The Link Between Gum Disease and Heart Disease: What Research Shows

For decades, researchers have noticed a pattern: people with gum disease tend to have higher rates of heart disease. This observation has led to a growing body of research exploring how the health of your mouth may affect the health of your heart. While the exact nature of this connection is still being studied, the evidence is strong enough that both dental and medical professionals now pay close attention to the link.

Periodontal disease affects roughly two in five adults between the ages of 45 and 64, according to data from the National Institutes of Health. Heart disease remains the leading cause of death in the United States. Understanding how these two common conditions relate to each other is important for anyone trying to protect their long-term health, especially older adults navigating their health coverage options.

What Is Periodontal Disease?

Periodontal disease, commonly called gum disease, is a chronic inflammatory condition that affects the tissues surrounding and supporting the teeth. It begins as gingivitis, a milder form of gum disease characterized by red, swollen gums that bleed easily. If left untreated, gingivitis can progress to periodontitis, a more serious condition where the gums pull away from the teeth, forming pockets that become infected.

As periodontitis advances, the bone and connective tissue that hold teeth in place begin to break down. This can eventually lead to tooth loss. According to the NIH, gum disease has been linked to more than 60 different health conditions, making it far more than just a dental problem.

The bacteria that cause gum disease thrive in plaque, the sticky film that forms on teeth. When plaque is not removed through regular brushing, flossing, and professional cleanings, it hardens into tartar, which can only be removed by a dental professional. This cycle of bacterial buildup and inflammation is at the heart of periodontal disease.

What the Research Shows: The Gum-Heart Connection

Multiple studies have found that people with periodontal disease are two to three times more likely to have a heart attack, stroke, or other serious cardiovascular event. The American Heart Association reviewed the available evidence and concluded that while an association clearly exists, a direct causal relationship has not yet been proven. Still, the strength and consistency of the association across many studies is notable.

Researchers have found oral bacteria in the fatty deposits that clog arteries, known as atherosclerotic plaques. This suggests that bacteria from the mouth can enter the bloodstream, particularly when gums are inflamed and bleeding, and may contribute to the process of arterial plaque formation. Some studies have also found that specific bacteria commonly involved in periodontal disease are present in damaged heart valves.

A key area of investigation is whether treating gum disease can improve cardiovascular outcomes. Preliminary research suggests that periodontal treatment reduces levels of C-reactive protein and other inflammatory markers in the blood. Since inflammation plays a central role in heart disease, reducing it through dental treatment could have broader health benefits.

The Inflammation Connection

Inflammation is the thread that ties gum disease and heart disease together. When your gums are infected, your body mounts an inflammatory response to fight the bacteria. In healthy people, this response is temporary. But with chronic periodontal disease, the inflammation never fully resolves. Your immune system stays activated, producing a steady stream of inflammatory chemicals that circulate throughout the body.

This chronic, low-grade inflammation can damage blood vessel walls, making them more vulnerable to the buildup of fatty deposits. It can also make existing arterial plaques less stable and more likely to rupture, which is what triggers most heart attacks and strokes. The inflammatory pathways involved in periodontal disease overlap significantly with those involved in atherosclerosis.

Inflammatory markers like C-reactive protein (CRP), interleukin-6 (IL-6), and fibrinogen are elevated in people with periodontitis. These same markers are also used by cardiologists to assess cardiovascular risk. The overlap is striking and helps explain why the two conditions so often occur together.

Shared Risk Factors

Part of the reason gum disease and heart disease are linked is that they share many of the same risk factors. Understanding these shared risks is important because managing them can help protect both your oral and cardiovascular health.

