March 18, 2026 • 38 mins
Priyanka and Hari explore the surprising connection between oral health and heart health. They break down gum disease, how it develops, and why plaque buildup can trigger inflammation throughout the body. They also cover the basics of brushing, flossing, and dental care, along with why access to dentistry remains a major public health issue. Then they unpack the growing research linking gum disease to cardiovascular disease. From bacteria entering the bloodstream to chronic inflammation, your mouth may be telling you more about your health than you realize.
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Episode Transcript
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Speaker 1 (00:00):
This podcast is for information purposes only and should not
be considered professional medical advice. The American College of Prostadontis
estimates that one hundred and seventy three million Americans are
missing one too.
Speaker 2 (00:17):
Whoa you go three times a year?
Speaker 3 (00:20):
I like it, I need it.
Speaker 1 (00:25):
I showed them pictures of what happens when you put
teeth in coca cola for like extended periods of time,
and now they brush their teeth twice a day, like
without fail.
Speaker 2 (00:36):
Them out, totally freake them out. I'm hurrycandbolu, I'm doctor
pre uncle Wally, and this is health stuff.
Speaker 3 (00:49):
Well hello there.
Speaker 2 (00:50):
Oh hello, how are you?
Speaker 3 (00:52):
I'm good.
Speaker 2 (00:53):
I'm good.
Speaker 3 (00:54):
Yeah, how are you?
Speaker 2 (00:56):
I'm fine. I started taking statns.
Speaker 3 (00:59):
Oh interesting, like this week.
Speaker 2 (01:02):
No, a few months ago. I've been having some This
is obviously an overshare, but this is what I do
in the beginning of all our episodes. So it's that's
why we're here. That's why we're here to get me
some free healthcare. But yeah, I started taking My cholesterol
has been high, and my good cholesterol has not been
high enough. So okay, I started taking statins maybe three
(01:24):
four months ago. So my heart I think is doing okay,
though I've noticed an increase of nose bleeds since you've
started the statin. Yes, because I went from never having
no like I've had, never had a nosebleed before, yeah,
other than like my butt my nose into something and
it caused it, but never randomly, to having random nose
bleeds every like a few weeks. So it's a little strange.
Speaker 1 (01:46):
You know. That's interesting because I obviously know a lot
about statins and their side effects, and nose bleeds is
not one of the side effects that I really heard about.
Speaker 3 (01:57):
Yeah, if it is, it's certainly not the top.
Speaker 1 (02:01):
Kind of side effects. Usually people complain about muscles, like
their muscles are aching, So that's new for me.
Speaker 2 (02:09):
Why do noses bleed? What is the reason for that, like,
other than like some kind of trauma to the nose,
like what else, anything that.
Speaker 1 (02:16):
Sort of disrupts the blood vessels. So, Like, even dry
climates can lead to nose bleeds. Obviously, if you get traumatizer,
you blow it really hard. A lot of it has
to do with just the temperature. I don't know, though,
you never had newsbleeds before. Now you're on a statin.
Now you have nosebleeds. That's a new one for me,
if I can be really honest, like it's certainly not
(02:39):
traditionally associated with causing nose bleeds. I would almost say that,
if anything, a statin could protect you from a nosebleed
because it's doing beneficial things.
Speaker 3 (02:52):
To like your blood vessels.
Speaker 1 (02:53):
Yea, So I'm a little stumped about huh.
Speaker 3 (02:59):
Yeah.
Speaker 1 (03:00):
I'll get nose bleeds from time to time, mostly like
if it's dry weather and stuff, and I hate that
feeling when when the blood drips behind your throat and
then you're tasting.
Speaker 2 (03:11):
Yeah, then I feel like it's one for me. But yeah,
going on like yeah, that's probably the weather. Then I
think it's probably the weather.
Speaker 1 (03:20):
Maybe maybe now if you were like, oh, my muscles ache,
I'd be like, yeah, that's a statin thing.
Speaker 2 (03:27):
Yeah, but I mean that then they would just bleed
into my muscles that already ached before. Just it's just
the same.
Speaker 1 (03:38):
You know. And today we're not talking about status at all,
but we are talking about our overall health and like
our heart health, but specifically through our mouths. We've talked
over different episodes like going to the dentists. I'm curious
how how often do you go to the dentists?
Speaker 2 (03:58):
You know, it's funny, but that feels like such a
personal question, and I'm so I'm good with sharing so much,
but that all of a sudden fills me with so
much guilt and dread. Really not often enough, not see
not yearly, which is really bad.
Speaker 3 (04:16):
Oh interesting, I go.
Speaker 1 (04:20):
Two to three times a year. I think for me,
it's something I can control. And you know, as someone
who has control issues and is constantly thinking about my health,
going to the dentist is one of the few things
in life that I feel like I can do, and
(04:40):
it just gives me this sense of like I'm doing
everything that I possibly can. I don't mind going to
the dentist. And recently I just switched dentists. I used
to hate.
Speaker 3 (04:51):
You know how when they clean your teeth it's so
damn loud.
Speaker 1 (04:55):
Yes, that it's so loud, and that the noise is
what actually really activates me and makes me feel like
very kind of shaky. It's not the cleaning itself, it's
how loud it is. But this new dentist actually offers
me ear plugs. Oh, and I was like, you're a keeper.
That's it's staying with you.
Speaker 2 (05:15):
So dentistry always felt like a strange, it felt optional
because I think my parents didn't grow up going to
dentists regularly. You know, we're talking about you know, small
town India in the nineteen fifties, you know, sixties, and
so they didn't like instill that in us growing up
(05:35):
that we had to go to the dentist. They didn't
take us every year, like it wasn't a thing. We
would go periodically, whatever the period is. And so, you know,
I think growing up by you know, I should have
I should have definitely compensated by going regularly, especially if
you're lucky enough to have dental insurance. Sure, like getting
those checkups are incredibly important, but I just I never,
(05:58):
you know, I think this this episode actually you know,
we'll get into it, but like it scares me into
going to the dentist more because when I think about
the dentist, I think it almost as a oh, it's
an extra thing optional. If I gotta do it, I
gotta do it. But like my teeth, it's almost like
the teeth and your oral health feel like a separate
(06:20):
entity from rest of your health. And as we're going
to talk about in this episode, that is not the case.
Speaker 3 (06:25):
Yeah.
Speaker 1 (06:27):
Yeah, and you know, I can actually really relate. I
didn't grow.
Speaker 3 (06:30):
Up going to the dentist often.
Speaker 1 (06:33):
Yeah, I think that was something I adopted much later
in life as an adult. Again, back to getting closer
to mortality control issues. To me, it was like, okay,
what are the things that you can do? So that's
I started doing it as an adult and now I
embrace it.
