Does gum disease cause heart disease?
Gum disease and heart disease are linked, but a cause has not been proven. A 2012 American Heart Association scientific statement found that people with periodontitis are more likely to have atherosclerotic vascular disease even after allowing for shared risks such as smoking, yet the evidence does not show that gum disease causes it or that gum treatment prevents it. The dentists at Creative Arts in Dubai treat gum disease for the health of your mouth.
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What does the research actually show?
For decades, studies have noticed that people with gum disease (periodontitis) are more likely to have heart and blood vessel disease. In 2012 the American Heart Association published a scientific statement reviewing that evidence. Its conclusions are worth knowing precisely, because they are often reported loosely:
- Observational studies support an association between periodontal disease and atherosclerotic vascular disease, the narrowing of arteries behind most heart attacks and strokes, independent of known confounding factors.
- They do not support a causative relationship.
- There is no evidence that periodontal treatment prevents atherosclerotic vascular disease or changes its outcomes.
In other words, the two conditions tend to occur together more often than chance would explain, but that does not prove that one causes the other. Research continues, and future studies may clarify the picture, but at present no one can honestly promise that treating your gums will lower your risk of a heart attack.
Why the caution? An association means two things are found together more often than expected. That can happen because one causes the other, because both are caused by something else, or because people with one condition differ in other ways that are hard to measure. Smokers, for example, are more likely to have both gum disease and narrowed arteries. Proving cause usually needs trials showing that treating one condition changes the other, and for gum treatment and heart disease that evidence is not there.
What is established, and what is not?
A summary of where the evidence stands, so that claims you read can be put in context.
| Statement | Where the evidence stands |
|---|---|
| People with gum disease are more likely to have heart and artery disease | Supported by observational studies |
| The link remains after allowing for shared risks such as smoking | Supported, according to the American Heart Association statement |
| Gum disease causes heart disease | Not proven |
| Treating gum disease prevents heart attacks or strokes | Not shown |
| Gum disease and heart disease share risk factors | Yes: smoking, diabetes and increasing age among them |
| Treating gum disease helps keep your teeth and mouth healthy | Yes; this is the main reason to treat it |
Why might gum disease and heart disease be connected?
Researchers have proposed several explanations, and they are not mutually exclusive:
- Shared risk factors. Smoking is a major risk factor for both, as are diabetes and age. People who smoke are more likely to have gum disease and heart disease for the same underlying reason. Studies try to adjust for this, but no adjustment is perfect.
- Inflammation. Periodontitis is a long-term inflammatory condition, and inflammation also plays a part in how arteries narrow. One theory is that ongoing inflammation in the gums adds to the body's overall inflammatory load.
- Bacteria entering the bloodstream. Inflamed, ulcerated gum in deep pockets bleeds easily, and mouth bacteria can briefly enter the blood during chewing or brushing. Their role in artery disease is studied but not established.
The AHA statement describes a contribution of gum disease to artery disease as biologically plausible, which is why the question is taken seriously. Plausible, however, is not the same as proven.
So why treat gum disease if it may not protect your heart?
Because periodontitis is a disease of the mouth that does real damage on its own terms. It destroys the gum attachment and bone that hold the teeth, causing over time receding gums, gaps, loose teeth and eventually tooth loss. It can cause persistent bad breath, bleeding and discomfort, and it makes later treatment such as implants or bridges more complicated. The WHO identifies poor oral hygiene and tobacco use as the main risk factors for it.
Treatment is usually effective at controlling it. It starts with measuring the gum pockets and taking X-rays, then removing plaque and tartar above and below the gum line, often with deep cleaning of the root surfaces, followed by regular maintenance. Our guides to gingivitis vs periodontitis and whether gum disease can be reversed explain the stages and what treatment can achieve.
A healthy mouth is worth having for its own sake. If research one day confirms a benefit for the heart, that will be a bonus; it is not the reason to act.
Bleeding gums, receding gums or teeth that feel loose? A gum assessment measures the pockets around each tooth and explains whether you have gingivitis or periodontitis, and what treatment would involve.
See gum treatmentWhat should heart patients tell their dentist?
Whatever the research eventually shows about gum disease and arteries, a heart condition does matter for dental treatment in practical ways. Before any treatment, tell the dentist:
- Which medicines you take, especially blood thinners (anticoagulants or antiplatelet medicines). Do not stop or change them before dental treatment unless your doctor tells you to; the dental team plans around them.
- If you have an artificial heart valve, have had infective endocarditis before, or have certain congenital heart conditions. Some people in these groups are advised by their cardiologist to take antibiotics before particular dental procedures. That decision follows your cardiologist's advice.
- If you have had a recent heart attack, stroke or heart surgery, as non-urgent treatment may be timed with your doctor's input.
- If you have a pacemaker or other implanted device, so the team can check that any equipment used is suitable.
Bring an up-to-date list of medicines to your appointment. If your gums need treatment, the dentist can coordinate with your doctor where needed.
How do you know if you have gum disease?
Gum disease often causes few symptoms until it is advanced, and smoking can hide the most common early sign, bleeding. Signs worth a check include:
- gums that bleed when you brush or floss;
- red, swollen or tender gums;
- gums that are pulling back from the teeth, making them look longer;
- bad breath or a bad taste that does not go away;
- teeth that feel loose, have moved or have new gaps between them;
- a change in how your teeth meet when you bite.
A dentist confirms gum disease by measuring the pockets between gum and tooth and, where needed, taking X-rays to see the bone. Our page on bleeding gums describes what to do in the meantime. If you have diabetes, the relationship with gum disease is closer and better studied; our guide to diabetes and gum disease explains it.
What can you do to protect both your gums and your heart?
The most useful steps happen to help both, through shared risk factors rather than through any proven direct effect of the gums on the heart:
- Stop smoking, including shisha and medwakh. It is one of the strongest risk factors for gum disease and for heart disease; our guide to smoking, shisha and vaping covers the effects on the mouth.
- Keep diabetes well controlled, with your doctor's help.
- Clean thoroughly every day: brush twice with fluoride toothpaste and clean between the teeth; our guide to flossing and water flossers helps you choose a tool.
- Keep regular check-ups and gum maintenance at the interval your dentist sets, and treat bleeding gums as a sign to act on.
For heart health itself, follow your doctor's advice on blood pressure, cholesterol, activity and diet. Dental care complements that; it does not replace it.