Periodontal Infection and Cardiovascular Heart Disease: Are They Directly Related?

After doing a good amount of research on this subject, I was able to learn quite a few things about the association between periodontal infections and cardiovascular health. Coincidentally, the media airways have been a bit saturated with this issue, so finding sources was a little easier than normal. And, so as not to be just another voice in the crowd, I am taking this information and applying it in conjunction with my family's situations. In many ways you would need a doctorate degree to be able to understand some of the information found in these medical documents. I will do my best to explain them in simple terms.

The History of the Periodontal/CVD Hypothesis

In 1989, Kimmo J. Mattila and colleagues "revived a century-old hypothesis relating chronic infections with vascular disease that originally was proposed by French and German scientists." Through their studies they tried to make a causal link between periodontal disease and cardiovascular disease. At the same time they tried to avoid an "epidemiologic phenomenon...referred to as 'confounding'." (JADA 2) Confounding is simply two factors that have a correlation, but one is not the cause of the other. The current belief by professionals is based on the confounding principle.

The studies documented in the British Medical Journal and The Journal of the American Dental Association essentially draw the same conclusion - they cannot find a causal link. "The mechanism by which dental infections could influence the development of myocardial infarction remains unknown." (BMJ 781) "...the critical question of whether periodontal infections are a risk factor for or contribute causally to CVD and cerebrovascular disease remains unanswered." (JADA 8) There are too many factors that can play a role in the overall picture. "If it's true that people with poor oral health have more heart attacks, it doesn't mean the poor oral health leads to them. People with good oral hygiene may just be taking better care of themselves." (Webmd 1)

• Plaque found in arteries contain the bacteria Porphyromonas gingivalis, the same bacteria found in periodontal infections.
• Both diseases involve inflammation. (Webmd 3)
• "Periodontal disease...is more common among patients with acute myocardial infarction than among controls matched for age and sex." (BMJ 781)
• "Periodontal infections seem to be found more frequently in patients with CVD (cardiovascular disease)." (JADA 8)

Over the past year three members of our family have had to deal directly with this periodontal/cardiovascular issue. My wife and I have spent a decent amount of time in the dentist's office getting our teeth cleaned and having cavities filled or removed. Both of us hate the butt-clenching experience of drills vibrating our jawbones and the subsequent smoke that rises to the ceiling and smells horrible! But, you have to do it.

My wife has had an infection in her upper jaw that she's been dealing with for a month or more. Unfortunately, genetics have not worked in her favor. When she was a child, her new teeth grew in with cavities. During this past month she's felt exhausted, even after nights of 8 hour sleep. Her energy levels are near zero and she continuously mentioned that her heart would flutter and skip beats. It had gotten to the point that it became a major concern. She is in very good health and quit smoking several years ago. Was there something seriously wrong?

I have had a few cavities that have needed to be filled, mostly in my wisdom teeth. I began to notice, as well, that when these cavities became really infected, my energy levels went way down. My heart would also flutter, roll in my chest, and skip beats. Prior to my latest two cavities, I did experience the worst cases of heart trouble. I do have mitral valve prolapse and quit smoking over 4 years ago, but there has got to be something more going on here.

Interestingly enough, and thank God, after both of received the necessary dental treatments along with Amoxicillin antibiotics, the heart troubles have ceased completely. Energy levels are back up to normal and our hearts are functioning smoothly. Is there really no causal connection between the teeth and heart?

I have two other stories to share that do not have a happy ending. A woman had recently suffered a stroke. She was diagnosed with some heart issues that has never healed since she was a child. During this time she was a regular smoker and, several years ago a crown popped off of her tooth that she never had replaced.

Over time, periodontal disease began spreading through her mouth. In her case there are several factors to consider. It is difficult to ascertain if the condition of her teeth caused the stroke. She is scheduled for heart surgery, but first must go through extensive dental work before this procedure can even happen. What doctors do know for a fact is that any hole in the mouth is a portal for infection to enter the bloodstream.

The last story comes from a college associate. Her nephew has had dental cavities since he was little and his parents never decided to have him in for treatment. He was a very athletic kid, involved in nearly every sport. One day, it was decided that he would finally have those cavities filled. Shortly after the procedures, he had a heart attack. He was 19 years old.

It is believed that the surge of bacteria into the bloodstream from the procedures was the cause. This heart attack has completely taken him out of sports He will never play again because his heart can no longer handle the stress of activity.

And so the big question bubbles to the surface. In each of these four cases, do they prove any causal link between periodontal disease and heart health? Or, are they just four more cases that can be explained through the concept of confounding? What do you think?

• Has anyone in your family had heart troubles before a dental procedure?
• If so, have these symptoms gone away after the cavities were filled?
• Do you believe that these two diseases are directly related? If so, I'd love to hear your comments!

http://m.jada.ada.org/content/137/suppl_2/14S.full

http://www.webmd.com/oral-health/features/healthy-teeth-healthy-heart?print=true

Mattila, Kimmo J., colleagues. "Association Between Dental Health and Acute Myocardial Infarction." British Medical Journal Vol. 298 March 25, 1989. pp. 779-781.