Speaker 2 (06:51):
I really it's great, which is fantastic.
Speaker 3 (06:53):
I'm like a big fan.
Speaker 1 (06:54):
And obviously my dentist loves me because I keep them
in business.
Speaker 3 (06:58):
Like dental insurance doesn't cover much past even like their
routine cleaning.
Speaker 2 (07:04):
So there said, but you know, the dentist things you
should get deep cleaning. And then I'm like, okay, does
the insurance cover it. They're like, no, it is several
thousand dollars. Yeah, It's like, what this is so necessary?
Why isn't it covered?
Speaker 1 (07:19):
Yeah, you know my dental insurance right now, they're basically like,
we're going to give you a couple hundred dollars for
the year and.
Speaker 3 (07:28):
That's all you get. If you got to make it work,
you can't. You don't get any care. It's like damn, Okay,
the pressure's on.
Speaker 2 (07:37):
See that's another reason why I think I didn't go
to the dentist as much. It wasn't even treated like
part of your health. It was. It was just the
fact that it's not covered, the fact that it's it's
seen as a separate entity, you know what I mean.
It's not seen as a part of the bigger picture.
Speaker 1 (07:54):
Right, like pap smears, prostate cancer screening, you know, blood
pressure checks, that's all covered, right, Cleaning your teeth, making
sure your teeth are clean not the most essential thing,
which is crazy because we're we now know there's so
much strong data showing that gum disease, yeah, increases your
(08:18):
risk of certain diseases, and specifically today.
Speaker 3 (08:21):
We're going to talk about heart disease.
Speaker 1 (08:23):
Yes, so let's talk about him.
Speaker 2 (08:26):
We know that brushing and flossing is important for dental
and oral health, but it's more than just about preventing cavities.
The health of our mouths are closely tied to our
overall health. Taking care of your teeth and gums is
important for a bunch of reasons. Oral health problems like
gum disease have been shown to increase your risk of
certain diseases and specifically cardiovascular disease. So let's get into it.
Speaker 3 (08:49):
Yeah, I mean, so this is wild, and I think it.
Speaker 1 (08:52):
First of all, what people need to understand is that
gum disease it's an it's an inflammation problem, and it's chronic.
And actually having gum disease is the leading cause of
tooth loss, which affects, by the way, nearly half of
Americans over the age of thirty.
Speaker 2 (09:14):
That's wild.
Speaker 1 (09:15):
That's a lot of people with missing teeth. It's actually
really common. You know. The American College of Prostadontis estimates
that one hundred and seventy three million Americans are missing
one teeth.
Speaker 2 (09:28):
Yeah. Literally, So if you're out there missing teeth, thinking
how am I going to find the one, just remember
there's one hundred and seventy three million other Americans also
missing teeth.
Speaker 1 (09:38):
Yeah, and more than forty million people are get this,
missing all of their teeth.
Speaker 2 (09:44):
Wow, And I'd imagine that's the older population generally, right,
Maybe not.
Speaker 1 (09:49):
Well, it's interesting because what we know is that tooth
loss is associated with a shorter life span. So like
people who have all or majority of their teeth by
age seventy, they live longer than those that have fewer
than twenty of their natural teeth left.
Speaker 2 (10:07):
What is that? What is the correlation?
Speaker 1 (10:09):
Do you think, Well, if you have fewer teeth, you're
less likely to be able to eat food normally, You're
more likely to have structural changes in your jaw. You're
more likely to then develop other infections. You know, it's
going to affect your ability to intake nutrition, which is
(10:29):
then going to affect your life later on. We know
as people age, getting enough protein is quite a challenge
because you waste muscle.
Speaker 3 (10:39):
Your muscle starts wasting. It's called sarcopenia.
Speaker 1 (10:42):
So you need to be able to have like a
good strong jaw with a nice set of teeth to
be able to eat your food, get your protein. You know,
keep yourself alive essentially, I mean teeth keep us alive.
It's one of the mark of being human. So it
would make sense that if you have fewer teeth, it's
gonna be harder.
Speaker 2 (11:02):
Right now, we've got three main types of gum disease, right,
the first being gingivitis, which I'm sure we've all heard
from the commercials, right.
Speaker 1 (11:10):
I love those commercials man ginger vitis. Yeah, and just
like the way they show the toothbrush and the SuDS,
the toothpaste SuDS, and it's like going away.
Speaker 3 (11:20):
If only if it was like that in real life, exactly.
Speaker 2 (11:23):
If it was, I'd served ford. I mean. Gingivitis is
the mildest form of periodontal disease. It's characterized by red,
swollen gums that may bleed easily during brushing and flossing,
often due to plaque build up. It's reversible with good
hygiene and routine dental cleanings. So there's there's a positive
in that it can go away.
Speaker 1 (11:43):
Yeah, very common. But the thing is then if you
don't treat the gingervitis, it then progresses to something called
periodone titis. So if you break down that word periodon titis,
itis is inflammation Perry means around Odontos is the Greek
word for teeth, So this is inflammation of the structures
(12:04):
around the teeth, like your gums and your connective tissue.
And if the gingivitis is untreated first, there's mild to
martar at periodontitis. This is where your gums, maybe your
dentist has told you before, like your gums are sort
of pulling away from your teeth and that's where you
can have signs of early bone loss. But this is
(12:26):
where like getting quick dental care can be really really
helpful for preventing further gum damage.
Speaker 2 (12:33):
Right from there it goes to moderate to advance periodontitis.
This is the most advanced stage of gum disease. And
we're talking major bone loss at this point and tissue loss.
There may be receding gums around the teeth, heavy bleeding,
bad breath, teeth may loosen and need to be removed,
and that's what we just discussed previously. Just but that's
(12:54):
something we're trying to avoid. Is you losing your teeth?
Speaker 1 (12:57):
Yeah, and again this is where getting dental care can
turn that ship around, Like it's possible, I've seen it.
The key here is preventing the gum disease from starting
from the get go. Right, we know the number one
cause of gum disease is the buildup of plaque. And
why does that happen, Like if you're not cleaning your
(13:19):
teeth properly or your food, you're eating food that creates
more plaque. We know there's an association between certain health
conditions like having diabetes. For example, diabetes is a disease
that affects wound healing. So the diagnosis itself, if you
have gum disease and there's inflammation in your mouth, it's
(13:42):
going to take longer to heal, especially if your blood
sugars are high. It's going to make it harder for
that gum disease to heal, which is why controlling blood
sugars is actually one of the ways you can prevent
gum disease.