• Smoking and tobacco use: Smoking is one of the most significant risk factors for both conditions. It damages gum tissue, weakens the immune response to oral bacteria, and accelerates the development of arterial plaque.
• Diabetes: Diabetes increases the risk of both gum disease and heart disease. High blood sugar impairs the body's ability to fight infection and promotes inflammation.
• Obesity: Excess weight contributes to chronic inflammation throughout the body and is associated with higher rates of both periodontal disease and cardiovascular disease.
• Poor diet: A diet high in sugar promotes the growth of harmful oral bacteria, while a diet high in saturated fat and processed foods contributes to cardiovascular problems.
• Age: The risk of both conditions increases with age. Adults over 65 are particularly vulnerable to both periodontal disease and heart disease.

What This Means for Patients

If you have been diagnosed with gum disease, it does not mean you will develop heart disease. And having heart disease does not mean your gum disease caused it. However, the association between the two conditions is strong enough that it makes sense to take your oral health seriously as part of your overall health strategy.

Tell your dentist if you have been diagnosed with any cardiovascular condition, and tell your doctor if you have been diagnosed with periodontal disease. This allows both providers to factor the information into your care plan. Some cardiologists now ask patients about their dental health, and some dentists screen for cardiovascular risk factors.

The CDC estimates that more than $45 billion in productivity is lost annually due to dental disease in the United States. When you factor in the potential cardiovascular consequences of untreated gum disease, the economic and personal costs become even greater. Taking care of your teeth is not just about avoiding cavities. It is about protecting your whole body.

The Importance of Preventive Dental Care

Preventive dental care is the most effective way to keep gum disease from developing or progressing. Regular dental visits allow your dentist to detect early signs of gum disease before it causes permanent damage. Professional cleanings remove plaque and tartar that regular brushing and flossing cannot reach.

For people who already have periodontitis, treatments such as scaling and root planing (a deep cleaning procedure) can help manage the condition and reduce inflammation. In more advanced cases, surgical procedures may be needed to restore damaged tissue. The earlier gum disease is caught, the simpler and less expensive treatment tends to be.

Good home care is equally important. Brushing twice a day with fluoride toothpaste, flossing daily, and using an antiseptic mouthwash can significantly reduce your risk of gum disease. If you smoke, quitting is one of the most impactful things you can do for both your oral and cardiovascular health.

Insurance and Coverage Considerations

One of the biggest challenges for older adults is maintaining dental coverage. Original Medicare does not cover routine dental care, including the cleanings and periodontal treatments that can help prevent gum disease from worsening. This gap in coverage means that many seniors go without regular dental care at the very time when their risk for both gum disease and heart disease is highest.

Many seniors lose their employer-sponsored dental insurance when they retire, creating a dental coverage gap that can have serious health consequences. Medicare Advantage plans often include dental benefits, and standalone dental insurance plans are available for those who prefer Original Medicare. Understanding your options is an important part of protecting both your oral health and your heart health.

If you have heart disease or other cardiovascular risk factors, investing in dental coverage can be a wise health decision. The cost of preventive dental care is far less than the cost of treating advanced periodontal disease, and maintaining healthy gums may help reduce your overall inflammatory burden.

Steps You Can Take Today

Protecting both your oral and cardiovascular health does not require complicated steps. Small, consistent actions add up over time.

• Schedule regular dental checkups: Visit your dentist at least twice a year for cleanings and exams. If you have gum disease, you may need more frequent visits.
• Tell your providers: Make sure your dentist and your doctor both know about all your health conditions. Coordinated care leads to better outcomes.
• Do not ignore bleeding gums: Gums that bleed when you brush or floss are not normal. This is often an early sign of gum disease that should be evaluated by a dentist.
• Review your dental coverage: If you are on Medicare, check whether your plan includes dental benefits. If not, explore Medicare Advantage plans or standalone dental plans in your area.
• Manage shared risk factors: Quit smoking, manage diabetes, eat a balanced diet, and stay physically active. These steps benefit both your gums and your heart.

The connection between oral health and overall health is becoming clearer with each new study. While scientists continue to investigate the exact mechanisms, the message for patients is straightforward: taking care of your teeth and gums is good for your whole body. If you also manage diabetes, learn about the two-way connection between dental health and diabetes to understand how these conditions interact.