Surprising link between gum disease and heart disease.

Dentists everywhere enjoy seeing a healthy smile as much as cardiologists enjoy a healthy heart. We can then ask ourselves, could the health of one reflect that of the other?

Body Care | Circulation | Digestion


Owen Wiseman
@AVogel_ca


17 April 2018

What’s in a smile?

The teeth we see are made of a compound called dentin, the calcified portion of the tooth that provides structure. The root of our teeth extends beneath the gum line and are covered by cementum which attaches to the bone and gums via ligaments that anchor the teeth in place. Just like any other body part, they must be supplied with nutrients and have their waste products transported away. Within each one is a central cavity known as the ‘pulp’ which contains the nerve fibers and blood vessels that supply each tooth.

How do they connect?

The blood vessels weaving their way throughout the entire body can be thought of like a great branching tree with the heart at their core. These blood vessels start as large arteries, branch into smaller arterioles, become capillaries at their smallest, and then return to the heart as they grow into venules and eventually form veins before completing their circuit. Just like a tree can direct water to the areas that need it most, the body responds to changes in a similar fashion. This system wide response has consequences however, as the highways of blood can be high jacked by bacteria, parasites, and viruses to travel around and spread the infection.

The location of the teeth becomes especially relevant for more serious conditions. The vessels feeding the teeth branch off of the carotid arteries, and then feed into the middle meningeal artery. The meninges are protective layers that protect the brain from a variety of intruders…unless that intruder gets in using the very vessels that supply the layers.

What are the consequences?

Unsurprisingly, missing teeth are associated with a higher incidence of gum disease. The surprising aspect is that fewer teeth and gum disease were also associated with a risk of stroke. Much like plaque can build up in the arteries and cause a host of problems such as heart attacks or lack of blood flow, dental plaque accumulates unless oral hygiene is practiced. This plaque degrades the teeth and creates an environment that the bacteria thrive in. As more bacteria take up residence, they release toxins that are absorbed through the gums and enter the bloodstream. These toxins can promote the formation of plaques in the bloodstream which can progress into clots or blockages.

As the bacteria colonize the teeth, they can also form a shelter of sorts. They begin to secrete a glue-like coating that binds them together and creates a barrier. When the body gets word of an intruder, it mobilizes an army of white blood cells to attack and eliminate the infection. The cells travel to the gums and teeth but end up caught in the biofilm shield, while those that make it through are slowed down as if running underwater. These films can also lead to chronic infections as the bacteria become increasingly more difficult to get rid of. Periodontitis comes from the Greek words ‘peri’, meaning around, ‘odous’ for teeth, and ‘itis’ for inflammation.

What are the symptoms of gum disease?

The most basic sign of inflammation will be swelling and redness of the gums. You may also notice tenderness during brushing, chewing, or any activity that causes impact to the gums. Since the gums have been subject to assault by the bacteria, they may be more prone to bleeding in which case care should be taken while flossing. As time passes, the accumulating bacteria can lead to halitosis, otherwise known as bad breath, as they release waste products such as methane and carbon dioxide.

You may notice that your teeth have started to lengthen…but rest assured that you haven’t suddenly become a vampire or werewolf, your gum tissue is wearing down and receding. As the gums recede, the cementum anchoring our teeth to the gums is exposed to collagenases, enzymes released by certain bacterial species that can break down the cementum leading to the final symptom of tooth loss.

How can I prevent this?

Without a doubt, making oral hygiene a part of your everyday routine is the most critical factor to preventing gum disease. This includes brushing after meals at minimum, as well as flossing…and not just on the day of your dental appointment. When you brush your teeth, the motion of the bristles disrupts the aggregation of the bacteria…but the toothpaste is also just as important.

One study demonstrated the benefits of Echinacea for oral care while others have analyzed its antibacterial benefits. Products such as Echinacea Toothpaste also contain some essential oils such as peppermint, rosemary, and eucalyptus. Eucalyptus is an especially potent addition to the product due to its antibiofilm qualities.

Vitamin deficiencies are another major contributor to gum disease. To be specific, studies have shown that those who are deficient in vitamin D and calcium experienced a greater amount of periodontal inflammation. Additionally, those who consumed daily at least 55g of lactic acid containing foods experienced a lower rate of gum disease. This is a byproduct of the beneficial probiotic bacteria, lactobacillus. This creates an environment that is uninhabitable by certain bacteria or pathogens. Another way to achieve this is through products such as Molkosan, which is rich in L+ lactic acid.

References:
http://www.dentistryiq.com/articles/2017/02/the-surprising-link-between-periodontal-disease-and-heart-health-what-dental-professionals-need-to-know.html
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3084572/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3645457/
https://www.ncbi.nlm.nih.gov/pubmed/10960010
https://www.ncbi.nlm.nih.gov/pubmed/16171451
https://www.ncbi.nlm.nih.gov/pubmed/19722793
https://www.ncbi.nlm.nih.gov/pubmed/23635385
https://www.ncbi.nlm.nih.gov/pubmed/26009695
https://www.ncbi.nlm.nih.gov/pubmed/28761777
https://www.ncbi.nlm.nih.gov/pubmed/29184589
https://www.ncbi.nlm.nih.gov/pubmed/29522803
https://www.ncbi.nlm.nih.gov/pubmed/29539042

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