Speaker 2 (13:54):
Believe it or not, how would you define plug. It's
basically like the detritus left from food intake, right.
Speaker 3 (14:01):
Yeah, that's eventually hardened.
Speaker 1 (14:03):
Yeah, And what's important to note is like if generally
forms what's called a biofilm, a biofilm is exactly just
that it's a filmy layer made by bacteria, and that's
essentially bacteria gets under that biofilm and then it grows
and forms a home and that's what causes an inflammation
(14:25):
and then eventually it can even get infected. And really
this phenomenon, like you create a pocket of inflammation somewhere
and then it leads to damage. That's the same phenomenon
that's happening in your blood vessels and your heart valves.
So there's a connection between the inflammation that we have
(14:47):
in our mouth and the inflammation that is in other
parts of our bodies, which is why, like we're doing
this episode because there's a strong causal association that's happening.
We will see you right after this break.
Speaker 2 (15:08):
Now knowing what we know, like we'll get more into
the connection between dental health and heart health. But knowing
what we know that it is this thing that affects
other parts of the body that you might lose teeth.
Why wouldn't people go to see a dentist? Now I
explained why I didn't. It just wasn't part of the
culture of how I grew up. And you know, part
(15:31):
of it is definitely laziness too, But a big part
of that also happens to be like the disparities in
oral health that exist by sex, income level, race and ethnicity,
education level, and smoking status, and that's across all age groups.
As of twenty twenty four, approximately fifty seven million Americans
(15:52):
lived in a dental health professional shortage area, and about
sixty seven percent of those shortage areas are in rural community.
So class plays a big part in this, as well
as urban and rural centers, and we can ignore the
fact that some of it is just straight up access.
I do not have access to a dentist. I'm going
(16:13):
to have to go a great distance to get a dentist.
Like that's going to play into it, you know.
Speaker 1 (16:17):
According to the American Dental Association, only thirty percent of
millennials see a dentist regularly, and the reason is lack
of insurance as a area to dental care, which nowadays, though,
I'll be honest, even if you have insurance, it's not
great coverage.
Speaker 2 (16:35):
Yeah, what will It will cover a basic check up.
Speaker 1 (16:38):
Like basic cleanings twice a year if you have a
decent dental insurance, But if you have like a real
dental issue, it's going to cost you.
Speaker 2 (16:49):
You know. That's so wild to me that regular insurance
does not. So if you break your tooth, that's not
something that regular insurance will cover. Dental insurance for.
Speaker 1 (17:01):
That, uh yeah, and there's no guarantee that that dental
insurance will also cover that cover it.
Speaker 2 (17:07):
Yeah.
Speaker 1 (17:07):
I remember cases that I saw in residency where people
were getting coverage to get the tooth taken out, but
not to get a replacement tooth put back in. So
I'm not gonna have teeth, but I can't get it
a fake one put in, you know, And it just
it just boggled my mind because to me, this is
(17:29):
like a basic need.
Speaker 3 (17:30):
You know.
Speaker 1 (17:31):
It's like you get your teeth taken out, you want
a new one put in. That's like a normal thing
that shouldn't be a privilege. There's so many psychological forget about,
like just the mechanical aspect of being able to eat food,
but it's the psychological, the psychosocial aspect of it. You know,
we're humans, like we want to show our face and
you know, so, yeah, what.
Speaker 2 (17:51):
Will people think of me if I'm missing a tooth?
Who will they think I am? What kind of Do
they think I'm poor? Do they think I'm not sophisticated?
Do they think that they're better than me because I'm
missing this too? Like all that stuff factors into the
mental One other thing I.
Speaker 1 (18:07):
Want to say is that a lot of people don't realize,
but pregnant women are at risk of complications. First of all,
the hormones from pregnancy increase the risk of gum disease.
Speaker 3 (18:20):
Even if let's.
Speaker 1 (18:21):
Say, historically you have not had a history of gum disease.
Speaker 3 (18:26):
It's very common.
Speaker 1 (18:27):
Suddenly a person becomes pregnant because of the hormonal changes.
Now there's gum inflammation. And here's the thing. When it
comes to pregnancy, gum disease is linked to low birth
weight and pre term labor. So there's an incentive to
want to do extra cleanings if you're.
Speaker 2 (18:44):
Pregnant, just to hammer out a previous point. Periodontitis is
twice as common among adults ages thirty and over with
low income compared with adults who have higher income. So
the class element again is so clear.
Speaker 1 (19:02):
Yeah, yeah, Well we'll put the dental stuff aside, but
let's talk a little bit about what you can do
at home. Okay, right, because the goal here is to
remove plaque. If you remove plaq, then you reduce inflammation
in the gums and you reduce the progression to periodontitis.
So brushing and flossing at least twice a day. For
(19:25):
get this, at least two minutes. This is a long
time to brush for two minutes. And my dentist explains
me you do thirty seconds in each quadrant, which is eternal,
especially if you have a busy morning and you don't
have time. But like you really have to slow and
stop down and do at least two minutes twice a day,
(19:46):
and then flossing every day.
Speaker 2 (19:48):
I got to hammer this home with my kid because
it's certainly not thirty seconds in a quadrant. Like it's
not thirty seconds I mean. And the thing, I feel
like I have time because I'm like, well, these teeth
are going to followt any way, so he'll get a
second chance. But like, we got to hammer this in before.
Speaker 1 (20:05):
Does your son exhibit any reluctance to brush his teeth
or do you have to motivate him or do you
what sort of he's good about it.
Speaker 2 (20:13):
He's really good about it. Like you know, he's not
gonna sometimes he won't do it unless you tell him,
but he knows he has to do it. He knows
it's part of his routine, and he's good about his routine.
Speaker 1 (20:22):
See, I don't know if I'm I don't know what
this says about me.
Speaker 3 (20:26):
Maybe you can give me some feedback.
Speaker 1 (20:28):
But I have nephews and they are first of all adorable,
but they weren't super motivated to brush their teeth, and
so I showed them pictures of what happens when you
put teeth in coca cola for like extended periods of time,
and now they they basically brush their teeth twice a day,
(20:50):
like without fail, totally take them out. I don't know
if that was like extreme, but I basically was like
if you if you eat these foods and you don't
brush your teeth, like this is what's gonna happen to
your teeth. And it totally works. Now they brush their teeth.
They don't argue at all, Like it's over amazing.
Speaker 2 (21:09):
Most cental experts recommend that you floss before you brush,
because it will help dislodge any food in plaque from
between teeth and will allow fluoride from your toothpaste to
reach teeth surfaces better. Now, floss before you brush.
