Poor dental health tied to heart disease

Untreated root tip infections can raise the risk of coronary disease according to a new study.

Dental health has been a topical issue in recent weeks after the news agency AP ran an article claiming that insufficient research supports the common notion that flossing your teeth helps prevent cavities and gum disease. That said, brushing your teeth and regular visits to the dentist are still undisputed.

In a new study published in the latest edition of the Journal of Dental Research, Finnish researchers found a link between infections in the root tips of teeth and coronary disease.

Most tooth infections among heart patients

The study was conducted at the University of Helsinki and involved 508 Finnish patients with heart disease symptoms. A little over a third had stable coronary syndrome, a third were undergoing acute coronary syndrome and a slightly less than a third were not suffering the disease to a significant degree. These participants were assessed for coronary disease and given a thorough dental check-up.

Information about age, gender, BMI, smoking, diabetes, use of medications and the number of teeth they had was also obtained and accounted for statistically in the analysis.

The Finnish researchers were primarily interested in scouting for a link between coronary disease and the root tip infection – apical periodontitis – which requires root canal treatment or the pulling of the tooth. 

“Acute coronary syndrome is 2.7 times more common among patients with untreated teeth in need of root canal treatment than among patients without this issue,” says researcher John Liljestrand in a University of Helsinki press release.

The researchers also found a convincing association between stable coronary disease and dental disease. They encountered higher levels of antibodies in the blood of patients with heart disease. This can indicate the presence of bacteria in the bloodstream.

Dental bacteria can spread to the heart

Their findings do indicate a link between tooth infections and heart disease. The researchers think that tooth disease could be an independent risk factor for both stable and acute coronary disease.

Research has never fully explained this link between dental health and coronary disease.

Lise Lund Håheim, a professor II at the Department of Oral Biology at the University of Oslo’s Faculty of Dentistry says that the hypothesis about the association between infections and heart disease is nothing new.

“Many studies have looked at the link between oral infections and cardiovascular diseases. But a variety of studies is needed to chart the cause-and-effect mechanisms.”

In the Finnish study the researchers looked into bacterial infections. Lund Håheim says the relation between bacterial infections and heart disease has also been researched in Norway.

“One of the findings in the Norwegian studies is the presence of bacterial DNA in the cardiac valves and outpouchings in the main artery – or aorta aneurisms – which indicate that bacteria can wander from the teeth to the heart through the circulatory system.”


The new Finnish study has its limitations. The number of participants, 508, is fairly small. Despite making allowances in their calculations for other factors linked to heart disease among these individuals, they did not control socio-economic status. Education and income are closely linked to health conditions, in particular regarding choices in lifestyle.

This means it is feasible that persons with poor dental health also have diets that raise the risk of cardiovascular diseases and this is an explanation for the link seen in this study.

On the other hand, the Finnish researchers did make allowances and statistical corrections for lifestyle facts such as BMI and smoking. In addition, the researchers point out that in Finland the whole population has the same access to dental services independent of socio-economic status.

A root tip infection is a common tooth disease, also amongst Norwegians. Lise Lund Håheim stresses that the maintenance of good dental health is vital in itself regardless of a prospective link to coronary disease, and people should continue to visit their dentists regularly.

John M. Liljestrand et al.: Association of Endodontic Lesions with Coronary Artery Disease. Journal of Dental Research. 1 August 2016.


Read the Norwegian version of this article at forskning.no

Translated by: Glenn Ostling

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