In the future, a simple mouthwash test during a patient's annual dental exam may provide insight into whether the patient is at increased risk for cardiovascular disease.
The link between periodontitis and cardiovascular disease is well established. However, most research in this area involves older patients, and little is known about whether mild oral inflammation, which typically occurs in young and apparently healthy people, affects cardiovascular health. Using a simple saliva test, a team of researchers from various Canadian institutions set out to determine whether lower levels of oral inflammation could be clinically significant for cardiovascular function.
Previous research into oral inflammation that precedes periodontitis has found that increased inflammation, reflected in higher concentrations of white blood cells in saliva, is associated with fewer healthy arteries and a potentially higher risk of cardiovascular disease.
“Even in young, healthy people, low levels of oral inflammation may have an impact on cardiovascular health, one of the leading causes of death in North America,” said study co-author Dr Trevor King from McMaster University in Hamilton. and Mount Royal University in Calgary, Alberta.
In their study, the researchers worked with 28 people aged 18 to 30 who did not smoke, had no risk factors for cardiovascular disease, and had no history of periodontal disease. The team used a simple mouthwash to determine whether the concentration of white blood cells in saliva could be associated with a higher risk of cardiovascular disease. The team chose flow-mediated dilatation, a measure of how well arteries can dilate to allow more blood flow, and pulse wave velocity, which measures arterial stiffness, as key indicators of cardiovascular risk.
Researchers have found that oral inflammation is a predictor of decreased blood flow-mediated dilatation, indicating a possible risk for cardiovascular disease. They hypothesized that inflammation that travels from the mouth to the vascular system may affect the arteries' ability to produce nitric oxide, which allows them to respond to changes in blood flow.
However, they found no relationship between oral inflammation and pulse wave velocity, indicating that there was no long-term effect of oral inflammation on arterial structure. This observation is consistent with previous studies involving older adults.
“We're starting to see more connections between oral health and cardiovascular disease risk,” said lead author Ker-Jung Hong of McMaster University. “If we see that oral health can influence the risk of developing cardiovascular disease even in young, healthy people, this holistic approach could be introduced earlier.”
“The mouthwash test can be used as part of an annual check-up with your family physician or dentist,” said study co-author Dr. Michael Glogauer of the University of Toronto. “It can be easily used as a tool to measure oral inflammation in any clinic.”
The researchers concluded that their study provides evidence that oral health can influence cardiovascular disease even in young and healthy people. The researchers hope to conduct further studies in larger populations and more people with more advanced forms of gingivitis and periodontitis to better understand the relationship between different levels of oral inflammation and cardiovascular health, Dr. King said.