Speaker 1 (21:24):
I mean, let's I'll be honest. I forget to do this.
I do it after I brush.
Speaker 2 (21:29):
Well, I think most of us don't floss. I mean
that's the problem, Like the idea of before you brush.
You're like like I don't floss consistently. It's terrible. I'm like, ah,
this is so time consuming.
Speaker 1 (21:41):
Really, see, I find satisfaction out of like finding little
pieces of food come out.
Speaker 3 (21:48):
Like to me, it's like I'm winning at life.
Speaker 1 (21:51):
I'm telling you this is my relationship with my teeth
is like the world may be falling apart, but at
least I can do this.
Speaker 2 (22:00):
Parents have all their teeth, and it's like, Okay, genetics
is helping me because if I did not have good genetics,
God knows what would be happening right now.
Speaker 3 (22:07):
So do they brush twice a day and floss? Do
they do all these things?
Speaker 2 (22:11):
They brush towye today, I've never asked them if they
f lost. I don't know. You think you know a person,
but I really have. I don't know if I mean, especially.
Speaker 1 (22:22):
If they have all their teeth, then they don't have problems. Yeah,
I love to know what their their recipe is.
Speaker 2 (22:28):
Yeah, Like I mean, I do think there's a genetic component,
which is another reason why you don't know what your
genetics are with regards to teeth. Sometimes, so you better off,
like be safe and do the whole thing. Yeah, like
brush for the two minutes, make sure you floss, like
all of it. Yeah.
Speaker 1 (22:45):
Now when you brush and you floss again. The goal
is to remove as much plaque as you can that
coats your teeth, because, believe it or not, there's more
than seven hundred different microbes that make up the plaque
on your teeth. So I mean, it's like a whole
ecosystem in there, and you got to disrupt that.
Speaker 2 (23:03):
Now, this is a question that I have thought about
because as growing up in an Indian household, tongue scrapers
were a phenomenon, right, the idea that you have a
little like a little piece of metal and it scrapes
all the gunk off your tongue like after you brush,
and that's supposed to promote clean health, and it's supposed
to prevent bacteria from going inside your body. Tongue scraping
(23:27):
can freshen breath, enhance taste, and reduce bacteria. But be
gentle to not irritate the tongue or injured taste buds
or gag.
Speaker 3 (23:37):
You don't want to gag either if you go too
far back.
Speaker 2 (23:39):
Right exactly, and proceed with caution, because some early studies
have found that certain microbes that live on the back
portion of the tongue are beneficial to the heart and
circulatory health. So, yeah, clean your tongue, but not all
the way there.
Speaker 1 (23:57):
Yeah, And I would just say the most compelling evidence
for tongue scraping is for bad breath. Yeah, I don't
really do much of the scrape. I'm not a big
tongue scrap Do.
Speaker 2 (24:09):
You do tongue scrape with my toothbrush? But I don't know.
Speaker 3 (24:12):
Oh with your toothbrush? Oh, but that's so like, isn't
it so rough?
Speaker 2 (24:16):
It's a little rough. It's not the best feeling in
the world. But I do a little bit of that.
And like I probably, I don't know. My parents are
really pushing the tongue scrapers on me and my kid.
I love that, really want us to be using tongue scrapers.
Speaker 3 (24:31):
Here's the thing.
Speaker 1 (24:32):
You know, you can do all this stuff at home,
but sometimes the plaque still remains, and what happens is
that it gets really hard and it turns into tartar,
and dental tartar.
Speaker 3 (24:45):
You can't remove it at home.
Speaker 1 (24:47):
This is where your dental cleaning really comes in. When
I go see the dentist, they always show me like
before and after photos of for the cleaning, after the cleaning,
sort of like proof of concept work, like see I
did help you kind of stuff, which in the beginning,
(25:08):
when I first started going to them, the before pictures weren't.
Speaker 3 (25:12):
Really embarrassing, like can we put this away?
Speaker 1 (25:17):
But fortunately, with regular cleaning, I've like I've made a
lot of progress. Let me just put it that way.
The recommendation is to get dental cleaning twice year. But
if you developed tarder, that's what gets the bacteria to
really get beneath your gum line, and that's when it's
(25:37):
going to cause problems like inflammation and then eventually infection.
Because once you have inflammation in your gums, if it
gets into your blood stream, now it could potentially affect
your blood vessels and your heart.
Speaker 2 (25:52):
And just like with anything, really early detection is best
consistent effort to stop the progression of gums disease. Like
you want to be on top of it, Yeah, says
man who goes to dentists maybe once yearly.
Speaker 1 (26:05):
I mean, do you think after researching for this episode
you might change.
Speaker 2 (26:10):
Your habits terrifying this look. I don't want to scare
the listeners, but there are certainly things while we're doing
the research that worried me as somebody who has a
history of heart issues in their family. Immediately I started
to think, oh, this is going to be something I
need to be more mindful of, because if I already
have heart issues in my family, I am already dealing
(26:33):
with the genetic part of it. I better be on
top of making sure like the oral health part doesn't
add more trouble. Yeah, exactly.
Speaker 3 (26:41):
Let's eliminate the things that are in your.
Speaker 2 (26:43):
Control kind of thing, right, Yes, that's right.
Speaker 1 (26:45):
I think in order to really appreciate like the impact
of gum disease on heart disease, let's first break down
heart disease after sclerotic cardiovascular disease.
Speaker 3 (26:55):
Aka the hardening of your arteries.
Speaker 1 (26:58):
So plaque builds up in the walls of your arteries,
and it's this plaque build up that then can eventually
cause your heart attacks and your strokes.
Speaker 2 (27:07):
It's a different type of plaque than the plaque on
your teeth.
Speaker 1 (27:10):
Well, yes and no. Yes, yes, it is different fundamentally.
But what I think is really crazy is that when
they looked at the bacteria in people's mouths, specifically it
was specific strands of strep. That they then looked at
the bacteria on plaques in people's hearts and they found
(27:33):
the same kind of strap.
Speaker 2 (27:34):
Uh. That's not fun to hear.
Speaker 1 (27:37):
Yeah, So if the bacteria in your mouth is what's
also in your arteries. There seems to be some sort
of significant association, and I think the fact that it
is the strep species of bacteria is significant. I think
that bacterial species matters because when you have exposure to
(27:58):
this specific type of strap Streptococcus, it actually activates platelets,
which are blood clotting factors, which then creates the development
of a blood clot which then turns into a plaque.
So when your artery is hardened, it basically reduces blood
(28:19):
flow and now you're at a risk of heart attacker strokes.
