As a dental enthusiast, I have always wondered why we have kept dentistry so separate from the rest of the body. It’s not like the mouth is not connected to the rest of the body. Just like our bodies, our mouths also house essentials such as blood vessels and nerves, enemies such as bacteria and viruses, and processes such as inflammation, etc. Even with these similarities, the mouth and the rest of the body were just treated as separate entities. Historically, this separation originated from the early evolution of dental practice as a distinct discipline, largely due to the practical, surgical, and educational differences that characterized the two fields. However, that idea is slowly changing.
“What happens in the mouth does not stay in the mouth.”
-Bonnie Feldman, DDS, MBA.
Recent studies have suggested a systemic link between oral health and cardiovascular disease. Turns out gum disease is connected to the heart!
So, what is periodontal disease?
Periodontal disease is a chronic inflammatory condition that affects the tissues supporting our teeth (gums and the bone). The main culprit is plaque, which is a bacterial biofilm. When not removed, this biofilm hardens into tartar. Tartar, in return, triggers an immune response, which is low-grade inflammation. This inflammation, over time, damages the gums and the bone.
Now, what is cardiovascular disease?
Cardiovascular disease (CVD) includes conditions like coronary artery disease, heart attacks, and strokes. While cholesterol often gets the spotlight, modern medicine recognizes that chronic inflammation plays a central role in the development of heart disease.
Notice the similarity? Chronic inflammation.
Systemic connection between gum disease and the heart
Studies have suggested three main systemic connections between cardiovascular disease and periodontal disease.
- Chronic Inflammation – Periodontal disease, being a low-grade inflammation, raises the levels of C-reactive proteins throughout the body. In other words, it causes a state of chronic inflammation throughout the body, including the arteries around the heart.
- Bacteria – Recent studies have shown the presence of oral bacteria in arteriosclerotic plaques in arteries, thus suggesting a contribution to arterial plaque formation.
- Shared Risk Factors – gum disease and heart disease have similar risk factors, i.e., smoking, obesity, diabetes, stress, poor diet, etc.
Why This Matters
Cardiovascular disease remains the leading cause of death worldwide. At the same time, periodontal disease affects nearly half of adults to some degree. With the association established, does that mean treating one will also improve the other?
For example, a randomized controlled trial by Tonetti et al. (2007) demonstrated that intensive periodontal therapy significantly reduced the progression of carotid artery intima-media thickness, a major predictor of cardiovascular disease. The same study also reported reductions in levels of systemic inflammatory biomarkers associated with cardiovascular risk following periodontal treatment.
This does not mean that taking care of your teeth will prevent heart disease, but there definitely is an association. Cardiovascular diseases have numerous causes… one of them could very well be periodontal disease.
Interdisciplinary Approach
This again calls for an interdisciplinary approach between the dental and the medical fields. It was observed that an average human visits their dentist more than their physician. Dental patients should be informed about the risks of poor periodontal health to their hearts and other organs. CVD patients should also be advised to have regular dental checkups. One should be told how all of his body is connected and how neglecting one part can inadvertently harm something else.
Conclusion
In conclusion, while further research and clinical trials are necessary to clarify the precise mechanisms linking periodontal and cardiovascular diseases, current evidence indicates a significant relationship. Given the substantial morbidity and mortality associated with cardiovascular disease, even a partial connection warrants serious attention from both the public and healthcare professionals. Raising awareness among patients regarding the impact of oral health on systemic conditions and encouraging collaboration between dental and medical practitioners may improve prevention and disease management strategies. Integrating oral health into standard medical care could contribute to broader improvements in public health, underscoring the importance of a holistic approach to patient well-being.
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References
- Viscomi R. Caring for the Oral Microbiome. WholeFoods Magazine. July 20, 2023. Available at: https://www.wholefoodsmagazine.com/articles/16267-caring-for-the-oral-microbiome. Accessed February 6, 2026. Quote by Bonnie Feldman, DDS, MBA, in presentation “Oral Health and Microbiome” at the Naturally Informed virtual event Nutri-Beauty: Mastering the Market.
- Coventry J, Griffiths G, Scully C, Tonetti M. ABC of oral health: periodontal disease. BMJ. 2000;321(7252):36-39. doi:10.1136/bmj.321.7252.36 https://pmc.ncbi.nlm.nih.gov/articles/PMC1127686/
- Henein MY, Vancheri S, Longo G, Vancheri F. The Role of Inflammation in Cardiovascular Disease. International Journal of Molecular Sciences. 2022; 23(21):12906. https://doi.org/10.3390/ijms232112906 https://www.mdpi.com/1906586
- Teles R, Wang CY. Mechanisms involved in the association between periodontal diseases and cardiovascular disease. Oral Dis. 2011;17(5):450-461. doi:10.1111/j.1601-0825.2010.01784.x https://pubmed.ncbi.nlm.nih.gov/21223455/
- Herrera D, Molina A, Buhlin K, Klinge B. Periodontal diseases and association with atherosclerotic disease. Periodontol 2000. 2020;83(1):66-89. doi:10.1111/prd.12302 https://pubmed.ncbi.nlm.nih.gov/32385870/
- Puzhankara, L., Janakiram, C., Gutjahr, G. et al. Risk correlates of cardiovascular diseases, diabetes, and periodontal diseases: a cross-sectional study in India. BMC Oral Health 25, 576 (2025). https://doi.org/10.1186/s12903-025-05742-8 https://rdcu.be/e2BFz
- Tonetti MS, D’Aiuto F, Nibali L, Donald A, Storry C, Parkar M, et al. Treatment of periodontitis and endothelial function. N Engl J Med. 2007;356(9):911-920 https://www.nejm.org/doi/full/10.1056/NEJMoa063186
