dentists found people with high levels of periodontal bacteria also had thicker internal linings of their carotid arteries, a major risk factor for stroke.

> Other evidence has also linked gum disease to stroke, according to Honos. A 10-year study that cross-referenced databases for stroke and dental surgery suggested victims of ischemic strokes had fewer teeth and more jawbone loss (signs of very poor oral health) than those who had not suffered strokes.

These studies show oral health tends to reflect heart health, but don’t prove gum disease is a direct cause of cardiovascular disease.

But it is never too early to start taking good care of your oral health, Honos says. A major U.S. study in 1993 of almost 10,000 dental examinations concluded gum disease increases the risk of coronary heart disease. And this association was strongest in young men. “It appears the oral infection/coronary artery disease link occurs primarily in younger rather than older people,” he says.

Among all this bad news is some good news. “Gum disease is both preventable and treatable,” says Honos. He recommends practising good oral hygiene and treating gum infections promptly.

The Canadian Dental As-sociation recommends taking the following steps to good oral health: see your dentist regularly; brush your teeth and tongue at least twice a day; floss every day; eat a balanced diet, avoiding excess sugar; watch for signs of unhealthy gums, such as bleeding, and see your dentist if you are concerned; and don’t smoke.

@page_break@“These measures should improve overall oral health and may eventually lower the risk of heart attack or stroke,” says Honos. IE