Researchers Discover Why Gum Disease Causes Heart Disease

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Think skipping your nightly dental care routine is no big deal? The results of a recent study linking gum health to inflammatory diseases like heart disease may convince you to never skip oral hygiene again

Medical science has firmly established a link between periodontal (gum) disease and inflammatory conditions such as cancer, heart disease and diabetes. But the mechanism linking these conditions has remained a medical mystery -- until now.

Researchers at the University of Toronto's Faculty of Dentistry have identified what they believe is the correlation between these conditions -- blood cells called neutrophils -- and their findings present the first evidence pointing to the body's own immune system response.

The controlled clinical experiment, conducted in collaboration with top dentists from Sinai Health Systems and Princess Margaret Cancer Centre in Toronto, indicates that neutrophil immune cell activity is the "missing link" connecting periodontal disease with other inflammatory diseases. Their findings were published in the October 2020 Journal of Dental Research.[i]

When the Immune System Uses Excessive Force

Neutrophils are a type of white blood cell that is activated to respond to areas of acute inflammation.[ii] When neutrophils, which play a critical role in immune system response, were activated to fight infections from active cases of gum disease, researchers observed a hyperactive, systemic response that they believe makes the body susceptible to damage from secondary inflammatory conditions.

The study's senior author, Professor Michael Glogauer, put it this way: "It's almost as if these white blood cells are in second gear when they should be in first."[iii]

Produced initially in in vivo models, the findings were confirmed through a controlled clinical experiment involving mice with induced periodontal disease (PD). A human gingivitis study was conducted in tandem, with volunteers being instructed to cease all oral hygiene practices for three weeks to induce gingivitis, followed by a two-week recovery period.

Blood and tissue samples were taken from the mice; blood and saliva samples were also collected from human gingivitis study volunteers. Multiplex cytokine analysis was performed on immune system cells for both human and mouse subjects to indicate the presence of neutrophils.

Periodontal Disease Can Aggravate Pre-Existing Conditions

After analyzing immune system cells harvested from the oral cavities of both healthy and PD-infected tissues, researchers observed that the numbers of neutrophils in diseased tissues were greatly increased over the neutrophils present in healthy tissues. They further found that PD in mice mimics human PD when it comes to the number of neutrophils recruited to sites of oral bacterial infection.

This aggressive neutrophil response to PD primes the immune system to attack, and much like what is seen in autoimmune diseases, the target of the attack is the body's own tissues and organs. If secondary infection sites are present in the body, as is often the case with cardiac and diabetic patients, the abundance of neutrophils can respond to these areas with excessive force, leading to negative health outcomes for patients.

The study's lead author, Noah Fine, states, "We believe this is the mechanism by which oral hygiene can impact vulnerability to unrelated secondary health challenges. Neutrophil (immune) priming … can connect these seemingly distinct conditions."[iv]

Healthy Mouth, Healthy Body

Studies like this underscore the importance of oral health as a window into the overall health of the body. Periodontitis is a serious yet common gum infection that can destroy the soft tissues and bone structure supporting teeth. Over time, this damage can result in permanent tooth loss and lead to worsening comorbid conditions.[v] Symptoms of periodontitis include:

  • Swollen, sore gums
  • Chronic halitosis (bad breath)
  • Red or purple spots on the gums
  • Bleeding of the gums when you brush or floss
  • Pain when chewing
  • Loosening or lost teeth[vi]

Tooth decay, or dental caries, is often a precursor to periodontitis and serves as a warning sign that oral hygiene, and possibly diet, need to be improved. Outside of poor oral care, dental caries are a common side effect of a high-sugar diet, especially in children.

The addition of probiotics has been shown to significantly reduce caries in young children,[vii],[viii] and both green tea and black tea have been effectively used in clinical studies as a mouth rinse to reduce the presence of harmful bacteria in the mouth.[ix],[x]

While most synthetic, non-nutritive sugar alternatives are toxic to the body, xylitol, made from birch bark, discourages bacterial growth that can lead to dental caries, and stevia is a safe, plant-based sweetener that can satisfy your sweet tooth without causing it to fall out.

Practice Healthy Eating and Oral Hygiene for a Happy Mouth

Fortunately, dental caries and periodontitis can be reversed and are largely preventable by reducing sugar consumption and paying attention to good oral hygiene. Start by brushing your teeth at least twice daily for around two minutes per session to remove dental plaque. Floss a minimum of once per day and use a water pic to remove bacteria around the gumline (where teeth meet the gums).

See your mercury-free dentist every six months and follow his or her recommendations for achieving and maintaining healthy teeth and gums.[xi] To learn more about natural remedies for dental caries, consult the research database, the world's most widely referenced, evidence-based natural medical resource.


[i] Fine N, Chadwick JW, Sun C, et al. Periodontal Inflammation Primes the Systemic Innate Immune Response. Journal of Dental Research. October 2020. doi:10.1177/0022034520963710

[ii] British Society for Immunology, Public Information, Bitesized Immunology, Cells, Neutrophils.

[iii] University of Toronto, Faculty of Dentistry, News, Mechanism linking gum disease to heart disease, other inflammatory conditions discovered, <>

[iv] University of Toronto, Faculty of Dentistry, News, Mechanism linking gum disease to heart disease, other inflammatory conditions discovered, <>

[vii] Svante Twetman, Christina Stecksén-Blicks. Probiotics and oral health effects in children. Int J Paediatr Dent. 2008 Jan; 18(1):3-10. PMID: 18086020

[viii] Keiko Tanaka, Yoshihiro Miyake, Satoshi Sasaki. Intake of dairy products and the prevalence of dental caries in young children. J Dent. 2010 Jul;38(7):579-83. Epub 2010 Apr 28. PMID: 20433890

[ix] Maryam Hajenorouzali Tehrani, Gholamreza Asghari, Maryam Hajiahmadi. Comparing Streptococcus mutans and Lactobacillus colony count changes following green tea mouth rinse or sodium fluoride mouth rinse use in children (Randomized double-blind controlled clinical trial). Dent Res J (Isfahan). 2011 Dec ;8(Suppl 1):S58-63. PMID: 23372597

[x] Vishal Arya, Lavina Taneja. Inhibition of salivary amylase by black tea in high-caries and low-caries index children: A comparative in vivo study. Ayu. 2015 Jul-Sep;36(3):278-82. PMID: 27313414

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