Have you been ignoring your oral hygiene? Overlooking the signs and symptoms of a gum disease that may cost you more than the health of your teeth and gums? Did you know that gum disease may increase your risk of cardiovascular disease, stroke and diabetes?
What is gum disease?
Gum disease is the inflammation of tissues around the teeth. It occurs when bacteria in your mouth forms sticky plaque around your teeth. Initially, it causes inflammation that makes your gums red and swollen. This early stage of gum disease is called gingivitis and if not treated in time, it can quickly progress into a more serious form called periodontitis. In this stage, you have painful bleeding gums that begin to recede away from the teeth.
In periodontitis, gums pull away and create spaces that gradually get bigger. Bacteria soon infects these spaces, causing more inflammation and swelling. This can eventually lead to disintegration of gum tissue, tooth loss and even erosion of bone. Poor oral hygiene, age, smoking and diabetes are some major factors that increase your risk of developing gum disease.
Poor gum health is not just limited to decaying teeth and break-down of gum tissue. It can also cause chronic inflammation in the body, which has been linked with problems like clogged arteries, cardiovascular disease, stroke, diabetes and arthritis.
In this blog post, we are going to explore the connection between gum disease and increased risk of heart disease.
So, what is the connection?
Periodontal disease may be associated with atherosclerosis (thickening and narrowing of arteries), heart attack and other issues related to cardiovascular health. Studies show that people with chronic gum diseases are twice more likely to have heart disease than people with healthy gums.
The truth is your oral health reflects your overall health and should be considered as an important marker for inflammation, heart diseases and many other inflammatory conditions in the body.
But how does poor oral health increase one’s risk of heart disease? The answer may lie in the gum inflammation and the bacteria involved in causing gum disease.
The bacteria and germs in your mouth can travel to other parts of the body through the bloodstream and can trigger immune responses that give rise to inflammation. For example, upon reaching the heart, these bacteria can cause inflammation and endocarditis, infection of the inner lining of the heart. Chronic inflammation has also been strongly linked to the onset and progression of atherosclerosis (clogged arteries), cardiovascular disease and stroke.
Inflammation happens when your immune system responds to injuries and foreign invaders like bacteria and virus. Your immune system sends its army of white blood cells, proteins, enzymes and various signalling molecules that destroy infection-causing microbes. This process also helps your body to repair and heal its damaged tissues. Redness, pain and swelling are a few tell-tale signs of the inflammatory responses that follow. Usually, these signs go away on their own once your immune system is able to eliminate these triggers. This stage is called acute inflammation and is often short lived.
However, in the presence of some persistent triggers (such as chronic stress, chronic infections and exposure to chemicals and environmental toxins), your body keeps fighting away. This is when chronic inflammation sets in. A person with chronic inflammation is likely to age faster and becomes more vulnerable to developing serious health issues. Chronic inflammation has been implicated in many health problems such as atherosclerosis heart disease, arthritis, cataracts, Parkinson’s, type 2 diabetes and cancer.
In an inflammatory condition like periodontitis, deep spaces around gums and teeth become the perfect dwelling place for bacteria, where they grow and thrive. These bacteria, along with the toxins and waste material they release, travel to the bloodstream – resulting in increased immune response. This increases the levels of many markers that indicate the presence of inflammation in the body, such as C-reactive protein.
A 2010 review article suggested a potential link between periodontal disease and cardiovascular disease and concluded that, “It seems from the scientific evidence gathered so far that interventional periodontal care remains invaluable not only for oral health but for general health as well.” 
Another study in 2016 also points to evidence that periodontal disease is associated with a higher risk of coronary heart disease. It reported that periodontal disease causes “increased inflammation, increased coagulation and insulin resistance”, adding that these pathways may explain why patients with periodontal disease may have an increased risk for CHD. 
