Heart disease: How brushing your teeth can help protect your heart

Want to help prevent heart disease? Then just take your dentists advice: brush and floss.

In previous e-alerts Ive told you about the growing evidence that periodontal disease (an advanced form of gum inflammation) may be linked to an increased risk of heart disease. Although scientists have been aware of the association for several years, research is still in the early stages.

This past week I came across a relatively large study from the University of Minnesota (UM) in the US that confirms the link. And although one of the results doesnt quite square up with previous studies, this is a welcome addition to the body of research on this important health issue.

Follow the inflammation
As reported in a February issue of the American journal Circulation, the UM team recruited more than 650 healthy subjects (with an average age of about 70) who were enrolled in the Oral Infections and Vascular Disease Epidemiology Study and had no history of stroke or heart attack.

Researchers collected more than 4,500 subgingival plaque samples (on average, about seven samples per subject), and assessed the samples for 11 types of periodontal bacteria. Cardiovascular risk factors were also examined, including C-reactive protein (CRP) levels, white blood cell count, and ultrasound scans of the carotid arteries (the major arteries in the neck).

Analysis showed a significant association between high levels of periodontal disease bacteria and a thickening of the carotid arteries. Enlargement of carotid arteries is an indication that plaque may be building up in other major arteries. In addition, subjects with excessive bacteria in the gums had elevated white blood cell counts, which is a marker for inflammation.

The UM team reported that elevated CRP (also an inflammation marker) was not found to be associated with increased periodontal disease bacteria. This conflicts with the findings of a 1997 study in which subjects with advanced gum disease had significantly higher levels of CRP compared to subjects who didnt have the disease.

So while gum disease appears to trigger inflammation, further studies will be needed before we completely understand the specific links between periodontal bacteria and an increased risk of obstructed arteries. 

Antioxidant shield 
So after youve brushed three times each day and flossed regularly, theres another step you can take that may help prevent periodontal disease.

A British study in 2003 examined 20 subjects - 10 with healthy gums, and 10 with advanced gum disease. From each subject, researchers took samples of gingival crevicular fluid, a solution within the gums that is routinely released from the crevices under the teeth.

All of the subjects with healthy gums were shown to have high levels of the antioxidant glutathione, while the subjects with periodontal disease had substantially lower levels of glutathione. When blood serum levels were tested for glutathione, the same disparity was recorded for the two groups.

In several previous e-alerts Ive told you about glutathione - an enormously effective antioxidant found in every cell of the body, most notably in immune system cells. Glutathione has not only been shown to protect against disease, but may also protect other antioxidants (such as vitamins C and E) from oxidising, prolonging and enhancing their effectiveness.

Get the NAC 
So, whats the best way to raise glutathione levels? One way NOT to do it is by oral supplement. Taking glutathione orally is regarded as ineffective because the molecules are too big to pass through the intestinal walls to the blood stream. There is, however, an important amino acid Ive mentioned before called N-acetylcysteine (NAC) that gives a powerful boost to your bodys natural production of glutathione.

The food sources that deliver glutathione precursors are meats and fresh fruits and vegetables. But even with a diet high in the proteins that supply glutathione amino acids, one of those amino acids - cysteine - is more difficult than the others to come by. A natural food component with high concentrations of glutathione precursors (including cysteine) is milk-serum-protein concentrate - more simply known as whey.