The link between healthy teeth and heart disease is not widely known and more should be done to educate the public, a leading dentist has said.

Gum disease is now recognised as an independent but preventable risk factor for cardiovascular illness, which is Scotland’s biggest killer.

Research has also revealed links between poor dental hygiene and endocarditis, a rare condition where the lining of the heart becomes infected.

Dr Maria Papvergos, who runs a dental practice in the Scottish Borders, said anyone with high blood pressure should consider visiting their dentist to assess gum health.

Periodontal disease in some form is thought to affect up to 80 per cent of adults and is also the leading cause of tooth loss. 

READ MORE: Scots study hopes for 'silent' heart complication that has 90% mortality rate

It is reversible if caught at an early stage and is caused by a build up of plaque on the teeth. 

Early symptoms include bleeding gums and pockets may form and become infected. 

In severe cases “oral pathogens” entering the blood vessels can put the body into a state of chronic inflammation putting you at risk of heart disease or stroke.

Regular visits to the dentist and good oral hygiene is generally sufficient to keep gums healthy, but some people are more susceptible and lifestyle factors including smoking can also heighten the risk.

Dental services have been significantly affected by the pandemic, with NHS and private patients continuing to experience delays for check-ups. 

Patient numbers remain capped due to social distancing restrictions and certain treatments are still off the table.

Hygienists tasked with improving gum health are still not permitted to use ultrasonic scalers due to the risk of airborne particles and must use hand scalers.

READ MORE: Scots cardiologists say impact of Covid on blood pressure 'major concern' 

Dr Papavergos believes oral health in general is overlooked in public health messaging.

She said: “Anyone with high blood pressure should be visiting their dentist to assess their gum health because actually if they can get control of their gum health their risk of heart disease can be reduced.

“It’s not common knowledge at all. There are a lot of links between the mouth and health in general that are overlooked.

"The mouth is the gateway to the whole body. You have a balance in your mouth of good bacteria and the bad bacteria, we refer to as pathogens.


“When it comes to gum disease you have a proliferation of the bad bacteria and that shift effectively causes localised problems such as dental decay and gum disease and as a result of this these pathogens  invade the  blood vessels.

“It puts our body into this low grade inflammatory state – effectively a state of chronic inflammation.

READ MORE: Major blood pressure study could transform treatments for heart attacks and stroke

“There is evidence that periodontal health or severe gum disease is actually now seen as an independent risk factor for cardiovascular disease.”

People with poor gum health are also said to be three times more likely to be diagnosed with Type 2 diabetes and there is a link to some auto-immune diseases including rheumatoid arthritis.

“I think people see dentists are someone who fixes problems as opposed to a preventative approach, said Dr Papvergos.

She said check-up delays caused by Covid were “a worry” because patients will be presenting later with health issues that can be picked up by dentists. 

She added: “I think people generally haven’t been looking after their teeth as well during the pandemic, not brushing their teeth twice a day, maybe the diet is not as good, snacking a bit more. Probably a few things have slipped.

“If you can get rid of the plaque on your teeth the effect is not just 
better oral health but better health in general.”

Regina Giblin, Senior Cardiac Nurse at the British Heart Foundation (BHF), said:“Keeping our mouths healthy can play a vital role in protecting our cardiovascular health.

"People with gum disease can be at risk of developing coronary heart disease or valve disease – and research has also revealed links between poor dental hygiene and endocarditis, a rare condition where the lining of the heart becomes infected.

"Practising good dental hygiene by flossing once a day and brushing your teeth for at least two minutes twice a day can help you take better care of your teeth and gums."