Speaker 2 (28:22):
Right, genetics obviously is a part of this high blood pressure,
bad cholesterol, that's LDL if you've ever seen that on
your health reports, LDL cholesterol, chronic health conditions like diabetes,
the amount of exercise you have, whether you're smoking. People
with one or more cardiovascular disease risk factors may benefit
(28:44):
from regular dental screenings and targeted periodontal care to address
chronic inflammation. If you're already dealing with this all these
other factors, why add another one with something you could prevent?
Speaker 3 (28:55):
Yeah, one hundred.
Speaker 1 (29:00):
After this break, what exactly is the link between gum
disease and heart disease. Well, we know, based off of
the established data that people who have gum disease they
also tend to have higher levels of cholesterol and triglycerides
(29:21):
than people with healthy gums. They've also found that people
with gum disease are significantly more likely to have a
heart attack, and those with severe gum disease have double
the risk of developing coronary artery disease.
Speaker 2 (29:39):
That correlation, I think is a little scary and again
is a reminder of why you have to take care
of your teeth and also another reason why it's absurd
that health insurance doesn't cover dentistry.
Speaker 1 (29:53):
Yeah, it certainly makes a case for it. Here's an
interesting study that I came across. They took people who
have high blood pressure, which we know is a risk
factor for heart disease, and they found that those who
would get their teeth cleaned more often had about a
ten point reduction in their blood pressure numbers compared to
(30:16):
those that weren't getting their teeth cleaned regularly. Wow. Yeah,
And there's also this other study I came across, like
a few looking at heart arrhythmias like atrial fibrillation, which
is a risk factor for stroke. They found that people
that brush their teeth three times a day have a
lower risk of atrial fibrillation than those that brush their
(30:37):
teeth once or twice a day.
Speaker 2 (30:39):
I mean, people with periandentitis have twice the risk of
a stroke compared to those without gum disease.
Speaker 1 (30:46):
And the goal here is not to for the listeners,
Like if you're listening and you're freaking out, the goal
here is not to scare you with this data. Remember,
severe gum disease takes time to develop and there are
interventions that can prevent it from developing. Like we know,
severe gum disease is linked to overall higher risk of
(31:07):
death because of the chronic inflammation that's in the mouth
therefore in the body. It's putting strain on the whole system.
But again we're sharing this information with the hopes that
you'll understand that dental cleaning, keeping your teeth clean, having
good oral hygiene is something very much that is in
one's control to prevent the progression of advanced gum disease.
(31:32):
If there's any healthcare providers listening, it's just a reminder,
right if you see a patient in your clinic and
they have heart disease, they have high blood pressure, they
have evidence of inflammation.
Speaker 3 (31:46):
Don't forget to ask them about their teeth.
Speaker 1 (31:49):
Ask them, you know, are they getting their teeth cleaned
regularly or if they're having access issues to a dentist.
Just remind them to brush their teeth at least twice
a day for two minutes, because that is a very
cost effective way of lowering someone's cardiovascular risk.
Speaker 2 (32:08):
What is inflammation exactly, It's just your body is reacting
to bacteria or a foreign body like what exactly.
Speaker 1 (32:19):
In medical school we learn about the four classic signs
of inflammation and it comes from these Latin words rubor
two more, color and dolar. So rubor is redness, tumor
is like a tumor, swelling, color is heat so temperature,
(32:40):
and dolar is pain. And those are the qualities that
make up inflammation. So on a cellular level, what's happening
is inflammatory activity means there's some type of swelling or
redness or painful activity have being on a cellular level.
(33:01):
So in heart disease, right, the formation of a plaque, right,
how does a platform there's some sort of break in
the vessel. Then platelets go to that break and they're
trying to fix it, and they're trying to heal it,
and in the process they're creating a lot of inflammation
and swelling and redness, and then eventually it forms a plaque,
(33:22):
which really is your body's way of trying to treat
that inflammation. And so when this is happening on like
a massive scale, you know, then we're talking like total
body inflammation. And this can happen from injury or infection,
and it's basically your body's response to this. Your body's
trying to heal it in its own way, but unfortunately,
(33:45):
over time it leads to tissue changes or the formation
of new blood vessels. I mean, cancer is a process
that's rooted in inflammation, and so heart disease is similarly
a process like that, and gum disease too.
Speaker 2 (34:02):
Now, in order to manage inflammation, there's a few things
that can be done. Follow a healthy diet, brush and
floss every day, aim for at least one hundred and
fifty minutes of moderate intensity exercise per week, Drink less alcohol,
quit smoking, get a good night's sleep. So a lot
(34:22):
of the things that you would want to do for
a healthy, healthy living generally speaking, anyway, is the same
thing that's going to help with inflammation generally.
Speaker 1 (34:31):
Yeah, and I would also add keep your stress levels
as low as possible because that can also raise inflammation.
So bottom line here for today's episode is number one,
there is a link between gum disease, periodontal disease, and
(34:51):
chronic inflammation in the body, which is then associated with
cardiovascular disease. The exact cause and effect is not solidly
established in the literature, but we've discussed some underlying theories
around why that could be happening. And I just want
to say that there's so many different types of treatments
(35:13):
that exist out there for gum disease, but remember the
best treatment is really prevention.
Speaker 2 (35:20):
You know, follow the two to two two rule to
maintain good oral health. Brush twice a day for two minutes,
and visit your dentist twice a year unless.
Speaker 3 (35:30):
You're neurotic, like man, you go three times?
Speaker 2 (35:32):
Do you go three times a year? I like it,
I need it. I need it.
Speaker 3 (35:39):
It's like the only thing that makes me feel okay
in the current situation we're in.
Speaker 1 (35:45):
So now that we've gone over this, what do you think,
do you think you'll change anything.
Speaker 2 (35:51):
Uh, I'll probably change something for the week, and hopefully
that will carry over to the next week and so forth.
I feel like whenever I get this new information, immediately
A'm like, like yesterday when I was reading this stuff,
I'm like, I'm gonna brush my teeth again. I feel
like brushing my teeth right now. So it's really just
trying to be consistent with it, or as consistent as
(36:12):
you can, just because you know, especially if you're someone
like me that worries about heart health pretty consistently, I
don't want to make it even more, make myself even
more vulnerable with something that is preventable.
Speaker 1 (36:25):
Yeah, to me, this seems like the analogy is low
bearing fruit that you can pick to kind of optimize things.
One thing, you know, for me, when my dentist first
told me you have to brush for at least two minutes,
I remember being like, what, that's crazy.
Speaker 3 (36:41):
That's so long.
