Written by: John Tunnell, DDS (Dallas County Dental Society member)
February is American Heart Month, which serves to raise awareness of heart disease in the general population. In the United States, coronary heart disease, which is the most common form of heart disease, is the #1 killer of both men and women. Peripheral artery disease (PAD) is a lesser-known form of heart disease that has been shown to affect 6% of adults aged 40 and older. PAD occurs when plaques, called atheromas, develop in the peripheral blood vessels and restrict blood flow to these areas, ultimately resulting in damage to the limb and possible loss of the limb or even death.
There has also been a rising body of evidence that suggests a link between patients having poor oral health and various forms of cardiovascular disease. In fact, several oral bacteria, especially those associated with periodontal disease, have been found in these atheromas. The presence of these bacteria in the atheroma may induce an inflammatory response that can contribute to the development and progression of cardiovascular diseases, such as PAD.
Heart disease can be especially dangerous in women, as 1 in 4 women in the United States will die from some form of heart disease. To assess whether or not there is a potential association between PAD and oral health, a group of researchers looked at 121,701 married female nurses in the United States who had an exam as part of the Nurses’ Health Study (NHS) from 1992 to 2008. These nurses self-reported their current health conditions, including whether or not they had been diagnosed with PAD, the number of missing teeth they had, and their smoking history. These same nurses were followed over several years and the changes in their health history were recorded. The researchers concluded that there was a significant association between recent tooth loss and PAD among women that tended to be modified by smoking status (i.e. those who smoked more cigarettes per day or smoked more often were more likely to lose teeth and develop PAD)1. Thus, this study highlights two important concepts. The first is that smoking not only affects your lungs, but can also affect your oral and cardiovascular health. Second, keeping and maintaining teeth appears to be important in avoiding PAD.
Maintaining good oral health is important not only for your mouth, but for your whole body. Visit your dentist or periodontist for regular checkups to make sure you and your heart are staying healthy!
1 Munoz-Torres FJ, Mukamal KJ, Pai JK, Willett W, Joshipura KJ. Relationship between tooth loss and peripheral artery disease among women. J Clin Periodontol. 2017;44:989-995. https://doi.org/10.1111/jcpe.12787.