The Important Connection Between Oral and Heart Health

Did you know that oral health and heart health appear to be connected? This February — which is Heart Month — familiarize yourself with recent research on the topic.

Over the past few years, a handful of studies have investigated the correlation between oral hygiene indicators and heart health. Although these studies were not able to answer the question of causality, several found significant associations that highlight the importance of good oral health in maintaining good heart health.

In 2012, the American Heart Association (AHA) released a statement on the possible link between periodontal disease (PD) and atherosclerotic vascular disease (ASVD) — the dominant cause of cardiovascular disease which affects more than 3 million Americans a year.

“The relation between PD and ASVD is potentially of great public health importance because of their high prevalence,” wrote Peter Lockhart et al. in the AHA statement. “Extensive review of the literature indicates that PD is associated with ASVD independent of known confounders.”

Ten years later, that statement largely remains true. A review article published in the International Dental Journal in February 2022 argues the same point based on evidence from three years of intervention studies, systematic reviews and meta-analyses. Still, the authors, Maria Febbraio, Christopher Bryant Roy and Liran Levin, note that there is a lack of high-quality, blind, randomized control trials, and that such trials run into ethical quandaries when it comes to the nontreatment of cardiovascular disease (CVD).

That said, recent studies have been able to include certain oral hygiene indicators that may lead to insights on periodontal interventions to reduce the risk of CVD. The findings also begin to better articulate the relationship between PD and CVD.

A study of 161,000 subjects in Korea found that improved oral hygiene was associated with a decreased risk of atrial fibrillation and heart failure. Frequent tooth brushing, for example, was significantly associated with a reduced risk of afib. Professional dental cleaning was negatively associated with risk of heart failure.

The authors emphasize that the findings show correlation, not causation, and that healthier oral hygiene habits may improve heart health, but there is no guarantee that they will. For example, it is important to consider possible confounding variables. Another study found that the relationship between poor oral health and coronary heart disease risk may be explained by cigarette smoking.

Even with the remaining uncertainties, Febbraio et al., the authors of the 2022 review article, are unequivocal: “Although the question of causality in the association between periodontal disease and cardiovascular disease remains unanswered, the importance of good oral health in maintaining good heart health is reiterated.”

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