Is there a link between heart disease and gum disease?

November 02, 2009|Judy Foreman

Q. Is there a link between heart disease and gum disease?

A. There is growing evidence that there is, indeed, such a link, and if you have either condition, you should pay extra attention to treating the other as well. That’s the conclusion of a “consensus’’ statement written by leading gum disease specialists and cardiologists published online earlier this year in the American Journal of Cardiology and the Journal of Periodontology.

“The mechanism of the relationship strongly points to inflammation’’ as the culprit in both cardiovascular disease and periodontitis, or gum disease, says Dr. Thomas E. Van Dyke, a professor of periodontology and oral biology at the Boston University School of Medicine.

It’s possible, he notes, that the bacteria that cause gum disease directly trigger the inflamed plaques in blood vessels that can rupture and cause heart attacks. But it’s more likely that local inflammation in the gums “spills over’’ and causes body-wide inflammation. Chronic inflammation is an underlying cause of a number of diseases.

Dr. Paul Ridker, director of the Center for Cardiovascular Disease Prevention at Brigham and Women’s Hospital, notes that “cardiologists now understand that inflammation is a major risk factor for heart disease. Patients with periodontal disease, rheumatoid arthritis, and psoriasis all have chronic inflammation, and all turn out to have higher cardiac risk than previously appreciated.’’

The gum disease specialists and cardiologists now recommend that if you have periodontitis and at least one risk factor for heart disease (such as smoking, a family history of heart disease, or cholesterol problems), you should get a medical evaluation if you have not had one in the past year.

People with known cardiovascular disease should also consider getting a periodontal evaluation if they have symptoms of gum disease, significant tooth loss, or unexplained high scores on a test called hs-CRP, which is a marker for inflammation.

E-mail health questions to foreman@globe.com.