Preventing heart disease is not as easy as brushing your teeth.
While numerous studies have linked gum disease with an increased risk of heart disease and stroke, there is no proof that bad gums actually cause heart disease or strokes, an American Heart Association committee said after reviewing 500 journal articles and studies.
Moreover, claims that dental treatment may prevent heart attack or stroke are unwarranted, the committee of doctors, dentists and infectious-disease researchers said in a statement.
"The message sent out by some in health care professions – that heart attack and stroke are directly linked to gum disease – can distort the facts, alarm patients and perhaps shift the focus of prevention away from well-known risk factors for these diseases," said committee member Dr. Peter Lockhart, a professor of oral medicine at the Carolinas Medical Center in Charlotte, N.C.
It is biologically plausible, the committee acknowledged, that oral bacteria infections could cause heart disease. Mouth bacteria can enter the bloodstream during dental procedures and tooth brushing.
However, gum disease and heart disease share many common risk factors, including cigarette smoking, age and diabetes, and these factors are more likely to explain why diseases of the blood vessels and mouth occur in tandem.
Studies that show a strong relationship between gum disease and heart disease have failed to account for these common factors, the committee said.
"Individuals who do not pay attention to the very powerful and well-proven risk factors like smoking, diabetes or high blood pressure may not pay close attention to their oral health, either," Lockhart said.
One study even found invasive dental procedures, which include some treatments for gum disease, could increase the risk of heart attack and stroke.
A large, long-term study would be needed to prove whether dental disease causes heart disease and stroke, Lockhart said. Such a study isn't likely to be done in the near future, and it's most important to let patients know "what we know now, and what we don't know," he added.
Good oral hygiene is still important for overall health, and some studies show treatment of gum disease reduces markers of inflammation in the body, the committee said.
The committee statement will be published in the journal Circulation. It was endorsed by the American Dental Association Council on Scientific Affairs and the World Heart Federation.