Doctor’s tip: How oral health affects heart risks
It’s becoming increasingly apparent that there is a strong connection between what goes on in your mouth and what goes on in your coronary and other arteries. One obvious connection is the relationship between the food you put in your mouth and the health of your heart. One of my favorite quotes (author unknown) is this: “The food you eat can be the safest, most powerful medicine or the slowest form of poison.”
But what I’d like to discuss in this column is the connection between disease of the teeth and gums and coronary artery disease. In their informative book “Beat The Heart Attack Gene,” Brad Bale, M.D. and Amy Doneen, N.P. Ph.D., note that recent evidence shows that diseases of the teeth (cavities, root canal infections) and gums (periodontal disease) can drive the formation of plaque in the arteries and can also cause the inflammation of arterial plaque that leads to plaque rupture, the cause of heart attacks and most strokes. This explains why some people have heart attacks and strokes without having the usual risk factors such as high cholesterol, hypertension, positive family history or diabetes.
So heart attacks and strokes are not all about cholesterol, and the missing piece of the puzzle is inflammation. People with inflammatory diseases such as rheumatoid arthritis are at much higher risk for a cardiovascular event. For the rest of us, inflammation is often dental. When Bale and Doneen see a patient for heart attack prevention, they routinely order a Cleveland Heart Lab test, that includes inflammatory markers. Highly sensitive C-reactive Protein is a non-specific inflammatory marker (an elevation could mean vascular inflammation but could mean arthritis or other inflammation). The myeloperoxidase (MPO) test is for inflammation of the endothelial lining of the arteries; the LpPLA2 (PLAC2) test is for inflammation of arterial plaque, which can lead to plaque rupture/heart attack or stroke. If the MPO or PLAC2 is elevated, Bale and Doneen refer the patient to a dentist who is well versed in the mouth-heart connection.
If you want to prevent a heart attack or stroke, good dental hygiene is very important: brush after meals; floss correctly (don’t just snap the floss between your teeth, but rather the floss should form a C-shape on each side) at least after your evening meal; use a water pick after your evening meal and ideally after every meal.
Bleeding from your gums is a sign of gum disease, and if this occurs see your dentist right away. See your dentist if you have any pain in your teeth, although you can have significant tooth infections without any symptoms so you should see your dentist routinely and have X-rays done periodically. Bale and Doneen say that anyone who has a heart attack or stroke should have a complete dental checkup, including a saliva test called MyPeriPath, which shows the balance between the different bacteria in your mouth, and in particular if “bad bacteria” have taken over.
I have taken the Bale-Doneen Method (of heart attack prevention) preceptorship, and recently attended their two-day preceptorship reunion. Interestingly, over half the attendees were dentists, who seem to be understanding the mouth-heart connection before physicians are.
Dr. Feinsinger, who retired from Glenwood Medical Associates after 42 years as a family physician, now has a nonprofit Center For Prevention and Treatment of Disease Through Nutrition. He is available for free consultations about heart attack prevention and any other medical concerns. Call 970-379-5718 for an appointment. For questions about his columns, email him at firstname.lastname@example.org.
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