World Heart Day 2023: Exploring the link between oral health and heart health

The global event aims to raise awareness and encourage action for heart health (Image: World Heart Federation)

World Heart Day, launched by the World Heart Federation (WHF), is celebrated each year on the 29th of September. Oral health has long been linked to overall wellness. However, a growing body of scientific research has uncovered an even deeper connection: the relationship between oral and heart health.

Cardiovascular disease (CVD) is the leading cause of death in the Western world. The most common cardiovascular diseases are coronary heart disease, heart failure, and cerebrovascular disorders. More than 20.5 million people die from these diseases each year. Cardiovascular diseases affect the heart and blood vessels, leading to severe and possibly even fatal complications. However, the WHF estimates that 80% of premature deaths from the disease are preventable.1

“By making small changes to our lifestyles, we can better manage our heart health and beat cardiovascular disease,” encourages the WHF.

Such changes include actions that help improve oral health. Good oral hygiene is more than just a beautiful smile. It is essential to look after your teeth and mouth because even seemingly harmless oral conditions can put you at risk of serious diseases.

Oral pathogens are not limited to the mouth

Cardiac and transplant surgeon, Dr Tommi Pätilä, at the New Children’s Hospital (HUS) in Helsinki, Finland stresses that a healthy heart requires a healthy mouth and thorough daily oral hygiene, where oral biofilm bacteria are the cause of 95% of dental diseases.

“Simple measures such as regular brushing and cleaning of the interdental spaces and regular dental check-ups can help prevent the onset of gum disease and, at the same time, minimise the risk of bacteria or their structures in the mouth entering the bloodstream and spreading to the rest of the body,” says Dr Pätilä.

Even chewing food can spread bacteria or parts of bacteria that cause oral infections to the rest of the body through infected gums. This results in a persistent inflammatory condition within the body, which may subsequently give rise to serious health conditions, including cardiovascular disease.

“On the other hand, sudden problems occur when live bacteria infect the heart valves,” Dr Pätilä continues.

Dr Tommi Pätilä’s (middle) experience as a cardiac and transplant surgeon motivated him to delve into the link between heart and oral health (Image: Lumoral)

In 2016, Dr Pätilä operated on a severe bacterial heart valve infection and was motivated to make a difference in oral health. 

“It turned out that the cause of the patient’s severe heart infection was bacteria from the mouth. At that point, I knew something had to be done to combat the residual plaque that causes disease and plagues in peoples’ mouths despite brushing and flossing,” says Dr Pätilä.

Pätilä is one of three Finnish researchers who have developed the antibacterial Lumoral method. Lumoral is a patented medical device that treats and prevents oral diseases at home. The Lumoral treatment can reportedly remove 99.99% of plaque bacteria from the tooth surface.2

Prevention and early diagnosis pays off

“In contrast to commonly held beliefs, a toothbrush is only capable of eliminating approximately 60% of oral biofilm. It’s no surprise then that cavities and gingivitis stand as the most prevalent diseases worldwide. If we want to improve oral health outcomes, we need to tackle the plaque left behind by tooth brushing,” says professor of Oral and Maxillofacial Diseases at the University of Helsinki, Timo Sorsa.

In Finland, it is estimated that up to two out of three people over 30 suffer from periodontitis. This common gum disease can lead to tooth loss if left untreated – but it is also linked to severe heart events. According to a study, individuals with periodontal disease are 30% more likely to experience a first heart attack compared to their healthy counterparts of the same age.3

According to another study published in the Journal of Periodontology, people with periodontal disease were almost twice as likely to develop coronary artery disease (CAD) than those with healthy gums.4 Meanwhile, a 2020 European Journal of Preventive Cardiology report found that poor oral health was associated with an increased risk of cardiovascular disease, particularly among those with gum disease.5

Prof Sorsa stresses that periodontal disease prevention is vital to maintaining a patient’s oral and overall health. “Untreated periodontitis leads to low-grade inflammation that affects the whole body, contributing to conditions like cardiovascular disease, diabetes, Alzheimer’s disease, and potentially even cancer.”

World Heart Day
Prof Timo Sorsa who researches periodontal diseases believes that preventing gum disease goes a long way in maintaining one’s overall health, and its links to hearth health (Images: University of Helsinki and WHF)

According to Prof Sorsa, in the long term, the prevention and rapid diagnosis of periodontal disease benefit the patient, public health, and the economy. This is also possible with the new modern diagnostic and treatment methods available that are revolutionising the whole field of dentistry.

