Periodontal Pathogens are Associated with Cardiovascular Disease

Autoimmunity & Healing Diets

Nov 05
periodontitis, oral health, dental health

What your dentist and doctor don’t know about periodontal disease may hurt you. Periodontal pathogens are associated with cardiovascular disease.

However, most dentists and doctors are still not fully aware of this important relationship. Functional medicine doctors are reaching out to dentists and other oral health professionals with new information.

Dr. Amy Doneen and Dr Bradley Bale have written a book called, Beat the Heart Attack Gene, The Revolutionary Plan to Prevent Heart Disease, Stroke, and Diabetes.

It involves the Bale and Doneen Method of Heart Attack and Stroke Prevention.

Periodontal Pathogens are Associated with Cardiovascular Disease

Heart attacks and strokes are the leading cause of death and disability in America. Every 40 seconds someone is having a stroke.

Standard medicine is still assessing patients based on a risk profile. These include things like cholesterol, age, blood pressure, whether or not you smoke, etc.

Stroke and heart attacks are still occurring even with the current risk profile standard of care

These numbers get calculated. Any treatment given is based on a calculated risk. According to Bale and Doneen, the problem with using calculated risk factors as the only way of establishing risk, is that it allows these cardiovascular events to keep happening.

Importantly, it allows these cardiovascular events to occur in people that have no suspicion that they even have cardiovascular disease.

Statistics indicate that 64% of women and 50% of men who have a heart attack had no idea they even had a vascular problem.

Furthermore, half of the people who have heart attacks have normal cholesterol.

Subclinical Atherosclerosis Needs to be Recognized

We need to assess for subclinical atherosclerosis and vascular inflammation.

There are 60,000 miles of vessels in the body. The cause of  cardiovascular disease – heart attack and stroke – is that atherosclerotic plaques develop in the wall of the artery.

Inflammation causes that plaque to rupture.

What Drives Inflammation?

Plaque can hide in the artery wall and if the plaque is inflamed and the artery wall is not protected, the plaque can rupture through the artery wall.

The body begins to heal the rupture by laying down clotting factors. The clot will cause a blockage and a cardiovascular event in the heart or brain.

Damage to the artery can happen over time by small tiny ruptures that cause no symptoms. The body will heal these with clots and these tiny clots start to add up over 10 or 20 years, eventually causing memory loss, end-stage kidney disease or peripheral vascular disease.

Inflammation Occurs Below the Lining of the Artery

The standard tests do not show plaque hidden in the wall of the arteries. However, there are new techniques that can, in fact, identify plaque.

  • Coronary Calcium Scanning is used to look for plaque in the heart and carotid arteries. The images look for different characteristics of plaque in the walls.
  • Coronary Calcium Score is used to assess calcification in the coronary arteries. If you have a positive calcium score you have heart disease. The plaque has been in the artery wall long enough to calcify. However, those with a low score may still have atherosclerosis, as it is a process.
  • Carotid IMT is used to look for soft uncalcified plaques first, to find out if there is plaque anywhere in the body.

Read more about How to Test for Plaque in Your Arteries and What to do If You Have It.

Inflammation can be anywhere in the body. It needs to be tested in various ways:

Testing for oral pathogens must also be evaluated.

You need to ask for these newer techniques because they are not included in the standard of care that most doctors follow.

The Bale-Doneen Method to prevent Heat Attack and Stroke

The Bale-Doneen method asks the question, does the patient have vascular disease and if so what is the root cause and how inflamed are the arteries?

Once the root cause is established and treated, the disease can stabilize.

The Root Cause of Vascular Disease

The causes of vascular disease could be from many causes  – way beyond cholesterol:

  • Gut dysbiosis
  • Genetic lipid abnormalities like lipoprotein A
  • Stress management or depression
  • Sleep disruption
  • Sleep apnea
  • Insulin resistance
  • Autoimmune disease
  • Gram negative high-risk pathogens that drive periodontal disease

How to Assess Inflammation

Inflammation must be accessed in order to make sure the treatment is effective. This is done through lab tests.

The endothelial layer of the artery must be assessed with the following lab tests:

  • Fibrinogen for clotting
  • HSCRP for systemic inflammation
  • Microalbumin/creatinine urine ratio
  • Myeloperoxidase
  • Oxidation of cholesterol

Bale-Doneen Method

Bale-Doneen Method uses the acronym EDFROG to remember all the steps that are included in the method.

  • E – Education of patients for vascular disease
  • D – Disease – do you have plaque in the wall of the artery or not?
  • F – Fire – inflammation will be assessed
  • R – Root causes – many
  • O – Optimal goals that has to be individualized
  • G – Genetics for screening and pharmaco-genetics to determine what medications and foods you should eat

This is individualized medicine at its best.

Dental Disease has a Strong Inflammatory Component

There is an atherogenic triad – 3 things necessary to drive vascular disease:

  1. Increased concentration cholesterol in blood – particularly ApoB which is associated with small, dense low-density lipoprotein (sd-LDL) concentrations.
  2. Vulnerability of the endothelial layer of the artery
  3. Lipoprotein trapped within the artery wall (this starts the process)

All 3 of these conditions are affected by different pathogens.

High-risk periodontal pathogens include:
  • Aggregatibacter actinomycetemcomitans
  • Porphyromonas gingivalis
  • Tannerella forsythia
  • Treponema denticola
  • Fusobacterium nucleatum

It is important to know which ones are present because they affect different things. Some affect the endothelium, some affect the ApoB bindings, some affect the concentration of Apo B. It helps to identify the exact pathogen because that will affect how it is treated.

Dentist and hygienists are in the perfect role address these pathogens. Testing for pathogens can be done in various ways with oral rinses, pocket point tests, tongue scrapes or all 3.

New technology that images the root of the tooth is called 3D cone beam CT scans. These should be used more frequently. Bite wing x-rays do not show the 3 dimensional aspects of the periapical aspect of the tooth.

Some people do not have any visible way to tell if they have periodontal pathogens. These folks should still be tested, especially if they have vascular disease.

Many dental practitioners are not even aware of the relationship or peridontal pathogens to vascular disease and do not know how to test. They need to be educated that the oral cavity is a critical part of strokes and heart attacks.

Is your dentist or doctor informed about the relationship of the oral cavity to systemic health?

Get my favorite dental products here.

Grab Beat the Heart Attack Gene, The Revolutionary Plan to Prevent Heart Disease, Stroke, and Diabetes

You might also be interested in Periodontitis Found to Trigger Rheumatoid Arthritis.











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