Anew study has revealed that taking care of your gums by brushing, flossing, and regular dental visits could keep heart disease at bay. Researchers at Columbia University’s Mailman School of Public Health have shown for the first time that as gum health improves, progression of atherosclerosis slows to a clinically significant degree. Artherosclerosis or the narrowing of arteries through the build-up of plaque is a major risk factor for heart disease, stroke, and death.

“These results are important because atherosclerosis progressed in parallel with both clinical periodontal disease and the bacterial profiles in the gums. This is the most direct evidence yet that modifying the periodontal bacterial profile could play a role in preventing or slowing both diseases,” Moise Desvarieux, MD, PhD, lead author of the paper and associate professor of Epidemiology at the Mailman School, said. The researchers followed 420 adults as part of the Oral Infections and Vascular Disease Epidemiology Study ( INVEST), a randomly sampled prospective cohort of Northern Manhattan residents. Participants were examined for periodontal infection. Overall, 5,008 plaque samples were taken from several teeth, beneath the gum, and analyzed for 11 bacterial strains linked to periodontal disease and seven control bacteria.

Fluid around the gums was sampled to assess levels of Interleukin-1a, a marker of inflammation. Atherosclerosis in both carotid arteries was measured using highresolution ultrasound. Over a median follow-up period of three years, the researchers found that improvement in periodontal health—health of the gums—and a reduction in the proportion of specific bacteria linked to periodontal disease correlated to a slower intima-medial thickness (IMT) progression, and worsening periodontal infections paralleled the progression of IMT. Results were adjusted for potential confounders such as body mass index, cholesterol levels, diabetes, and smoking status. There was a 0.1 mm difference in IMT change over three years among study participants whose periodontal health was deteriorating compared with those whose periodontal health was improving.

Previous research has shown that a .033 mm/year increase in carotid IMT (equivalent to approximately 0.1 mm over three years) is associated with a 2.3-fold increased risk for coronary events. “When it comes to atherosclerosis, a tenth of a millimeter in the thickness of the carotid artery is a big deal. Based on prior research, it appears to meet the threshold of clinical significance,” Tatjana Rundek, MD, PhD, a co-author of the study and professor at the University of Miami whose lab read the carotid ultrasounds, said.