Reviewed by a board-certified geriatrician
Could your gums affect your heart? It's a fair question, and the answer is "possibly." Here is what the research shows, what it doesn't, and why caring for your teeth and gums is worth it either way.
What gum disease is
Gum disease starts when bacteria build up along the gumline. At first the gums get red and may bleed when you brush (gingivitis). If it goes on, the gums pull away from the teeth and the bone that holds them can wear down (periodontitis). This is common with age, and it often doesn't hurt, so many people don't know they have it.
How it may be linked to your arteries
The link is real. People with gum disease have more heart and blood vessel disease, even after taking smoking, diabetes and other risks into account [1][2].
Mouth bacteria travel. Inflamed gums bleed easily, which lets bacteria into the bloodstream. Traces of mouth bacteria, and in a few studies live bacteria, have been found inside artery plaque [2].
Inflammation adds up. Gum disease keeps the body's inflammation turned up a little, all the time. That same low-level inflammation is part of how plaque grows and becomes unstable.
Soft plaque, early evidence. In one small study of people with unstable chest pain, those with worse gum disease had more soft plaque and more of the plaque features linked to heart attacks on a CT angiogram [3].
What we don't know yet
A link is not the same as a cause. People with gum disease are also more likely to share other risks, and studies can't fully separate them. The American Heart Association concluded that gum disease is linked to artery disease but has not been shown to cause it [1].
Treating gum disease does help the arteries in the short term. In one trial, people who had intensive gum treatment had better artery function six months later than those with usual care [4]. Gum treatment also lowers a blood marker of inflammation [2]. But no study has yet shown that it prevents heart attacks or strokes [1][2].
Why it's worth caring for your gums anyway
Healthy teeth and gums make it easier to eat well, speak and smile comfortably, and they may help your heart too. Experts in both heart and gum health advise people with heart disease to take gum health seriously [2]. Everyday steps [5]:
Brush twice a day with fluoride toothpaste, and spit it out rather than swallowing.
Clean between your teeth once a day with floss or small brushes.
See your dentist regularly for checkups and cleanings.
Don't smoke. Smoking raises the risk of gum disease.
If you wear dentures, keep them clean and take them out at night so your gums can rest.
If arthritis makes brushing hard, try an electric toothbrush, a brush with a thicker handle, or a floss holder.
If your mouth is often dry, sip water and ask your dentist or doctor about it, since some medicines cause dry mouth.
One caution about mouthwash: in a small study, a week of strong antiseptic mouthwash raised blood pressure slightly, because it also killed helpful mouth bacteria [6]. Use one only if your dentist recommends it.
Tell your dentist about your heart conditions and medicines, especially blood thinners, and tell your doctor if your gums bleed often or your teeth feel loose. Our articles on hard and soft plaque and blood pressure and cholesterol cover other ways to protect your arteries.
This article is for general education and isn't a substitute for advice from your own doctor or dentist.
Sources
Lockhart PB, et al. Periodontal disease and atherosclerotic vascular disease: does the evidence support an independent association? A scientific statement from the American Heart Association. Circulation. 2012;125(20):2520-2544.
Sanz M, et al. Periodontitis and cardiovascular diseases: consensus report. J Clin Periodontol. 2020;47(3):268-288.
Rodean IP, et al. Periodontal disease is associated with increased vulnerability of coronary atheromatous plaques in patients undergoing coronary CT angiography: results from the Atherodent study. J Clin Med. 2021;10(6):1290.
Tonetti MS, et al. Treatment of periodontitis and endothelial function. N Engl J Med. 2007;356(9):911-920.
National Institute on Aging. Taking care of your teeth and mouth.
Kapil V, et al. Physiological role for nitrate-reducing oral bacteria in blood pressure control. Free Radic Biol Med. 2013;55:93-100.