At the heart of the matter

29 September 2023

 Could oral indicators of CVD improve preventive healthcare? Micheal Sultan discusses the importance of World Heart Day.

We all know that oral and heart health are linked. There has been much research on the topic over the years, though more is needed to determine the exact mechanisms involved. I was interested to read recently about how a mouth rinse could be used to assess a patient’s risk of heart problems.

The concept is based on a study that explored the oral inflammatory load and whether this could predict vascular function in young adults. The cross-sectional and correlational analysis looked at 28 systemically healthy 18 to 30-year-olds. Mouth rinse samples were collected from each participant and tested for oral neutrophils – white blood cells – which are a validated measure of oral inflammatory load. Researchers also tested participants for blood pressure, arterial stiffness and endothelial function (brachial artery flow-mediated dilation), which is a known early risk factor for cardiovascular disease (CVD).

The study found a link between high oral neutrophil counts in the mouth rinse sample and impaired endothelial function. This suggests that testing for oral neutrophils in a mouth rinse could indicate a risk of heart problems in the future.

Of course, this line of research requires further study before it can be reliably implemented within the dental or healthcare workflow. For a start this was a small-scale study and the first of its kind as far as I’m aware. However, it offers an exciting new way of supporting the preventive healthcare we professionals dream of. It is the latest in a line of scientific findings that show just how important the mouth is for the health of the entire body. It’s also another way to integrate dental and general healthcare, promoting a truly holistic approach.

Such a risk assessment could also prove useful for patient education – especially if it works from such a young age as 18. If we have a quantitative measure that clearly defines a patient’s risk of CVD, this offers gravitas for our professional recommendations and may help to persuade patients of the need to make and maintain positive lifestyle changes. As this year’s World Heart Day campaign promotes, it is essential for patients to know their own hearts and how to keep them healthy.

Until such a time when this or a similar test becomes available to dental professionals, it remains our duty to help patients achieve and maintain high standards of oral health for the good of their mind and body. With regards to optimising heart health in particular, this includes avoiding or treating gingival diseases through excellent plaque control and regular dental or dental hygiene appointments. A thorough at-home oral hygiene routine with clinically proven products and professional support as necessary remains the gold standard for all patients.


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