While inflammation has been long implicated in the development of atherosclerosis, experts like Dr. Uffe Ravnskov believe that infectious bacteria may also contribute. He explains: “Mortality in myocardial infarction and stroke increases during influenza epidemics and people with infected teeth or with bacteria in the blood are at greater risk than healthy people. Further, about a third of all patients with acute myocardial infarction or stroke have had an infectious disease immediately before onset.” 
Oral conditions such as gingivitis and periodontitis clearly increase inflammatory stress on the body. And oral bacteria can also reach the heart tissue via the bloodstream, where they can attach themselves to a damaged area and cause endocarditis – an infection of the inner lining of the heart also called as endocardium. Infective endocarditis is a rare but life-threatening condition and is often caused by bacteria present in the teeth. 
The bacteria can also damage blood vessels and cause inflammation, giving rise to atherosclerosis or clogged arteries. This increases the risk of blood clots, heart attack and stroke. Studies have found fragments of oral bacteria within blood vessels inflicted with atherosclerosis.  There is some evidence that properly treating periodontal disease may reduce systemic inflammation. 
Gum disease is related to other diseases too
Gum diseases were once believed to have complications that were simply localized to the gums and teeth. New findings, however, increasingly show that poor oral hygiene casts a wider net on your overall health. Studies show that periodontitis is also associated with diabetes, rheumatoid arthritis, and pregnancy complications.
This longitudinal cohort study demonstrated that periodontal disease increases the risk of non-communicable diseases such as angina, obesity and osteoporosis. 
Gum disease and diabetes
The relationship between gum disease and diabetes appears to be a bi-directional road. On one hand, periodontitis increases your risk of developing diabetes or it can even make it difficult for diabetic people to control their blood sugar levels. In fact, studies show that people with gum disease often have higher blood sugar levels than those with healthy gums. Gum disease may also increase the risk for health complications typically associated with diabetes. 
On the other hand, people suffering from diabetes are more likely to develop gum disease. Diabetes is considered as an important risk factor in increasing the severity of gingivitis and periodontitis. It is mostly because raised sugar levels in the blood increases inflammation and also the risk of overall infections. Studies suggest that the treatment of PD may help control blood sugar levels in patients with both diabetes and periodontal diseases.
Gum disease and pregnancy complications
Gum disease is also linked to pregnancy complications such as pre-eclampsia – a condition where a pregnant woman develops high blood pressure. Other symptoms such as swelling in hands and feet also occur. Studies show that periodontal disease can be viewed as a probable risk for premature delivery and a baby born with low birth weight , which is associated with complications like breathing problems, lung disease and jaundice in a new born.
Changes in the levels of hormones like oestrogen and progesterone during pregnancy are believed to cause an increased risk of gum disease. Dental treatment at the right time may help reduce the risk of premature delivery.
Gum disease and rheumatoid arthritis
The inflammatory environment present in the gum disease may also play some role in the development of rheumatoid arthritis.   Porphyromonas gingivalis (P. gingivalis) is the main bacteria involved in the colonization of the dental plaque and development of periodontal disease. PD triggers the formation of antibodies that cause destructive autoimmune response, which then drives the destruction of gum tissue and synovial joint tissue.
Symptoms of gum disease
You know you have gum disease if you have:
- Gums that are red, swollen or tender gums
- Gums that bleed when you brush, floss or even eat
- Gums that seem to be receding away or pulling away from the teeth
- Persistent bad breath or bad taste in mouth that remains even after brushing or flossing
- Loose teeth
- Pus between the gums and teeth
- Small pockets around the tooth
One of the best ways to prevent gum disease is to maintain a regular oral hygiene regime.
- Brush and floss twice a day
- Regularly use a mouthwash to remove dental plaque
- Change your toothbrush around every two-three months
- Be regular with your dental clean up and examination
- Limit your intake of sugary foods, sugary drinks and alcohol
- Quit smoking
- Manage your blood sugar levels
- Be aware of the early signs and symptoms of gum disease
You can’t ignore the role of eating a healthy diet in keeping your body vibrant and healthy. Why would your oral health be any different? Inadequate nutrition often means your body lacks the antioxidant support it needs to fight oxidative damage and inflammation that causes infections and diseases, including gum diseases.