Speaker 1 (36:41):
I don't do that, And so I actually bought a
sand dial. I bought a two minutes sand dial, and
I would flip it and then when the sand would
get all the way down, I'd be like, Okay, now
you've done your too much.
Speaker 2 (36:54):
You actually do two minutes.
Speaker 1 (36:56):
Oh, I definitely do two minutes now. And I'll tell
you I noticed a dramatic improvement in just the development
of plaque and tartar. There was like less tartar the
next time I showed up. So the two minute thing
definitely it works for sure.
Speaker 2 (37:14):
Amazing, amazing. Yeah, please like and subscribe you know wherever
you listen to your podcast. We would love the support
to keep this thing alive. So we appreciate it.
Speaker 1 (37:24):
And if you don't like the podcast, send it to
all your enemies and have.
Speaker 2 (37:27):
Them like it. Tell exactly.
Speaker 1 (37:35):
Health Stuff is a production of iHeart Podcasts. The show
is hosted by me, doctor preancle Wally, and Harrikondebolu. Producers
are Rebecca Eisenberg, Jenna Cagel, Christina Loranger, Maya Howard, and
Katrina Norvel. Our researcher is Maria Tremarki and our intern
is Katya sobel Leayala. To send us a question, you
(37:56):
can email us a voice memo at health Stuff Podcasts
at gmail. Thanks so much for listening.
This podcast is for information purposes only and should not
be considered professional medical advice. The American College of Prostadontis
estimates that one hundred and seventy three million Americans are
missing one too.
Speaker 2 (00:17):
Whoa you go three times a year?
Speaker 3 (00:20):
I like it, I need it.
Speaker 1 (00:25):
I showed them pictures of what happens when you put
teeth in coca cola for like extended periods of time,
and now they brush their teeth twice a day, like
without fail.
Speaker 2 (00:36):
Them out, totally freake them out. I'm hurrycandbolu, I'm doctor
pre uncle Wally, and this is health stuff.
Speaker 3 (00:49):
Well hello there.
Speaker 2 (00:50):
Oh hello, how are you?
Speaker 3 (00:52):
I'm good.
Speaker 2 (00:53):
I'm good.
Speaker 3 (00:54):
Yeah, how are you?
Speaker 2 (00:56):
I'm fine. I started taking statns.
Speaker 3 (00:59):
Oh interesting, like this week.
Speaker 2 (01:02):
No, a few months ago. I've been having some This
is obviously an overshare, but this is what I do
in the beginning of all our episodes. So it's that's
why we're here. That's why we're here to get me
some free healthcare. But yeah, I started taking My cholesterol
has been high, and my good cholesterol has not been
high enough. So okay, I started taking statins maybe three
(01:24):
four months ago. So my heart I think is doing okay,
though I've noticed an increase of nose bleeds since you've
started the statin. Yes, because I went from never having
no like I've had, never had a nosebleed before, yeah,
other than like my butt my nose into something and
it caused it, but never randomly, to having random nose
bleeds every like a few weeks. So it's a little strange.
Speaker 1 (01:46):
You know. That's interesting because I obviously know a lot
about statins and their side effects, and nose bleeds is
not one of the side effects that I really heard about.
Speaker 3 (01:57):
Yeah, if it is, it's certainly not the top.
Speaker 1 (02:01):
Kind of side effects. Usually people complain about muscles, like
their muscles are aching, So that's new for me.
Speaker 2 (02:09):
Why do noses bleed? What is the reason for that, like,
other than like some kind of trauma to the nose,
like what else, anything that.
Speaker 1 (02:16):
Sort of disrupts the blood vessels. So, Like, even dry
climates can lead to nose bleeds. Obviously, if you get traumatizer,
you blow it really hard. A lot of it has
to do with just the temperature. I don't know, though,
you never had newsbleeds before. Now you're on a statin.
Now you have nosebleeds. That's a new one for me,
if I can be really honest, like it's certainly not
(02:39):
traditionally associated with causing nose bleeds. I would almost say that,
if anything, a statin could protect you from a nosebleed
because it's doing beneficial things.
Speaker 3 (02:52):
To like your blood vessels.
Speaker 1 (02:53):
Yea, So I'm a little stumped about huh.
Speaker 3 (02:59):
Yeah.
Speaker 1 (03:00):
I'll get nose bleeds from time to time, mostly like
if it's dry weather and stuff, and I hate that
feeling when when the blood drips behind your throat and
then you're tasting.
Speaker 2 (03:11):
Yeah, then I feel like it's one for me. But yeah,
going on like yeah, that's probably the weather. Then I
think it's probably the weather.
Speaker 1 (03:20):
Maybe maybe now if you were like, oh, my muscles ache,
I'd be like, yeah, that's a statin thing.
Speaker 2 (03:27):
Yeah, but I mean that then they would just bleed
into my muscles that already ached before. Just it's just
the same.
Speaker 1 (03:38):
You know. And today we're not talking about status at all,
but we are talking about our overall health and like
our heart health, but specifically through our mouths. We've talked
over different episodes like going to the dentists. I'm curious
how how often do you go to the dentists?
Speaker 2 (03:58):
You know, it's funny, but that feels like such a
personal question, and I'm so I'm good with sharing so much,
but that all of a sudden fills me with so
much guilt and dread. Really not often enough, not see
not yearly, which is really bad.
Speaker 3 (04:16):
Oh interesting, I go.
Speaker 1 (04:20):
Two to three times a year. I think for me,
it's something I can control. And you know, as someone
who has control issues and is constantly thinking about my health,
going to the dentist is one of the few things
in life that I feel like I can do, and
(04:40):
it just gives me this sense of like I'm doing
everything that I possibly can. I don't mind going to
the dentist. And recently I just switched dentists. I used
to hate.
Speaker 3 (04:51):
You know how when they clean your teeth it's so
damn loud.
Speaker 1 (04:55):
Yes, that it's so loud, and that the noise is
what actually really activates me and makes me feel like
very kind of shaky. It's not the cleaning itself, it's
how loud it is. But this new dentist actually offers
me ear plugs. Oh, and I was like, you're a keeper.
That's it's staying with you.
Speaker 2 (05:15):
So dentistry always felt like a strange, it felt optional
because I think my parents didn't grow up going to
dentists regularly. You know, we're talking about you know, small
town India in the nineteen fifties, you know, sixties, and
so they didn't like instill that in us growing up
(05:35):
that we had to go to the dentist. They didn't
take us every year, like it wasn't a thing. We
would go periodically, whatever the period is. And so, you know,
I think growing up by you know, I should have
I should have definitely compensated by going regularly, especially if
you're lucky enough to have dental insurance. Sure, like getting
those checkups are incredibly important, but I just I never,
(05:58):
you know, I think this this episode actually you know,
we'll get into it, but like it scares me into
going to the dentist more because when I think about
the dentist, I think it almost as a oh, it's
an extra thing optional. If I gotta do it, I
gotta do it. But like my teeth, it's almost like
the teeth and your oral health feel like a separate
(06:20):
entity from rest of your health. And as we're going
to talk about in this episode, that is not the case.
