Gum disease and heart disease: is there a link?
Yes, they’re linked, but it’s not proven one causes the other. No trial shows treating gum disease protects your heart. And one habit raises the risk of both.
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Is gum disease linked to heart disease?
Yes, in studies. The American Heart Association found people with gum disease have more artery disease, even after allowing for known shared risks. But those studies don’t show that gum disease causes it.
UK dental guidance agrees. It says the debate goes on and no firm conclusions can be drawn yet.
| Question | What experts found |
|---|---|
| Are they linked? | Yes. People with gum disease have more heart and artery disease in studies. |
| Does gum disease cause heart disease? | Not proven. Studies so far don’t show cause. |
| Does gum treatment protect the heart? | Evidence too weak to say. Only two small trials, both at high risk of bias. |
| Is gum treatment safe for the heart? | Yes. European experts judged it safe. |
Sources: American Heart Association; Cochrane; EFP and World Heart Federation
A link is like seeing two friends at the same parties. You know they turn up together. You don’t know if one brings the other, or if a mutual friend, like smoking, brings them both.
So gum disease doesn’t mean your heart is damaged. Experts say it is a reason to keep your heart risks in check, like blood pressure and cholesterol.
How could gum disease affect your heart?
Experts in gums and hearts say a direct effect is biologically plausible. That means it makes sense on paper, but trials haven’t proved it.
The idea experts are testing
- 1
Sore gums
Gum disease is red, swollen gums that may bleed.
- 2
Into the blood
Mouth germs can get into the bloodstream.
- 3
Inflammation in the body
They may set off inflammation in the body.
- 4
Not yet proven
Trials haven’t shown this leads to heart attacks.
Sources: EFP and World Heart Federation; NHS; Cochrane
Gums red, swollen or bleeding? The NHS says it’s important to get them checked by a dentist, whatever the heart link turns out to be.
What do gum disease and heart disease have in common?
A lot. The two share smoking, age and diabetes as risks. So people often have signs of either or both.
| Risk | Gum disease | Heart and circulation disease |
|---|---|---|
| Smoking | A profound effect on risk. | Raises risk. |
| Diabetes | Assume a higher risk. | Raises risk. |
| Age | Severe cases peak at 60 to 64. | Mainly affects people over 50. |
| Being overweight | Evidence not clear. | Raises risk. |
Sources: UK dental guidance; NHS
The one habit that raises the risk of both is smoking. Stopping can prevent further damage to your gums, and the NHS lists it as a way to cut your heart risk.
Want help to quit? See vaping to stop smoking.
Can looking after your gums protect your heart?
Not proven. A Cochrane review found the evidence too weak to say whether gum treatment prevents heart disease. It says more trials are needed.
One big study of 247,696 adults in Korea without heart disease found something hopeful. Each extra brush a day was linked to a 9% lower risk of heart and artery events. A link, not proof.
Six steps for your gums and your heart risks
- Brush with fluoride toothpaste at least twice a day. Spit after brushing, don’t rinse.
- Clean between your teeth every day with floss or interdental brushes.
- See a dentist and hygienist for regular check-ups, especially if you’re pregnant or have type 2 diabetes.
- Stop smoking if you smoke.
- Get your blood pressure and cholesterol checked if you have gum disease.
- On blood thinners? Tell your dentist before gum treatment.
Sources: NHS: gum disease; NHS: CVD; EFP and World Heart Federation
European experts say the dentist should not change your blood thinners for gum surgery, and should check with your doctor if unsure. Never stop or change a prescribed medicine without your prescriber.
More on cleaning: interdental brushes or floss and what to do about bleeding gums. For your heart, see how to lower cholesterol.
Can bad teeth cause a heart infection?
Rarely. Endocarditis is swelling of the heart’s inner lining, usually caused by an infection. It usually happens when germs get into your blood through your mouth or skin, such as during dental work.
It’s rare but can be life-threatening. Your risk is higher if you have heart valve disease, an artificial valve, a pacemaker or a device that shocks your heart back into rhythm (ICD), some heart conditions you were born with, or a thickened heart muscle (hypertrophic cardiomyopathy). It’s also higher if you’ve had a heart transplant or endocarditis before, work closely with farm animals or inject drugs.
In that group, the NHS says to take care of your teeth and gums and have regular check-ups. You may be advised to speak to a doctor before dental work.
Antibiotics before dental work are not routinely advised by NICE. Ask your heart team what applies to you.
When to speak to a GP
Book an appointment if:
- You think you’re at higher risk of heart disease, for example you smoke, have diabetes or have gum disease and haven’t had a heart check.
- You have a heart valve problem, an artificial valve or a pacemaker, and need dental work: ask if you should speak to a doctor first.
- You have signs of endocarditis, such as a high temperature or feeling hot, cold or shivery, headaches, feeling very tired, joint or muscle pain, night sweats, feeling breathless, or loss of appetite or losing weight without trying. Get help from NHS 111.
- Call 999 if someone has signs of a stroke, which endocarditis can cause: face weakness, weakness or numbness down one side or in one arm, can’t lift both arms, slurred or confused speech, or blurred vision or loss of sight.
Gums bleeding, sore or swollen, or bad breath? See a dentist. Have gum disease plus very sore, swollen gums, loose teeth, mouth ulcers or red patches, or a lump in your mouth or on your lip? Ask for an urgent appointment.
Aged 40 to 74? Ask about a free NHS Health Check of your heart and blood vessels. See also heart health.