A man with a toothache goes to his dentist for help. The dentist examines every tooth carefully but finds no obvious problem. There’s no decay, no cracks, no signs of infection. X-rays show all to be normal.
Once dental causes have been ruled out, the dentist asks, “Do you happen to have any history of heart problems?”
“No,” says the patient, confused. “Why?”
“Sometimes heart problems can cause pain that feels like a toothache. It’s a good idea to have your heart checked to be safe.”
This kind of scenario plays out more often than you might think. The connection between oral health and heart health runs deep, after all, as decades of research have confirmed. This was rather recently highlighted by a review in BMC Oral Health, which found that the evidence to date supports the link between gum disease, tooth loss, and cardiovascular diseases. In fact, those with gum disease face significantly higher risks of heart attacks, strokes, and other cardiovascular events.
Now, new research in the Journal of the American Heart Association sheds light on HOW this connection might work.
The study focused on coronary plaques from people who died suddenly of heart problems, as well as arterial samples from patients who were undergoing vascular surgery. Its authors found that DNA from viridans group streptococci – common bacteria that normally live harmlessly in the mouth – was found in 42.1% of the plaques and 42.9% of the surgical samples.
Notably, these weren’t just random bacterial fragments floating around. The research team found evidence that these microbes were forming actual biofilms within the arterial plaques themselves. Biofilms are complex, organized communities in which bacteria work together, share resources, and protect each other from threats. Their very structure acts like a protective shield, holding the community together and sustaining it so it can thrive even in challenging environments. In your mouth, biofilms form what we commonly call dental plaque.
Now this research suggests not only that they can form in your arteries, too, but appear to operate in some interesting ways. As the researchers put it,
Viridans streptococcal biofilm was not detected by macrophages of the innate immune system, which, in contrast, detected virulent streptococci that were dispersed from the biofilm infiltrating the ruptured fibrous cap of the atheroma of people experiencing sudden cardiac death….
In other words, the immune system couldn’t see the bacterial communities hiding in the plaques. It could detect individual bacteria that broke away and invaded the areas where heart attacks occurred. This suggests a possible scenario in which dormant biofilms suddenly activate and release harmful bacteria that could contribute to the kind of plaque rupture that triggers heart attacks.
It’s a sobering reminder that chronic infections can have serious consequences down the line.
Of course, this research represents only one possible mechanism among potentially many others. The relationship between oral and heart health is a complex one, after all, involving multiple pathways – systemic inflammation, shared risk factors, and more. Still, it powerfully highlights the sophisticated ways in which oral bacteria can affect your overall health.
Gum disease isn’t just a simple infection that stays in the mouth. They’re complex microbial communities that are able to establish themselves throughout the body and influence systems far from their first home. In the research team’s words,
Latent chronic bacterial inflammation evades immune detection and may contribute to the pathogenesis of complicated atherosclerotic plaques and fatal myocardial infarction.
In simpler terms, hidden bacterial inflammation may help cause the kind of dangerous plaque changes that lead to heart attacks.
And that’s another good reminder of the importance of doing all you can to maintain a healthy oral microbiome. That goes way beyond simply brushing and flossing. The behavior of biofilms is influenced by many factors, including nutrition, sleep quality, stress, blood sugar regulation, and overall immune function. Regular biological dental cleanings matter, too.
The bacteria that live in your oral cavity don’t recognize the artificial boundaries that many still insist on drawing between dental and medical health.
