There are good reasons to keep an eye on your gums; bacteria under the gum line does not only affect the mouth. More and more research studies show a connection between gum inflammation, tooth loss and increased risk of heart attacks.

Most of us brush our teeth every day but lifting the lip afterwards and examining the gums is not as common.

For patients with diabetes, for example, a treatment that reduces oral inflammation contributes to lower blood glucose levels.

Björn Klinge

“If the gums are red, swollen or bleed when brushing, this is a sign of inflammation. If the problems persist, you should contact your dentist because once you get bacteria under the gum line, it can be difficult to remove yourself,” says Björn Klinge, senior professor of periodontology at Malmö University.

He has spent a significant proportion of his professional life investigating the connection between gum health, tooth loss and cardiovascular disease; he is also involved in a large study where heart, teeth, inflammation and epidemiology specialists collaborate.

Just over 800 patients who had suffered their first heart attack were matched with an equal number of people in a control group. And the results were clear: the risk of having their first heart attack was about 30 per cent greater for the patients who had periodontal disease, compared to those who did not.

“In our follow-ups with the patients, we also see that the risk of having a new cardiovascular event was greater for those who had already suffered one and who also have periodontal disease,” says Klinge.

But how can lazy tooth brushing actually contribute to atherosclerosis and heart attacks? Periodontitis begins with an accumulation of bacteria at the gum line causing an inflammatory reaction in the gums. The gums swell and trap more bacteria under the gum line and if that process is allowed to continue, jawbone and gum tissue begins to break down.

In cases of inflammation, small wounds on the inside of the gum pocket can cause bacteria to leak into the bloodstream. The researchers also believe that leakage of inflammatory substances affects the atherosclerosis process in our blood vessels; more and more studies show a connection between periodontal disease and chronic inflammatory diseases, such as diabetes, rheumatoid arthritis and intestinal diseases.

“The inflammation of the mouth is then not seen as the only cause of other diseases, but rather something that interacts with another ongoing chronic inflammation. For patients with diabetes, for example, a treatment that reduces oral inflammation contributes to lower blood glucose levels,” says Klinge.

Periodontal disease is relatively uncommon before the age of 40 and since we now retain more teeth even as we age, this also means an increased load on the gums compared to before. Two important risk factors are smoking and genes. However, the biggest risk factor is the mismanagement of oral hygiene.

“Genetics can make you more prone to the development, but it is not genes alone that drives the development of the disease. In the vast majority of cases, thorough cleaning with a toothbrush and flossing is enough to keep the gums healthy,” concludes Klinge, adding: "Of course the individual oral hygiene becomes even more important if you have a genetic disease background.”

Text: Anna Dahlbeck & Adrian Grist

Text: Communications Department