Speaker 3 (06:25):
Yeah.
Speaker 1 (06:27):
Yeah, and you know, I can actually really relate. I
didn't grow.
Speaker 3 (06:30):
Up going to the dentist often.
Speaker 1 (06:33):
Yeah, I think that was something I adopted much later
in life as an adult. Again, back to getting closer
to mortality control issues. To me, it was like, okay,
what are the things that you can do? So that's
I started doing it as an adult and now I
embrace it.
Speaker 2 (06:51):
I really it's great, which is fantastic.
Speaker 3 (06:53):
I'm like a big fan.
Speaker 1 (06:54):
And obviously my dentist loves me because I keep them
in business.
Speaker 3 (06:58):
Like dental insurance doesn't cover much past even like their
routine cleaning.
Speaker 2 (07:04):
So there said, but you know, the dentist things you
should get deep cleaning. And then I'm like, okay, does
the insurance cover it. They're like, no, it is several
thousand dollars. Yeah, It's like, what this is so necessary?
Why isn't it covered?
Speaker 1 (07:19):
Yeah, you know my dental insurance right now, they're basically like,
we're going to give you a couple hundred dollars for
the year and.
Speaker 3 (07:28):
That's all you get. If you got to make it work,
you can't. You don't get any care. It's like damn, Okay,
the pressure's on.
Speaker 2 (07:37):
See that's another reason why I think I didn't go
to the dentist as much. It wasn't even treated like
part of your health. It was. It was just the
fact that it's not covered, the fact that it's it's
seen as a separate entity, you know what I mean.
It's not seen as a part of the bigger picture.
Speaker 1 (07:54):
Right, like pap smears, prostate cancer screening, you know, blood
pressure checks, that's all covered, right, Cleaning your teeth, making
sure your teeth are clean not the most essential thing,
which is crazy because we're we now know there's so
much strong data showing that gum disease, yeah, increases your
(08:18):
risk of certain diseases, and specifically today.
Speaker 3 (08:21):
We're going to talk about heart disease.
Speaker 1 (08:23):
Yes, so let's talk about him.
Speaker 2 (08:26):
We know that brushing and flossing is important for dental
and oral health, but it's more than just about preventing cavities.
The health of our mouths are closely tied to our
overall health. Taking care of your teeth and gums is
important for a bunch of reasons. Oral health problems like
gum disease have been shown to increase your risk of
certain diseases and specifically cardiovascular disease. So let's get into it.
Speaker 3 (08:49):
Yeah, I mean, so this is wild, and I think it.
Speaker 1 (08:52):
First of all, what people need to understand is that
gum disease it's an it's an inflammation problem, and it's chronic.
And actually having gum disease is the leading cause of
tooth loss, which affects, by the way, nearly half of
Americans over the age of thirty.
Speaker 2 (09:14):
That's wild.
Speaker 1 (09:15):
That's a lot of people with missing teeth. It's actually
really common. You know. The American College of Prostadontis estimates
that one hundred and seventy three million Americans are missing
one teeth.
Speaker 2 (09:28):
Yeah. Literally, So if you're out there missing teeth, thinking
how am I going to find the one, just remember
there's one hundred and seventy three million other Americans also
missing teeth.
Speaker 1 (09:38):
Yeah, and more than forty million people are get this,
missing all of their teeth.
Speaker 2 (09:44):
Wow, And I'd imagine that's the older population generally, right,
Maybe not.
Speaker 1 (09:49):
Well, it's interesting because what we know is that tooth
loss is associated with a shorter life span. So like
people who have all or majority of their teeth by
age seventy, they live longer than those that have fewer
than twenty of their natural teeth left.
Speaker 2 (10:07):
What is that? What is the correlation?
Speaker 1 (10:09):
Do you think, Well, if you have fewer teeth, you're
less likely to be able to eat food normally, You're
more likely to have structural changes in your jaw. You're
more likely to then develop other infections. You know, it's
going to affect your ability to intake nutrition, which is
(10:29):
then going to affect your life later on. We know
as people age, getting enough protein is quite a challenge
because you waste muscle.
Speaker 3 (10:39):
Your muscle starts wasting. It's called sarcopenia.
Speaker 1 (10:42):
So you need to be able to have like a
good strong jaw with a nice set of teeth to
be able to eat your food, get your protein. You know,
keep yourself alive essentially, I mean teeth keep us alive.
It's one of the mark of being human. So it
would make sense that if you have fewer teeth, it's
gonna be harder.
Speaker 2 (11:02):
Right now, we've got three main types of gum disease, right,
the first being gingivitis, which I'm sure we've all heard
from the commercials, right.
Speaker 1 (11:10):
I love those commercials man ginger vitis. Yeah, and just
like the way they show the toothbrush and the SuDS,
the toothpaste SuDS, and it's like going away.
Speaker 3 (11:20):
If only if it was like that in real life, exactly.
Speaker 2 (11:23):
If it was, I'd served ford. I mean. Gingivitis is
the mildest form of periodontal disease. It's characterized by red,
swollen gums that may bleed easily during brushing and flossing,
often due to plaque build up. It's reversible with good
hygiene and routine dental cleanings. So there's there's a positive
in that it can go away.
Speaker 1 (11:43):
Yeah, very common. But the thing is then if you
don't treat the gingervitis, it then progresses to something called
periodone titis. So if you break down that word periodon titis,
itis is inflammation Perry means around Odontos is the Greek
word for teeth, So this is inflammation of the structures
(12:04):
around the teeth, like your gums and your connective tissue.
And if the gingivitis is untreated first, there's mild to
martar at periodontitis. This is where your gums, maybe your
dentist has told you before, like your gums are sort
of pulling away from your teeth and that's where you
can have signs of early bone loss. But this is
(12:26):
where like getting quick dental care can be really really
helpful for preventing further gum damage.
Speaker 2 (12:33):
Right from there it goes to moderate to advance periodontitis.
This is the most advanced stage of gum disease. And
we're talking major bone loss at this point and tissue loss.
There may be receding gums around the teeth, heavy bleeding,
bad breath, teeth may loosen and need to be removed,
and that's what we just discussed previously. Just but that's
(12:54):
something we're trying to avoid. Is you losing your teeth?
