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Heart Talk - March 2018

An Easy Four-Step Plan to Optimize Oral Health & Prevent Heart Attacks

Heart-healthy and Stroke-free Living with Eric A. Goulder, MD, FACC

December 2020 Newsletter for the Heart Attack and Stroke Prevention Center of Central Ohio

Following a simple four-step plan to protect your oral health can lower your risk for heart attacks, stroke, diabetes, colds, flu, arthritis and even some forms of cancer. In fact, a recent study of more than 5,600 older adults found that one of the simplest –and most effective – keys to a long life is combining regular dental checkups with excellent self-care, including daily brushing and flossing.


Here’s why optimal oral health can add years to your life. A landmark BaleDoneen study published in Postgraduate Medical Journal (PMJ) is the first to identify oral bacteria from periodontal (gum) disease as a contributing cause of cardiovascular disease (CVD), the leading killer of Americans. To find out how to combat these bacterial villains — and achieve a perfect 10 in dental wellness – we talked to Cris Duval, the BaleDoneen Method’s new Director, Oral Wellness Liaison, who offers these four easy-to-implement steps to protect your oral and arterial health.


Step 1. Partner with your dental provider and set goals to take your oral health to the next level of excellence.

With study after study linking poor oral health to increased risk for life-threatening conditions, says Duval, patients are taking an increasingly active role in their health and dental care. “Patients are looking for clinicians who share more knowledge, show them how to prevent problems, and prepare for a healthier tomorrow,” she says.


To find a dental provider in your area who is trained in the latest science of heart attack and stroke prevention and evidence-based strategies to optimize and protect oral-systemic health, consult the BaleDoneen Method Medical-Dental Provider Map, advises Duval. Make the most of your next dental visit by preparing a list of your oral health goals, concerns and questions, such as these:

• How do you rank my oral health on a scale of 1 to 10?

• What are my risk factors?

• What needs to happen for the two of us to get my oral health to a 10?

• Are you willing to partner/coach me on how to achieve my oral health goals?

• How do you rank my overall health on a scale of 1 to 10 and are there any red flags in my medical history that stand out?

• What needs to happen for the two of us to get my overall health to a 10?

Also ask to be screened for gum disease, Duval says.


Step 2. Ask your dental provider to test you for high-risk oral bacteria.

The PMJ study discussed above could transform how dental providers diagnose and manage periodontal disease (PD), a chronic oral infection that affects the majority of U.S. adults age 30 and older. If untreated, bacteria from PD often enter the bloodstream and inflame arterial plaque, leading to blood clots that can trigger heart attacks and strokes.


Research suggests that the harmful cardiovascular effects of gum disease are due to a few high-risk oral bacteria discussed in the study: Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola or Fusobacterium nucleatum. To find out which patients harbor these dangerous bacteria, The BaleDoneen Method recommends using available diagnostic tests that measure oral pathogens through DNA analysis, including OralDNA, OraVital and Hain Diagnostics.

Because people without gum disease can also harbor these dangerous bacteria, Duval recommends this painless oral testing for all dental patients: “I’ll even test children if one of their parents has a high load of oral pathogens, since the bacteria can spread easily between family members through kissing or sharing food. Dogs are another potential source of bacterial infection, so avoid letting your pet lick you or your kids on the face. Always wash your hands after handling objects your dog has licked or chewed, such as his toys or food bowl.”


Step 3. Disinfect your entire mouth daily.

In the study of older adults, those who brushed and flossed daily outlived people with neither habit. However, there are a few additional self-care habits that can truly optimize your oral health, notes Duval, who recommends the following ways to safeguard your smile and overall wellness:

• To reduce harmful bacteria in your mouth, don’t just brush your teeth and gums. Also brush your cheeks, the roof of your mouth and the vestibule (the area between the teeth, lips and cheeks.)

• Use a tongue scraper — not a toothbrush — to clean your tongue.

• After flossing, also use dental picks (such as G.U.M. Soft-Picks) to efficiently remove debris between teeth that floss doesn’t reach.

• Fight bacterial buildup by using a high pH (alkaline) toothpaste, such as CariFree or CloCYS. These companies also have high pH mouthwashes.

• Choose dental products that contain xylitol, a compound with an antimicrobial effect. Several studies show that xylitol products, such as toothpaste, chewing gum and lozenges, help prevent cavities and may reduce risk for gum disease.

• Go to bed with a clean mouth. Since your mouth makes less saliva when you are sleeping to wash your teeth and gums, it’s particularly important to disinfect your mouth thoroughly at bedtime.

• Avoid mouthwashes that contain sugar or alcohol.


Step 4. Get a dental cleaning every 3 months, or as advised by your dental provider.

Doing so could actually save your life! In the study of older adults, those who hadn’t seen a dentist in the previous year had a 50% higher death rate than who went multiple times a year.


“One of our goals is to keep all of our patients in what I call the ‘safety zone,’ as opposed to the danger zone where gum disease and high-risk bacteria create a perfect storm of inflammatory responses that leave people susceptible to heart attacks and strokes,” says Duval.


To stay in the safety zone, it’s crucial to get dental checkups and any necessary treatments on the schedule advised by your dental provider. If you have gum disease, treatments include nonsurgical periodontal therapy, a daily program of self-care to follow at home, prescription mouthwashes, dental trays with antibacterial gel (PerioProtect), and in some cases, a short course of antibiotics. Regardless of which treatment is prescribed, the BaleDoneen Method recommends repeating the DNA testing to make sure the treatment was successful.


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Heart Talk - March 2018
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