Your gums are tissues that hold your teeth in place. Brushing and flossing help to take care of both your teeth and gums, removing the buildup of bacteria that can stick to your teeth and other areas of your mouth. If you don't maintain these habits and you don't visit the dentist for regular cleanings, you can put yourself at higher risk for gum disease -- and possibly even heart disease.
The first sign of poor oral health is gingivitis. This is when bacteria cause plaque, which is a sticky film of bacteria, to build up on your teeth and around your gums, which can cause your gums to swell and bleed. Left unchecked, this can develop into gum disease, also called periodontitis, a type of infection that can lead to bone loss around the teeth and tooth loss in advanced stages. Periodontitis is the leading cause of tooth loss in adults.
About 47% of American adults over age 30 have some form of periodontal disease, according to the Centers for Disease Control and Prevention.
In addition to poor oral health, there are a few other risk factors associated with having gum disease:
-- Age. In those age 65 and over, 70% are reported to have periodontitis, the CDC reports.
-- Genetics. If your parents have gum disease problems, you may be prone to them even if you have good oral care.
-- Having diabetes that is not well controlled. High blood sugar levels make it easier for bacteria in the mouth to grow.
-- Having dry mouth. This is because your mouth lacks saliva, and saliva helps to remove food particles and can help fight against bad bacteria.
-- Hormonal changes for women, such as during menstruation and pregnancy. Estrogen and progesterone can increase blood flow to the mouth and make the gums more sensitive, causing them to swell and bleed.
-- Smoking, which doubles your risk for gum disease. That's because smoking makes your immune system weaker. Then it's harder for your body to fight off a gum infection.
-- Stress. Need another reason to stress less? Here you go. Stress can weaken the body's ability to fight off infection, leaving you more vulnerable to periodontitis and many other health problems.
-- Using medications that reduce the flow of saliva in your mouth. These can include antihistamines used for allergies, antidepressants and certain drugs for high blood pressure or pain.
The Link Between Oral Health and Heart Health
Gum disease is associated with several chronic health problems, including diabetes. Observational studies also show that gum disease is associated with heart disease, including a greater risk for heart attack and stroke.
That doesn't mean there's a direct cause and effect, says Dr. Salim S. Virani, a professor of medicine in the cardiology and cardiovascular research division at Baylor College of Medicine in Houston. Virani is also chair of the American College of Cardiology's Prevention of Cardiovascular Disease Council. However, there does appear to be a link between the two, notes Virani, who has participated in research on oral health and heart health.
Health experts have theories about the link between gum disease and heart disease. One theory suggests that the bacteria that causes gum disease also cause s damage to the heart and blood vessels, says Dr. Marianela Areces, a cardiologist with Pritikin Longevity Center in Miami.
This bacteria may travel from your mouth to enter the bloodstream and go to elsewhere in the body, such as your heart and other organs, explains Dr. Sally J. Cram, a periodontist in Washington, D.C., and a spokesperson for the American Dental Association.
A second theory is based on the idea that gum disease causes chronic inflammation in your mouth. Inflammation is part of your body's normal response to injury or an infection. However, chronic inflammation in the body can increase the presence of inflammatory markers in your bloodstream, causing blood vessels near the heart to narrow and raising your heart disease risk, Cram says.
Yet it's challenging for researchers to pinpoint the link between oral health and heart disease. That's because those with poor oral health and gum disease also are more likely to have other systemic diseases that affect heart health, including diabetes, high blood pressure and obesity. They also are more likely to smoke, and smoking raises the risk for both periodontitis and heart issues.
It could be that poor health habits -- such as smoking, eating unhealthy foods and not seeking preventive health care -- put you at higher risk for various health problems, including heart disease and gum disease, Areces says. Conversely, many people with a healthy heart often have healthy lifestyle habits and better oral health, she adds.
Large randomized trials are needed to get to the bottom of the link between oral health and heart health, Cram says.
