The link between oral health and heart health

It is now apparent that brushing and flossing do more than give you a prettier smile: they can also improve your health. In particular, research suggests that good oral health can contribute to good heart health. Here's what you need to know.

There is increasing evidence that chronic gum disease, as a cause of low-grade inflammation, could be linked to coronary disease. In fact, people with chronic bacterial infections of the gums are nearly twice as likely to have fatal heart attacks as those with healthy gums.

In one U.S. study of more than 700 men and women with no history of heart disease, researchers found a direct relationship between missing teeth (an indicator of serious dental disease) and plaque buildup in the arteries.

In 1993, another study of 10,000 found that gum disease significantly increased the risk of coronary heart disease.

European researchers treated 94 otherwise healthy patients who had severe gum disease. Before treatment, those with more severe infection had a more than fivefold increase in cardiovascular disease risk. After treatment of their gum disease, the patients' average risk levels were significantly reduced.

Other studies have linked gum disease with increased resting heart rate, abnormal electrocardiograms and poor blood sugar control — all symptoms of, or contributors to, heart disease.

We've intuitively known for centuries that bad teeth signify bad health.

It's only recently, though, that we have identified the scientific connection — inflammation.

The theory is that bacteria from dental plaque seep into the bloodstream via inflamed gums and produce enzymes that make blood platelets stickier and more likely to clot, contributing to the hardening of the arteries.

The good news is that gum disease is a risk factor you can easily control. Here's what to do.

Brush for two minutes: 

• Buy a two-minute bathroom timer (usually marketed for children) and use it.
• New electric toothbrushes have a built-in timing mechanism.
• Use gentle, circular strokes to brush at a 45-degree angle to your gums.
• Brush until the timer ends, working on all surfaces of the teeth — front, back and top.
• Brushing reduces levels of all harmful bacteria in your mouth.
• Brush twice a day, in the morning and before going to bed — and after lunch and dinner, if possible.

Replace your toothbrush.

• Most dentists agree that worn-out toothbrushes cannot clean your teeth properly and may actually damage your gums.
• They advise changing your toothbrush every two to three months because when bristles become splayed, they do not clean properly.
• Some dentists advocate storing the brush head in hydrogen peroxide.

Floss every day.

• The Canadian Dental Association estimates that only 30 per cent of Canadians floss daily.
• To floss properly, you should use about 50 centimetres (18 inches) of waxed dental floss, wind the majority around your left middle finger and the rest around your right middle finger, leaving a few centimetres in between. Then use your index fingers to guide the floss between your teeth.

Use mouthwash.

• Rinsing with an anti-bacterial mouthwash can help to reduce tooth plaque but you should avoid long-term use of alcohol-based mouthwashes.
• Alcohol-based mouthwashes have been associated with oral cancers (being in contact with the fragile mucosa lining the mouth for longer than the average sip of an alcoholic drink).

Book in advance.

• Make appointments with the dental hygienist for cleanings twice a year, or every three months if you have heart disease.
• Discuss any drugs you take as some, such as pills for high blood pressure, can increase your risk of gum disease.

Bear this information in mind to help remind you to take care of your teeth and gums so that you can keep your heart healthy.