When it comes to effective management of gum diseases like gingivitis and PD, CoQ10 stands out among other supplements. CoQ10 also plays an important role in keeping your heart healthy.
CoQ10 supplements in periodontal disease
Many dentists in Japan are known to recommend CoQ10 supplements to treat periodontal disease. It is a powerful antioxidant that reduces gum inflammation and associated symptoms like swelling, pain and redness. CoQ10 also heals damaged gums and improves immunity to fight bacterial infections in the gum.
Your cells make their our own CoQ10, which helps them fight oxidative damage as well as produce energy. However, your body produces less CoQ10 as you get older. In addition, your need for CoQ10 increases if you are dealing with any persistent infection, chronic disease or you are being continuously exposed to chemical toxins and heavy metals. Stress also depletes CoQ10 from the body.
We should also mention that CoQ10 is considered as one of the most important supplements you can take to support your heart health. This is not surprising given that CoQ10 reduces oxidative stress and inflammation strongly implicated in congestive heart failure, ischemic heart disease and other heart diseases.
CoQ10 supplements have been found to improve the quality of life in people with heart failure and also reduce their symptoms and risk of unexpected hospitalization and surgery. CoQ10 supplements also reduce the side effects caused by statins, drugs often prescribed to lower cholesterol levels. It is because long term use of statins leads to reduced production of Coq10, that may cause muscle fatigue, muscle pain and even increased risk of heart disease. Recharging the levels of depleted Coq10 may help mitigate some of these risks and keep you in good shape.
In a nutshell
Emerging evidence suggests that gum disease may have consequences that echo beyond poor gum health and gum inflammation. We have some high-quality studies that suggest that bacteria and inflammation in the oral cavity may play an important role in increasing systemic, body-wide inflammation – leading to risk factors known to cause cardiovascular disease. Maintaining oral health and addressing the signs and symptoms associated with gum disease may help reducing your risk of heart disease and other conditions.
Consult your doctor before taking a CoQ10 supplement. While it is generally safe and well tolerated, CoQ10 may interact with certain drugs like warfarin, those used for diabetics, beta blockers and anti-depressants. You should also consider that this supplement may reduce your reliance on such artificial medication.
- Dhadse et al. The link between periodontal disease and cardiovascular disease: How far we have come in last two decades ? J Indian Soc Periodontol. 2010
- Mathews et al. Oral health and coronary heart disease. BMC Oral Health. 2016
- Uffe Ravnskov. The Real Cause of Heart Disease? part 3 of 4. Spacedoc
- Lockhart et al. Poor oral hygiene as a risk factor for infective endocarditis–related bacteremia. J Am Dent Assoc. 2009
- Mahendra et al. 16S rRNA-based detection of oral pathogens in in coronary atherosclerotic plaque. Indian J Dent Res. 2010
- Tonetti et al. Periodontitis and atherosclerotic cardiovascular disease: consensus report of the Joint EFP/AAP Workshop on Periodontitis and Systemic Diseases. J Clin Periodontol. 2013
- Lee et al. Association between periodontal disease and non-communicable diseases. Medicine (Baltimore). 2017
- Mealey et al. Diabetes mellitus and inflammatory periodontal diseases. Current Opinion in Endocrinology, Diabetes & Obesity 2008
- Soroye et al. Association between periodontal disease and pregnancy outcomes. Odontostomatol Trop. 2015
- Linda Peckel. Bi-Directional Links Between Rheumatoid Arthritis and Periodontal Disease. Rheumatology Advisor. 2017.
- Bingham et al. Periodontal disease and rheumatoid arthritis: the evidence accumulates for complex pathobiologic interactions. Curr Opin Rheumatol. 2013