Periodontal and heart disease: what’s the link and can it be prevented?

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More than 30%1 of Australians have moderate to severe gum disease (periodontitis). We know that gum disease is the most common cause of tooth loss among adults. But did you know there may also be a link between gum disease and heart attacks?

You might not automatically associate your oral health with your heart health. But research shows that if you have gum disease you may be twice as likely to develop heart disease.2 This includes coronary heart disease, stroke, and heart attack among other cardiovascular events.

In 2022, coronary heart disease was the leading cause of death. It accounted for 10% of all deaths in Australia and 41% of cardiovascular disease-related deaths.3

Keep reading to learn more about the link between periodontal and heart disease. Plus, find out how you can manage your oral health to help reduce your risk.

What does the research tell us?

Over the last two decades or so a growing body of research has found a connection between oral health and overall health. A key area of focus has been the relationship between periodontitis and heart health.

One study found that not only does periodontitis increase the risk for cardiovascular disease, but the more severe the gum disease the greater the risk.

So, what are the key factors about periodontitis that potentially cause heart-related problems? Here’s a look at three theories.

Patient undergoes periodontal clean to remove bacterial plaque.
The bacteria that causes gingivitis and periodontitis doesn’t just infect the gums. It can also travel through the bloodstream to the arteries.

Common risk factors

There are a number of lifestyle and health factors that contribute to both gum disease and heart disease. For example smoking, obesity, and poor oral health are all independent risk factors for periodontitis. Yet each of these factors alone may increase the likelihood of heart disease.

For example, if you smoke you are two to four times more likely to get cardiovascular disease than non-smokers.4 Smokers also have twice the risk of periodontitis compared to non-smokers.

It’s well known that obesity is a major risk factor for heart disease.4 But people who are obese also have double the risk of periodontitis, while severe obesity increases the risk three-fold.5

What this means is that gum disease itself doesn’t add to the risk of heart disease. Yet, the underlying cause of gum disease may increase your risk of heart disease.


The main cause of gum disease is bacterial plaque. This is a sticky, translucent film containing millions of bacteria. It coats the teeth and builds up along the gumline, causing the gums to become red and inflamed and bleed easily.

The bacteria that causes gingivitis and periodontitis doesn’t just infect the gums. When gums are inflamed (such as in gingivitis and periodontitis), bacteria from the plaque on teeth frequently enter the bloodstream where it can interact with the inside of arteries in the heart and the carotid arteries that supply blood to the brain. It is thought that these bacteria from the mouth might increase the buildup of atherosclerotic plaques, which lead to heart attack or stroke.


Although bacteria in plaque on teeth lead to bleeding and inflamed gums, it is the inflammation that actually causes the damage. People with severe periodontitis might have up to 20 cm2 of inflamed, diseased gum tissue. The inflammatory cells and molecules that form in the diseased gum tissue enter the bloodstream and travel to other parts of the body. This is often referred to as systemic inflammation.

These inflammatory molecules might add to and promote atherosclerotic plaque formation. It is those atherosclerotic plaques which narrow the coronary arteries and can lead to angina and heart attack. They can also lead to stroke when atherosclerotic plaques form in blood vessels that supply the brain (carotid arteries).

So, instead of pointing the finger at bacteria, it may be inflammation that’s to blame. Or it could be a combination of the two.

Each of these theories is interesting. But, because there are so many factors at play in the human body, it’s very hard to pinpoint one definite cause. And so, the research into gum disease and cardiovascular risk continues.

Dr Ed discussed gum disease prevention with a patient at EO Perio.
While it’s very possible that gum disease could affect heart health, it may not be the only cause. Nonetheless, we should all be encouraged to take steps to prevent or manage existing gum disease through good oral hygiene.

How to reduce your risk

We can’t say for sure if there’s a direct causal link between poor oral health/periodontitis and heart disease. But it pays to brush up on your oral hygiene habits anyway.

If you haven’t been diagnosed with periodontitis, it can be helpful to know the warning signs of gingivitis to watch out for. Gingivitis is the early form of periodontitis. Unlike periodontitis, gingivitis is curable—as long as it’s caught early.

Signs of gingivitis or gum disease include:

  • Plaque builds up on your teeth along the gum line 
  • Bleeding gums
  • Swollen gums
  • Persistent bad breath
  • Loose teeth

Correct tooth brushing is the best way to guard against periodontitis and manage the disease if you’ve already been diagnosed. It’s important to brush teeth twice a day, using fluoride toothpaste.

Remember to clean all sides of the teeth. This includes in between the teeth, where plaque can get stuck. There are a range of simple tools to help you to do this. For example, interdental brushes and floss, among others.

And don’t forget that a regular dental check-up and clean is an important part of preventative oral care.

Final thought…

Many studies have investigated the link between periodontal disease and heart disease, but the results have been mixed. While it’s very possible that gum disease could affect heart health, it is certainly not the main factor.

Nonetheless, we should all be encouraged to take steps to prevent or manage existing gum disease through good oral hygiene. Keep up with at-home practices and book in for a regular check-up and clean with your dentist or periodontist.

Need help brushing up on your oral hygiene?

Let us help you find the best method for keeping plaque at bay and even reaching those tricky spots in between your teeth.

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