At this time of year, hearts are everywhere you look, so it's fitting that February is American Heart Month, a time to focus on cardiovascular health. Cardiovascular disease, which includes heart disease and stroke, is the number one cause of death around the world. But did you know that there's a link between the health of your heart and the health of your mouth?

People with advanced gum disease have a higher risk of having a heart attack, stroke or other cardiovascular event, but what is the connection? For one, oral bacteria found in gum disease can enter the bloodstream, where it has been found in artery-clogging plaque. In addition, untreated gum disease has been determined to worsen high blood pressure, a major contributor to heart attack, stroke and heart failure. One study reported that when gum disease was treated, high blood pressure fell by up to 13 points. But perhaps the most significant common denominator between gum disease and heart disease is inflammation, according to many researchers.

Gum disease is the most common inflammatory disease, affecting nearly 50% of US adults over 30, and 70% of those aged 65 and older, according to the U.S. Centers for Disease Control. The body's inflammation response is a key weapon in fighting infection. However, when there is chronic low-level inflammation such as occurs with untreated periodontal (gum) disease, many adverse health effects can result. In one Harvard University study, chronic inflammation was found to triple the risk of heart attack and double the risk of stroke.

The relationship between gum disease and heart disease is still not completely understood, but there's no denying that a connection exists between the two, so it's worth doing what you can to take care of both your gums and your cardiovascular health. Here are some tips:

• Eat a heart-healthy—and gum-healthy—diet. A diet low in refined carbohydrates, high in fiber, vitamins C and D, antioxidants and Omega-3s has been shown to lower inflammation, benefitting your gums and your heart.
• Quit smoking. Using tobacco in any form is a risk factor for developing both gum disease and heart disease.
• Take care of your oral health. Gum disease can often be prevented—and reversed if caught early—simply with good oral hygiene, so be diligent about brushing your teeth twice a day and flossing once a day.
• Come in for regular cleanings and checkups. Regular cleanings can help keep your gums healthy, and an examination can determine if you have gum disease. Be sure to tell us about any medical conditions or medications.

As you think about what you can do to take care of your heart health and overall health, don't forget your gums. If you have questions about how to improve your oral health, call us or schedule a consultation. You can learn more in the Dear Doctor magazine articles “Good Oral Health Leads to Better Health Overall” and “Carbohydrates Linked to Gum Disease.”

Tooth decay is a highly destructive dental disease, responsible along with periodontal (gum) disease for most adult tooth loss. And we become even more susceptible to it as we get older.

One form of decay that’s especially prominent among senior adults is a root cavity. Similar to a cavity in the crown (visible tooth), this form instead occurs at or below the gum line in the roots. They happen mainly because the roots have become exposed due to gum recession, a common consequence of periodontal (gum) disease and/or brushing too hard.

Exposed roots are extremely vulnerable to disease because they don’t have the benefit of protective enamel like the tooth crown, covered instead with a thin and less protective mineral-like material called cementum. Normally, that’s not a problem because the gums that would normally cover them offer the bulk of the protection. But with the gums receded, the roots must depend on the less-effective cementum for protection against disease.

Although we treat root cavities in a similar way to those in the crown by removing decayed structure and then filling them, there’s often an added difficulty in accessing them below the gum line. Because of its location we may need to surgically enter through the gums to reach the cavity. This can increase the effort and expense to treat them.

It’s best then to prevent them if at all possible. This means practicing daily brushing and flossing to remove bacterial plaque, the thin, built-up biofilm on teeth most responsible for both tooth decay and gum disease. You should also visit your dentist at least twice a year for professional cleanings and advanced prevention methods like topical fluoride to strengthen any at-risk teeth.

You should also seek immediate treatment at the first sign of gum disease to help prevent gum recession. Even if it has occurred, treating the overall disease could help renew gum attachment. We may also need to support tissue regeneration with grafting surgery.

Root cavities are a serious matter that could lead to tooth loss. But by practicing prevention and getting prompt treatment for any dental disease, you can stop them from destroying your smile.

If you would like more information on diagnosing and treating root cavities, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Root Cavities: Tooth Decay near the Gum Line Affects Many Older Adults.”

If you think gum disease only happens to the other guy (or gal), think again. If you’re over 30 you have a 50-50 chance for an infection. After 65 the risk climbs to 70 percent.

Fortunately, we can effectively treat most cases of gum disease. But depending on its severity, treatment can involve numerous intensive sessions and possible surgery to bring the disease under control. So, why not prevent gum disease before it happens?

First, though, let’s look at how gum disease most often begins—with dental plaque, a thin film of bacteria and food particles built up on teeth and gum surfaces. If plaque isn’t consistently removed through daily brushing and flossing, it doesn’t take long—just a few days—for the bacteria to infect the gums.

While it’s not always easy to detect gum disease early on, there are signs to look for like red, swollen and tender gums that bleed easily when you brush or floss, and bad breath or taste. The infection is usually more advanced if you notice pus-filled areas around your gums or loose teeth. If you see any of these (especially advanced signs like loose teeth) you should contact us as soon as possible.

Obviously, the name of the game with prevention is stopping plaque buildup, mainly through daily brushing and flossing. Technique is the key to effectiveness, especially with brushing: you should gently but thoroughly scrub all tooth surfaces and around the gum line, coupled with flossing between teeth.

To find out how well you’re doing, you can rub your tongue along your teeth after you brush and floss—you should feel a smooth, almost squeaky sensation. You can also use plaque-disclosing agents that dye bacterial plaque a particular color so you can easily see surface areas you’ve missed. You can also ask us for a “report card” on how well you’re doing during your next dental visit.

Dental visits, of course, are the other essential part of gum disease prevention—at least every six months (or more, if we recommend) for cleaning and checkups. Not only will we be able to remove hard-to-reach plaque and tartar, we’ll also give your gums a thorough assessment. By following this prevention regimen you’ll increase your chances of not becoming a gum disease statistic.

If you would like more information on recognizing and treating gum disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “How Gum Disease Gets Started.”