How routine dental check-ups could help spot early signs of cardiovascular disease

Annual dental check-ups could soon double up as a routine evaluation of our heart health, if further research on mouthwash to spot signs of cardiovascular disease is successful.

Recent studies into how saliva can identify warning signs of cardiovascular disease by spotting the number of white blood cells in an oral rinse is the latest example of how our mouths can reflect our overall health.

Scientists at the University of Western Ontario in Canada found high levels of white blood cells correlated with compromised flow-mediated dilation, an early indicator of poor arterial health.

The research found inflammation leading up to periodontitis – or gum disease – was linked to less healthy arteries and a potentially higher risk of cardiovascular disease, even in healthy young adults.

Results were published in the journal Frontiers of Oral Health.

It follows recent research by the University of Sharjah that also found gum disease was more common in those who were obese, with poor overall health often replicated in tooth decay due to more mouth bacteria.

Identifying early signs of cardiovascular disease during routine dental check-ups could allow for pre-emptive treatment to avoid heart attacks or strokes in later life.

“We are starting to see more relationships between oral health and risk of cardiovascular disease,” said Ker-Yung Hong, study author at the University of Western Ontario.

“If we are seeing that oral health may have an impact on the risk of developing cardiovascular disease even in young healthy individuals, this holistic approach can be implemented earlier on.”

Healthy young people without diagnosed gum problems were assessed to determine if lower levels of oral inflammation were clinically relevant to cardiovascular health.

Researchers think inflammatory factors could enter the bloodstream via the gums, and damage the vascular system that regulates blood flow around the body, hampering delivery of essential oxygen and nutrients.

The study looked at the oral health of 28 non-smokers aged 18 to 30, without any co-morbidities or other illnesses that could affect their heart health.

Participants fasted for six hours, then rinsed with a saline solution that was analysed for white blood cells.

Measurements were taken for indicators of cardiovascular disease such as blood pressure and an electrocardiogram to show arterial blood flow and stiffness.

The study was restricted due to the young age of participants and their overall good health, leading for calls to extend the research into the wider population.

Red flags

Doctors said the type of screening was a good idea that could be done in line with a regular dental check-up to spot early signs of heart problems.

“In general, when we have patients with cardiovascular issues we notice problems with their periodontal health, such as gingivitis,” said Dr Ali Barhum, a general dentist at Saudi German Hospital in Dubai.

“Dry mouth is also a serious problem related to saliva and can be related to tooth decay or certain medications like beta blockers or other hypertension drugs.

“It is usually a red flag.”

The oral cavity can be a road map to potential health issues elsewhere, with dentists constantly on the lookout for other telltale signs.

This can include dry mouth or a fissured tongue that can indicate Sjogren syndrome, a common autoimmune disease that attacks glands producing moisture in the eyes, mouth and elsewhere.

It can also be associated with stress or the menopause.

As well as cardiovascular disease, poor mouth health can be presented as skin and gastrointestinal problems and an indicator of bone problems.

“Around 60-70 per cent of other health issues in our body have an oral manifestation,” said Dr Barhum.

“When we see inflammation and we correlate that with a patient’s age, physical activity and any previous history, we can often relate this to cardiovascular disease,”

Dr Barhum acknowledged that anti-depressants can also cause inflammation and said looking at the overall health status of a patient was important.

“Most people think a visit to a dentist is purely to examine their teeth but that is not the case.

“We are medical practitioners and looking inside the mouth can give a good indication of someone’s general health and well-being.

“If we see any sign of systemic disease or psychological issues, we always then call for more screening of the patient.”

Updated: August 22, 2023, 3:30 AM