HEALTH

A closer look at heart disease and dental care

Gum disease and heart problems — there has been a long-standing belief that there is a link between these two health issues. Researchers speculate that bacteria in the mouth, which cause gum disease, move into the bloodstream and cause inflammation of the blood vessels. This, in turn, may contribute to heart disease and stroke. Alternatively, some heart medications can alter your taste, cause dry mouth or lead to gum overgrowth.

“Studies have been done that both support the link and refute the possible link between gum disease and heart disease,” says Benico Barzilai, MD, Section Head of Clinical Cardiology at Cleveland Clinic, who stresses that maintaining optimal oral hygiene is an important component of your overall health whether or not there is a link.

What your dentist needs to know
Dr. Barzilai recommends brushing your teeth a minimum of twice daily and doing regular flossing. This will help to reduce the incidence of dental decay, gum inflammation and oral infections such as abscess formation. He also stresses the importance of frequent dental checkups if you have heart disease and making sure that your dentist knows the details of your heart condition.

He says to first make sure that your dentist has a complete list of the names and dosages of all medications you are taking for your heart and other medical conditions. Also make sure that your dentist has the names and contact information for your heart physicians in case there is a need for them to communicate about your dental care.

“This will help your dentist decide on the best treatment course for you, including medicine selection when you’re having a dental procedure,” Dr. Barzilai explains.

Drug to avoid and excessive bleeding
Epinephrine is one such drug your dentist may avoid. It is a common additive in local anesthesia, and for patients with hypertension and other heart conditions, it can cause dangerously high blood pressure, angina, heart attack or arrhythmias.

Another major concern is excessive bleeding during some oral surgeries if you are taking blood-thinning medications such as Plavix® or Coumadin®. In addition, people with certain heart conditions that make them prone to heart valve infections (bacterial endocarditis or BE) would need to take an antibiotic before having any dental work done.

Ease your fears, talk to your dentist
“If you are particularly nervous about having a dental procedure, talk with your dentist about strategies for controlling dental pain and easing fears,” says Dr. Barzilai. “You don’t want additional stress to affect your heart condition.” Researchers continue to investigate the possible relationship between gum disease and cardiovascular disease. There is no doubt, however, that if you have heart problems you should take special care when you are having any dental procedures.

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