Does gum disease cause cardiovascular disease?

By Alvin Danenberg, DDS, contributing writer

May 24, 2017 -- Does gum disease cause cardiovascular disease (CVD)? This is a critical question. It needs to be answered, if possible. I will offer my opinion shortly.

3 peer-reviewed papers

The prestigious journal Circulation published an article in 2012 titled "Periodontal disease and atherosclerotic vascular disease: Does the evidence support an independent association?" (Circulation, May 2012, Vol. 125:20, pp. 2520-2544).

Alvin Danenberg, DDS
Alvin Danenberg, DDS.

The conclusion of this important paper stated that there is an association between periodontal disease and CVD. However, the authors could not find a causal relationship. In other words, there was no evidence that the treatment of periodontal disease would prevent atherosclerotic vascular disease. The authors went further to suggest that there could be unknown factors that might be causing both chronic diseases.

The Postgraduate Medical Journal published a review article in April 2017 titled "High-risk periodontal pathogens contribute to the pathogenesis of atherosclerosis" (Postgrad Med J, April 2017, Vol. 93:1098, pp. 215-220).

The authors of the article stated that periodontal disease, because of its high-risk pathogens, is a contributory cause of atherosclerosis.

On May 4, 2017, the International Journal of Chronic Obstructive Pulmonary Disease published an article titled "Is periodontitis a comorbidity of COPD or can associations be explained by shared risk factors/behaviors?" (Int J Chron Obstruct Pulmon Dis, May 2017, Vol. 12, pp. 1339-1349).

These authors suggested that periodontal disease and chronic obstructive pulmonary disease (COPD) most likely share common causes. They proposed that these common causes also might be those related to other chronic diseases such as CVD.

Common source

My research suggests that a common source of chronic diseases of the human body could begin with the gut. Unhealthy bacteria could overgrow in the gut because of various insults -- damaging food choices, lack of necessary nutrients, and toxic and irritating substances. The bad bacteria and irritating substances in the gut could cause leakage in the intestinal lining that could allow bad things to seep into the blood system. Our immune system would then become activated like an army fighting an invader. The result would be chronic inflammation.

Chronic inflammation could travel to all the organ systems in the body. Chronic inflammation could affect all vascular walls and the tissues surrounding the teeth in the jaw. This chronic inflammation could be the initial cause of CVD and periodontitis.

The bacteria in the gum pocket could become unbalanced and pathogenic, especially if they were fed by poor food choices. Importantly, once periodontal infection was to take hold, it would become another continuous source of further damage and infection leaking into the circulatory system.

The vicious cycle would involve the infected and damaged gut being a source of further chronic disease, and the infected and damaged gum spaces around teeth being another source of further chronic disease. Bad food choices would continue to feed an unhealthy gut and infected gum pockets.

My opinion

Ultimate prevention for cardiovascular disease would require treatment and repair of the gut, as well as treatment and repair of the infected gum pockets. Only treating one or the other will not prevent CVD.

A functional medicine practitioner should evaluate the gut to determine if there is damage and treat it. A dentist should determine if there is active gum disease and treat it. If there is other chronic infection in the body, the source must be treated. A medical doctor must evaluate for various chronic diseases and integrate therapy with the functional physician and dentist to treat them.

The goal must be to re-establish a healthy gut and healthy gum tissues. In addition, and probably most important of all, the patient must begin a diet and lifestyle that includes nutrient-dense, anti-inflammatory foods that support a healthy gut and healthy gum tissues moving forward.

A version of this column first ran on Dr. Danenberg's blog. appreciates the opportunity to reprint it. His book Crazy-Good Living is available on July 15, 2017, by Elektra Press.

Alvin Danenberg, DDS, practices at the Bluffton Center for Dentistry in Bluffton, SC. He is also on the faculty of the College of Integrative Medicine and created its integrative periodontal teaching module. He also spent two years as chief of periodontics at Charleston Air Force Base earlier in his career. His website is

The comments and observations expressed herein do not necessarily reflect the opinions of, nor should they be construed as an endorsement or admonishment of any particular idea, vendor, or organization.

Copyright © 2017

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