Your Weekly Checkup: Can Gum Disease Lead to Heart Attacks or Cancer?

“Your Weekly Checkup” is our online column by Dr. Douglas Zipes, an internationally acclaimed cardiologist, professor, author, inventor, and authority on pacing and electrophysiology. Dr. Zipes is also a contributor to The Saturday Evening Post print magazine. Subscribe to receive thoughtful articles, new fiction, health and wellness advice, and gems from our archive. 

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As a youngster growing up without fluoride in the water, I had a gazillion cavities in my teeth. Now, as a senior citizen, I’ve paid the price with root canals, caps, and transplants. Through it all, however, I’ve tried to maintain the best dental hygiene possible to avoid losing more teeth, getting more cavities, and having bad breath. That turns out to be a simplistic notion because we now need to also think about the risks of cardiovascular disease and cancer.

Periodontal disease is a chronic inflammatory process caused by bacteria affecting the soft and hard structures holding the teeth in place. Being male, current cigarette smoking, and diabetes mellitus are important risk factors for developing periodontal disease. The disease appears to be pervasive, affecting up to 90% of the population worldwide. Half of Americans aged 30 or older have periodontitis, and the inflammation, which can affect the entire body (be systemic), can be associated with heart attacks and strokes. Recent studies suggest a rise in the incidence of stroke worldwide and have reported an association between periodontal disease and stroke. These reports suggest that stroke has a stronger association with periodontal disease than coronary artery disease.

Preventing and treating inflammation is an important component for maintaining good cardiovascular health. For example, the ARIC (Atherosclerosis Risk in Communities) sub study assessed dental hygiene and stroke rates. They found that all categories of periodontal disease were associated with higher rates of stroke when compared with the perfectly normal group without periodontal disease or inflammation. Those in the worst periodontal disease category had more than twice the risk for stroke. Importantly, the ARIC study found that patients who received regular dental care had a 23% less risk of stroke compared with those patients receiving episodic care. The important message is that regular dental care can reduce the stroke risk. An increase in tooth brushing frequency decreases the concentrations of systemic inflammatory markers in the blood.

In addition, a paper published in the Journal of the National Cancer Institute indicated that individuals with severe gum disease may be at greater risk for developing multiple types of cancer compared to those with no or mild gum disease. Dental exams were performed on more than 7,400 people. Researchers found that after 15 years, individuals with severe gum disease had a 24 percent higher risk of developing any kind of cancer. The risk for lung cancer was more than doubled for those with severe gum disease compared to those with no or mild gum disease. The risk of developing colorectal cancer was increased as well, especially in the group of nonsmokers who had severe gum disease.

The message is clear. As a part of staying healthy, see your dentist regularly, floss and brush your teeth frequently.