Doctors and dentists are having a heart-to-heart about the MouthBody Connection®, particularly when it comes to heart disease and stroke. We–Lulu Tang, DDS, and Harris Khakwani, MD–recently discussed how our respective fields, dentistry and medicine, are coming together to prevent, identify and even treat heart disease by addressing the health of their patients’ mouths.
A Collaborative Conversation Between Dentistry and Medicine
A little about ourselves: Dr. Tang practices dentistry at Sahara Modern Dentistry in Las Vegas, Nevada, while Dr. Khakwani is a physician at PDS Medical Group in Buckeye, Arizona.
Although our fields are different, we both believe that we play critical roles in heart health. In fact, studies have found that bacteria in the mouth have a significant effect on the development of heart issues.1 Addressing these issues through specialized testing and treatment can have a significant impact on a person’s heart health.
How Oral Bacteria Can Influence Heart Disease and Stroke
Dr. Tang
A patient was referred to my office by his cardiologist to explore potential causes of his cardiovascular condition. The cardiologist recommended salivary screening –a non-invasive lab test that identifies bacteria levels in the saliva to help detect periodontal disease and other health issues.
This patient was diligent about brushing, flossing, and attending routine dental visits, so he was skeptical that the test would reveal anything significant. However, the results showed elevated levels of bacteria associated with chronic periodontitis–a form of gum disease that affects nearly half of adults over age 30 in the U.S.2 This was a wake-up call for him, as he had no symptoms and was unaware that this bacteria was triggering an inflammatory response, putting both his oral and heart health at risk.
Treating his periodontitis required a collaborative effort involving myself, our hygienist, and a periodontist–a dentist who specializes in gum disease. Together, we addressed the infection and inflammation. His cardiologist later shared that his stress test results had significantly improved, and they were even able to reduce his high blood pressure medication.
Dr. Khakwani
The reverse is also true. When a patient comes into my medical office, we can look and say, “Your cholesterol is great, and you’re otherwise healthy, but you've got a strong family history of heart disease and stroke.” We could then refer them to their dentist to test for cardiac inflammatory markers that are normally not tested when you usually go to your primary care doctor.
One of these markers, myeloperoxidase, is an enzyme usually elevated if there is severe gum disease. This can be detected in a chairside saliva screening for periodontal disease at the dentist’s office. Elevations in myeloperoxidase cause inflammation in blood vessels. So, even if our patient has controlled cholesterol, if he has severe inflammation of the blood vessels, it can increase the risk for heart attacks and strokes.
Having the dentist do deep cleanings and periodontal evaluations reduces that risk. You end up having a much healthier patient overall.
Dr. Tang
It gets interesting when patients receive medical diagnoses in the dentist’s chair.
Dr. Khakwani
Yes. Take, for example, diabetic patients. They have a higher incidence of heart disease and stroke.
What we are seeing now on the dental side is that dentists are screening for A1C, the marker used to diagnose diabetes and prediabetes. So, essentially, dentists in these instances are acting as primary care providers, expanding the scope of dentistry and becoming part of the patient’s wholebody health. They refer their patients to doctors for the next steps in evaluating prediabetes or diabetes and treating these conditions. The earlier that these can be detected, the better. It’s very exciting to see this kind of referral system develop.
Expanding the Role of Dentistry in Whole-Body Health
Dr. Tang
It is exciting to see more of my peers on the medical side embracing this connection.
The biggest takeaway is that teeth are like an organ in your body. They’re connected by blood vessels, just like every other organ, and–for our overall health–we have to treat them that way.
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Smile Generation blog articles are reviewed by a licensed dental professional before publishing. However, we present this information for educational purposes only with the intent to promote readers’ understanding of oral health and oral healthcare treatment options and technology. We do not intend for our blog content to substitute for professional dental care and clinical advice, diagnosis, or treatment planning provided by a licensed dental professional. Smile Generation always recommends seeking the advice of a dentist, physician, or other licensed healthcare professional for a dental or medical condition or treatment.
