Healthy gums are good for the heart
Inflammation doesn’t just cause bad breath. They have effects throughout the body and can increase the risk of cardiovascular disease.
Good dental hygiene not only helps against bad breath, it helps the whole body.
Foto: Getty Images
It should be pink, sit tight on the tooth neck and not bleed when brushing your teeth: These are the criteria for healthy gums – and whoever has them enjoys many advantages. The teeth remain intact longer, painful inflammation is prevented and bad breath is prevented. In addition, researchers have long suspected that the positive consequences of a healthy oral cavity go even further. Inflamed gums not only have unpleasant local consequences, they could also have a disease-promoting effect throughout the body.
A new Study by ETH Lausanne provides another piece of the puzzle for this assumption: inflammation in the mouth may increase the risk of cardiovascular disease. Cardiovascular diseases are among the most common causes of death in Switzerland. Many of those affected suffer from coronary heart disease, in which the vessels around the heart narrow due to deposits on the vessel walls (arteriosclerosis). If one of the vessels becomes blocked, a heart attack occurs. These deposits in the vessels are favored by inflammatory processes in the body, presumably also by those in the mouth.
For their study, the scientists led by geneticist and precision physician Jacques Fellay evaluated data from around 3,500 people who had taken part in the long-term CoLaus/PsyCoLaus study in French-speaking Switzerland for 12 years. Among other things, the researchers looked for traces of antibodies to 15 viruses, six bacteria and one parasite. “For this analysis, we selected pathogens that are long-term companions of humans,” says Fellay, professor at the EPFL and the CHUV. These are, for example, the herpes or chickenpox viruses, both of which remain in the body after an infection.
Bacteria trigger inflammation
The team then compared the antibody levels of those participants who developed cardiovascular disease within the study period with those who did not. Several studies have recently shown that viral diseases can also play a role in the development of non-contagious diseases. For example, it has been shown that an infection with the Epstein-Barr virus increases the risk of developing multiple sclerosis.
Of all the antibodies examined, one stood out, directed against Fusobacterium nucleatum. This bacterium causes gingivitis and bad breath. The cardiovascular patients had higher antibody levels against the Fusobacterium.
This bacterium can also occur in small amounts in the oral flora of people with healthy gums. “But in order for antibodies to be detectable, it probably needs an active, painful inflammation of the gums,” says Fellay.
“There has long been a discussion in research as to whether gingivitis is a risk factor for cardiovascular diseases.”
Further studies should now show whether the risk of developing cardiovascular disease can be reduced by treating inflammation caused by this bacterium in the mouth. Such therapy could then complement other preventive measures. It is already known today that high cholesterol levels, lack of exercise, smoking, obesity or high blood sugar levels increase the risk of cardiovascular disease.
“There have been discussions in research for a long time as to whether gingivitis is a risk factor for cardiovascular diseases,” says Isabella Sudano, professor at the Department of Cardiology at Zurich University Hospital and an expert in prevention. It is very difficult to prove the connection causally, but there are various indications. For example, the increased oxidative stress and inflammation that occurs somewhere in the body could also cause damage to the inner wall of the coronary arteries.
The connection has already been clearly proven in endocarditis, an inflammation of the inner lining of the heart. If the gums are severely inflamed, the pathogens can get into the bloodstream and up to the heart. For this reason, people who have an artificial heart valve must also pay attention to particularly good oral hygiene and take antibiotics for prophylaxis during dental procedures.
Our behavior is crucial
There are various behavioral tips to promote gum health: It is important to brush your teeth thoroughly at least twice a day and also to clean the spaces between your teeth with dental floss or interdental brushes. Tartar should be professionally removed once a year. A low-sugar diet and not smoking can also help.
In their study, the EPFL researchers not only analyzed antibodies to various pathogens. They also checked genetic risks, thereby confirming what is already known from international studies. According to this, there is a certain genetic predisposition that increases the risk of cardiovascular diseases.
It is not about individual rare variants, but about the so-called Polygenic Risk Score (PRS). These are thousands of common gene variants that are distributed in a specific combination over a person’s genome. The good news, however, says Fellay: “The factors that you can control with your behavior have a greater influence.”
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