Healthy gums and healthy hearts

Philip J. Goscienski, M.D.

August 2010

Your dentist or your dental hygienist has probably lectured you about how important it is to floss your teeth. Have they ever told you all the reasons why? Periodontal disease that is caused by poor oral care is the primary reason why many persons over the age of 60 have lost one or more teeth. However, losing a tooth or two is not the most important reason for maintaining healthy gums.

In persons who neglect to brush and floss their teeth daily, bacteria and their by-products, together known as plaque, accumulate in the space between the gums and the teeth. The earliest signs are mild swelling and bleeding at the gum line, referred to as gingivitis. As the damage progresses the gum tissue begins to separate from the teeth, (periodontitis) leading eventually to loss of bone that holds the teeth in place.

There is a significant association between periodontitis and diseases of the cardiovascular system. The inflammation of periodontitis results in the production of chemicals known as cytokines. These inflammatory substances damage the lining of blood vessels in distant parts of the body and may eventually lead to heart attack and stroke.

As the cardiovascular threat of periodontitis comes under closer scrutiny, more associations are appearing. It may be related to osteoporosis in women although the exact mechanism is unclear. In pregnant women it may cause prematurity and low birth weight, an observation that awaits further confirmation.

Most persons who suffer from chronic obstructive lung disease are or have been smokers but that leaves about 20 percent of cases unaccounted for. Periodontitis may be the reason. Some of the bacteria present in pockets of infection might be inhaled over a period of years, slowly and silently damaging the air sacs of the lungs so that they can no longer absorb oxygen as efficiently. In addition, cytokines may also harm the vessels of the lungs.

Finally, the epidemic of type 2 diabetes may bring new urgency to a problem that was once thought to involve only the teeth. Diabetes increases the risk, the frequency and the severity of periodontitis. On the other hand, inflammation worsens diabetes. This vicious cycle could seriously undermine the health of seniors, more than half of whom have diabetes or prediabetes.

The good news is that gum disease is easily prevented and easily treated. And those measures might be lifesaving.

Philip J. Goscienski, M.D. is the author of Health Secrets of the Stone Age, Better Life Publishers 2005. Contact him at