This may be hard to do because of the different treatments needed depending on gum disease severity, Virani notes. He and colleague Anwar T. Merchant reported in the journal Current Atherosclerosis Reports that the use of electronic medical records may make it easier in the future to research the exact link between oral health and heart disease.
9 Tips for Better Oral Health
Although research doesn't yet show an exact cause and effect related to gum disease and heart disease, it makes sense for your overall health to aim for better oral care, Virani says.
You can't reverse bone loss that may occur with severe gum disease, but you can stabilize the problem, Cram says. Good oral care also can help lower inflammation, she adds.
Here are nine tips that can help you maintain healthy teeth and gums and potentially slash your risk for heart problems, whether you're heart disease-free or if you already have heart risks.
1. Brush your teeth at least twice a day, two minutes each time, using a soft-bristle brush.
Talk to your dentist about the best type of toothbrush for you. Some people will do better with an electric toothbrush, especially if they have dexterity issues, Cram says.
2. Floss at least once a day, especially before you go to bed.
You may be tired of hearing that you need to floss, but this can really help to get out the gunk from in between your teeth. If flossing is truly a struggle, talk to your dentist about alternatives such as a water flosser.
3. Find a dentist or periodontist you like.
A periodontist specializes in inflammation of the mouth, so you may see this type of specialist if you already have gum disease. You should have enough of a rapport with your dentist or periodontist that you feel comfortable asking questions about how to improve your oral health. Dental hygienists also can answer many questions related to improving your oral home care.
Some patients may choose to avoid seeing a dentist because they're worried about cost or are afraid of any pain involved. If that's you, think about the flip side, Cram cautions. If you don't get your teeth checked regularly, you could have problems that become much worse and require more extensive work and cost. "I'd say 95% of tooth problems are preventable."
4. Schedule regular dental checkups.
If you have gum disease, your dentist will probably want to see you every three to four months for cleanings, Cram says. If you don't have any signs of gum disease, every six months is usually sufficient, she adds.
5. Schedule regular visits with a primary care provider.
Having gum disease doesn't necessarily mean that you will have a heart attack or develop diabetes, but it does raise your risk. If you see a primary care doctor regularly, he or she can regularly screen for common health conditions and monitor your labs, including blood sugar and cholesterol, Virani says. Earlier treatment can help fend off more serious problems.
6. Don't smoke.
As mentioned earlier, smoking doubles your risk for gum disease and can lead to certain types of cancer, diabetes and heart disease. If you're not sure how to quit smoking, ask a doctor or dentist for help, or go to SmokeFree.gov.
7. Eat healthy.
What you eat can affect your overall health and your oral health, Areces says. Aim for less sugar, enough water, more vegetables and fruit, whole grains and low-fat dairy foods.
8. Manage stress.
It's hard to do in today's world, but stress management goes a long way toward helping your immune system and preventing disease, Areces says. Sleep, regular physical activity and activities like yoga or meditation that calm the mind all can help you manage your stress, she explains.
9. Know when you need to see a dentist. In addition to routine checkups, you should see a dentist for a potential problem with your oral health if you have:
-- Bad breath.
-- Bleeding gums.
-- Loose teeth.
-- Receding gums.
Vanessa Caceres began writing for U.S. News in 2017, originally specializing in diabetes. She's a nationally published health, travel and food writer with an undergraduate degree in journalism and psychology from Hampshire College in Amherst, Massachusetts, and a graduate degree in linguistics/bilingual education from Georgetown University in Washington, D.C. In addition to U.S. News, Vanessa's health writing has been published with Everyday Health, Self, Newsday HealthLink, EyeWorld, The Rheumatologist and various other publications. She is a member of Business Networking International (BNI). Vanessa has lived in Florida since 2009, when she became fascinated by the Sunshine State. That fascination led to Florida-themed articles published in regional and national publications, and on websites. Connect with her on Twitter at @FloridaCulture.