Prof Sorsa’s research career has long focused on developing an immunological rapid test for active matrix metalloproteinase-8 (aMMP-8). The quick test can detect whether a person’s gum tissue is undergoing periodontal breakdown before it is visually apparent. It, thus, makes invisible and often symptomless developing periodontitis visible by alarming before clinical manifestations.

The test can be performed by a healthcare professional or the consumer independently at home – similar to the COVID-19 antigen test or the traditional rapid pregnancy test.6

“The aMMP-8 rapid test can measure and assess active periodontal adhesive tissue loss and the risk and grade/rates of its progression within five minutes in the dental chair non-invasively, i.e. without disturbing the tissue under examination. The test complements the diagnosis, follow-up, and maintenance treatment of periodontitis and peri-implantitis,” says professor Sorsa.

When discussing new treatment methods and prevention of periodontitis, he highlights Lumoral therapy. He calls Lumoral a drug-free alternative for treating and preventing severe gum disease. 

Lumoral enhances the effects of the toothbrush, and studies show that it also significantly improves in a preventive manner the results of professional oral care. At the same time, the device can potentially reduce the need to use drugs traditionally used to treat gum disease, such as antibiotics, chlorhexidine, and sub-antimicrobial dose doxycycline. Additionally, Lumoral is anti-microbial, anti-inflammatory and anti-proteolyti.2,6

Based on photodynamic therapy, a light-activated antibacterial effect, Lumoral slows down plaque formation significantly reduces the burden of harmful bacteria in the mouth and reduces tissue destructive proteolytic aMMP8. 2,6 The product’s user profile is suitable for all ages, but it is particularly recommended for those with a history of problems with common oral diseases, tooth decay, and gum disease. 2 

References

  1. World Heart Federation. (20 May 2023). Deaths From Cardiovascular Disease Surged 60% Globally Over The Last 30 Years: Report. https://world-heart-federation.org/news/deaths-from-cardiovascular-disease-surged-60-globally-over-the-last-30-years-report/.
  2. Pakarinen, S., Saarela, R. K. T., Välimaa, H., Heikkinen, A. M., Kankuri, E., Noponen, M., Alapulli, H., Tervahartiala, T., Räisänen, I. T., Sorsa, T., & Pätilä, T. (2022). Home-Applied Dual-Light Photodynamic Therapy in the Treatment of Stable Chronic Periodontitis (HOPE-CP) Three-Month Interim Results. Dentistry Journal, 10(11), [206]. https://doi.org/10.3390/dj10110206
  3. Rydén L, Buhlin K, Ekstrand E, de Faire U, Gustafsson A, Holmer J, Kjellström B, Lindahl B, Norhammar A, Nygren Å, Näsman P, Rathnayake N, Svenungsson E, Klinge B: Periodontitis Increases the Risk of a First Myocardial Infarction. A Report From the PAROKRANK Study. 13.1.2016 Circulation. 2016;133:576–583 https://doi.org/10.1161/CIRCULATIONAHA.115.020324
  4. Nesarhoseini V, Khosravi M. Periodontitis as a risk factor in non-diabetic patients with coronary artery disease. ARYA Atheroscler. 2010 Fall;6(3):106-11. PMID: 22577425; PMCID: PMC3347825.
  5. Pirkko J Pussinen, Eija Könönen, Oral health: A modifiable risk factor for cardiovascular diseases or a confounded association?, European Journal of Preventive Cardiology, Volume 23, Issue 8, 1 May 2016, Pages 834–838, https://doi.org/10.1177/2047487316636506
  6. Sorsa T, Nwhator SO, Sakellari D, Grigoriadis A, Umeizudike KA, Brandt E, Keskin M, Tervahartiala T, Pärnänen P, Gupta S, Mohindra R, Bostanci N, Buduneli N, Räisänen IT. aMMP-8 Oral Fluid PoC Test in Relation to Oral and Systemic Diseases. Front Oral Health. 2022 Jun 10;3:897115. doi: 10.3389/froh.2022.897115. PMID: 35757444; PMCID: PMC9226345.

Related: New home saliva test developed for gingivitis detection