Gum Health Associated With Carotids

GumsOver the years I have attended lectures led by Bradley Bale, MD and Amy Doneen, RN who promote the theory that inflammation is one of the major causes of acute heart attack and stroke.  They measure inflammation in men and women with normal lipid levels, normal blood pressure who are non-smokers and exercise but still have cardiovascular events such as heart attacks and strokes.  They talk about the formation of soft lipid plaque or foam cells forming in the walls of the blood vessels and then erupting into the lumen of the blood vessel under the influence of inflammation setting off a clotting cascade that leads to heart attacks and strokes acutely. They measure the degree of inflammation using a series of blood tests patented by the Cleveland Clinic and look for atherosclerosis by doing carotid ultrasounds in a special way to measure carotid artery intimae thickness which they believe correlates with the presence of atherosclerosis, soft plaque and the risk of an acute event.  When all traditional major  risk factors such as smoking, blood pressure, blood glucose level, high blood pressure , activity level and family history have been taken into account and treated there are individuals who still have inflammation and acute events.  They believe oral periodontal disease is the culprit and suggest treating it.

They receive confirmation of their theory in an online article in the Journal of the American Heart Association written by Moise Desvarieux, MD, PhD of Columbia University’s Mailman School of Public Health in NYC with his colleagues.  They demonstrated that by reducing periodontal disease over a three year period there was less progression of carotid artery intima media thickening.  As the gums improved and the oral microbes that are associated with periodontal disease decreased the progression of intimal thickness slowed.

It is clear that more research is needed but while it is ongoing simply seeing your dentist regularly and caring for your teeth and gums can go a long way to reducing your risk of a heart attack or stroke. The long hypothesized relationship between mouth disease and vascular disease has much stronger evidence after this study and it makes it necessary for those of us discussing prevention and risk factor reduction to ask you at your visits “are you up to date on your dental visits and dental hygiene?” It additionally adds clout to the argument that health insurance includes dental coverage as well!