Dear readers,

Many studies have been published on the connection between oral hygiene and cardiovascular diseases. Please search for such studies on the internet.

Regards and best wishes.

Harpal Buttar

There is a co relationship between the cardio vascular and dental health care the cardic patients must be ensure their health safety from the cardiologist before the dental surgery.

Dental Hygiene is greatly important for CVD , Bacterial contamination ( focus) in any debris in mouth and teeth will affect directly the heart health.

we have certain varieties of bacteria that may involve like streptococcus , staph species ,Pseudomonas that may affect.

Another pathway is via calcium since calcium buildup may reflect healthy teeth and this may be related to cardiac function

Bacterial colonies from advanced periodontitis can form thrombi and translocate to the systemic circulation, lodging in the heart and causing endocarditis, or the kidneys, causing kidney injury (Abdulhadi, Ali M. Hussein, Iqbal Amer, and Mariam Khalil Mohammed. "Gram Positive Bacteria and Their Distributions According Anatomical Site in Oral Cavity and Effects on Oral Health." International journal of health sciences 8.2: 180-193.)

According to the British Heart Foundation as of early 2023, there are about 7.6 million people in the UK living with heart and circulatory disease. Of that around 4 million are men and 3.6 million women. Further, it states that heart and circulatory disease causes around a quarter of all deaths in the UK, which sums up to 460 each day. People with coronary heart disease or those who have had a heart attack are at a higher risk of having a stroke.

There is evidence that mental health disorders such as depression and anxiety can develop when people suffer from heart conditions. As oral health issues such as cavities and tooth decay can lead to periodontal disease it in turn leads to increased risk of heart disease, it is important to maintain good oral health with good oral hygiene habits, to reduce this potential risk.

According to the WHO, ‘Most oral diseases and conditions share modifiable risk factors with the leading noncommunicable diseases (cardiovascular diseases, cancer, chronic respiratory diseases and diabetes)’. When bad bacteria levels become high they lead to oral infections that cause periodontal disease and conditions including inflammation of the gums and bone that support the teeth. Called gingivitis during the early stages it causes swollen and bleeding gums. The increased bacteria travel through the bloodstream and latch onto the heart causing damage to the area and inflammation. This is basically how gum disease and cardiovascular disease are interlinked and how bad oral health increases the risk of heart .

Cardiovascular health refers to the health of the heart and blood vessels which if compromised can lead to a number of health issues such as strokes, heart failure, heart valve problems, heart arrhythmias as well as coronary heart disease. When you have increased bacteria in the mouth it crosses into your bloodstream and enters the heart and directly infects the heart valves which affects your cardiovascular health.

Another concern is that poor oral health puts additional strain on your immune system which is in a constant state of agitation caused by the excess bacteria entering your bloodstream. This affects its ability to fight again common illnesses.

Dental hygiene is indirectly associated with infective endocarditis , Therefore ensure dental hygiene before valve Replacement surgery.

the association between dental conditions and development of CVD was studied and results were in favor for a positive association between tooth loss, periodontal disease, and CVD . Conventional risk factors

for atherosclerosis and CAD such as smoking, diabetes, hypertension, high low-density lipoprotein (LDL) serum level, obesity, male gender, and genetic predisposition have been evidently recognized and systematically searched after cardiovascular event . Smoking and familial history play the pivotal role in the development of CVD in young patients . Unconventional risk factors like chronic inflammatory reactions have also been identified as predictors

of CVD. When the inflammation occurs, circulating markers and hemostatic factors were diligently linked with the development of myocardial infarction . Particularly, chronic oral infection was associated with chronic heart diseases. Dental infections were associated with anincreased prevalence of heart disease , as the oral cavity was the main site of inflammation and chronic infection, especially in cases of tooth loss and chronic periodontal diseases

Research suggests that there is an interrelationship between

oral infection, inflammation and systemic health. Patients, dental

hygienists, dentists, dental specialists and other health care

providers should be aware of the consistent relationships

between oral inflammation and systemic diseases. They should

value the need to modify assessment, prevention, and treatment

protocols to improve the oral health as well as total health of the

patients they treat in the office each day.

Atherothrombotic disease (ATD) and dental disease are both inflammatory diseases, but the inflammatory state in ATD is due to ATD risk factors, whereas the inflammatory state in dental disease is due to infection. As @Paul Ridker MD, pointed out over two decades ago, inflammation is high in sub-Saharan Africa, but ATD events are not. There is a link between ATD and dental disease, however, and that is tobacco. Cigarette smoking is the chief risk factor for clinical ATD, closely followed by dyslipidemia. Tobacco use--especially chewing tobacco--is a prominent cause of dental disease. (The role of chewing tobacco in ATD is subject to debate.)

The 2019 consensus report and other recent studies have reviewed a great deal of research to determine and outline the probable mechanistic links between these two inflammatory diseases.

There are at least two mechanistic reasons why periodontal disease increases the risk of cardiovascular disease. These links are rooted in:

• Microbiology: There is significant evidence that oral bacterial species can enter patient blood circulation and cause bacteremia. A 2020 study found that the kind of bacteria found in patients with periodontal disease are also a contributing factor to the development of atherosclerosis when they enter a patient’s bloodstream.
• Immune response: Periodontitis causes immune responses that increase levels of inflammatory mediators throughout the body. The heightened presence of these inflammatory mediators may raise the risk of aberrant inflammation throughout the body, including in the cardiovascular system.

In a nationally representative sample of the population, suboptimal oral health markers were found to be significantly associated with increased risk for negative cardiac out comes. Conversely, improvements in oral health parameters are linked to a diminution in the risk profiles of these outcomes. Targeted oral health interventions could serve as a vital compo nent of a multi-disciplinary approach to disease management and prevention. Future research should delve into the causal and temporal relationships between oral health and heart and vas cular conditions, incorporating clinical assessments alongside self-reported data to enhance accuracy and consider medication use as a potential confounder. Additionally, examining the efficacy of oral health interventions on disease outcomes and dissecting variability across demographic groups could yield critical insights for tailored public health strategies.