Speaker 1 (12:57):
Yeah, and again this is where getting dental care can
turn that ship around, Like it's possible, I've seen it.
The key here is preventing the gum disease from starting
from the get go. Right, we know the number one
cause of gum disease is the buildup of plaque. And
why does that happen, Like if you're not cleaning your
(13:19):
teeth properly or your food, you're eating food that creates
more plaque. We know there's an association between certain health
conditions like having diabetes. For example, diabetes is a disease
that affects wound healing. So the diagnosis itself, if you
have gum disease and there's inflammation in your mouth, it's
(13:42):
going to take longer to heal, especially if your blood
sugars are high. It's going to make it harder for
that gum disease to heal, which is why controlling blood
sugars is actually one of the ways you can prevent
gum disease.
Speaker 2 (13:54):
Believe it or not, how would you define plug. It's
basically like the detritus left from food intake, right.
Speaker 3 (14:01):
Yeah, that's eventually hardened.
Speaker 1 (14:03):
Yeah, And what's important to note is like if generally
forms what's called a biofilm, a biofilm is exactly just
that it's a filmy layer made by bacteria, and that's
essentially bacteria gets under that biofilm and then it grows
and forms a home and that's what causes an inflammation
(14:25):
and then eventually it can even get infected. And really
this phenomenon, like you create a pocket of inflammation somewhere
and then it leads to damage. That's the same phenomenon
that's happening in your blood vessels and your heart valves.
So there's a connection between the inflammation that we have
(14:47):
in our mouth and the inflammation that is in other
parts of our bodies, which is why, like we're doing
this episode because there's a strong causal association that's happening.
We will see you right after this break.
Speaker 2 (15:08):
Now knowing what we know, like we'll get more into
the connection between dental health and heart health. But knowing
what we know that it is this thing that affects
other parts of the body that you might lose teeth.
Why wouldn't people go to see a dentist? Now I
explained why I didn't. It just wasn't part of the
culture of how I grew up. And you know, part
(15:31):
of it is definitely laziness too, But a big part
of that also happens to be like the disparities in
oral health that exist by sex, income level, race and ethnicity,
education level, and smoking status, and that's across all age groups.
As of twenty twenty four, approximately fifty seven million Americans
(15:52):
lived in a dental health professional shortage area, and about
sixty seven percent of those shortage areas are in rural community.
So class plays a big part in this, as well
as urban and rural centers, and we can ignore the
fact that some of it is just straight up access.
I do not have access to a dentist. I'm going
(16:13):
to have to go a great distance to get a dentist.
Like that's going to play into it, you know.
Speaker 1 (16:17):
According to the American Dental Association, only thirty percent of
millennials see a dentist regularly, and the reason is lack
of insurance as a area to dental care, which nowadays, though,
I'll be honest, even if you have insurance, it's not
great coverage.
Speaker 2 (16:35):
Yeah, what will It will cover a basic check up.
Speaker 1 (16:38):
Like basic cleanings twice a year if you have a
decent dental insurance, But if you have like a real
dental issue, it's going to cost you.
Speaker 2 (16:49):
You know. That's so wild to me that regular insurance
does not. So if you break your tooth, that's not
something that regular insurance will cover. Dental insurance for.
Speaker 1 (17:01):
That, uh yeah, and there's no guarantee that that dental
insurance will also cover that cover it.
Speaker 2 (17:07):
Yeah.
Speaker 1 (17:07):
I remember cases that I saw in residency where people
were getting coverage to get the tooth taken out, but
not to get a replacement tooth put back in. So
I'm not gonna have teeth, but I can't get it
a fake one put in, you know, And it just
it just boggled my mind because to me, this is
(17:29):
like a basic need.
Speaker 3 (17:30):
You know.
Speaker 1 (17:31):
It's like you get your teeth taken out, you want
a new one put in. That's like a normal thing
that shouldn't be a privilege. There's so many psychological forget about,
like just the mechanical aspect of being able to eat food,
but it's the psychological, the psychosocial aspect of it. You know,
we're humans, like we want to show our face and
you know, so, yeah, what.
Speaker 2 (17:51):
Will people think of me if I'm missing a tooth?
Who will they think I am? What kind of Do
they think I'm poor? Do they think I'm not sophisticated?
Do they think that they're better than me because I'm
missing this too? Like all that stuff factors into the
mental One other thing I.
Speaker 1 (18:07):
Want to say is that a lot of people don't realize,
but pregnant women are at risk of complications. First of all,
the hormones from pregnancy increase the risk of gum disease.
Speaker 3 (18:20):
Even if let's.
Speaker 1 (18:21):
Say, historically you have not had a history of gum disease.
Speaker 3 (18:26):
It's very common.
Speaker 1 (18:27):
Suddenly a person becomes pregnant because of the hormonal changes.
Now there's gum inflammation. And here's the thing. When it
comes to pregnancy, gum disease is linked to low birth
weight and pre term labor. So there's an incentive to
want to do extra cleanings if you're.
Speaker 2 (18:44):
Pregnant, just to hammer out a previous point. Periodontitis is
twice as common among adults ages thirty and over with
low income compared with adults who have higher income. So
the class element again is so clear.
Speaker 1 (19:02):
Yeah, yeah, Well we'll put the dental stuff aside, but
let's talk a little bit about what you can do
at home. Okay, right, because the goal here is to
remove plaque. If you remove plaq, then you reduce inflammation
in the gums and you reduce the progression to periodontitis.
So brushing and flossing at least twice a day. For
(19:25):
get this, at least two minutes. This is a long
time to brush for two minutes. And my dentist explains
me you do thirty seconds in each quadrant, which is eternal,
especially if you have a busy morning and you don't
have time. But like you really have to slow and
stop down and do at least two minutes twice a day,
(19:46):
and then flossing every day.
Speaker 2 (19:48):
I got to hammer this home with my kid because
it's certainly not thirty seconds in a quadrant. Like it's
not thirty seconds I mean. And the thing, I feel
like I have time because I'm like, well, these teeth
are going to followt any way, so he'll get a
second chance. But like, we got to hammer this in before.
Speaker 1 (20:05):
Does your son exhibit any reluctance to brush his teeth
or do you have to motivate him or do you
what sort of he's good about it.
Speaker 2 (20:13):
He's really good about it. Like you know, he's not
gonna sometimes he won't do it unless you tell him,
but he knows he has to do it. He knows
it's part of his routine, and he's good about his routine.
Speaker 1 (20:22):
See, I don't know if I'm I don't know what
this says about me.
Speaker 3 (20:26):
Maybe you can give me some feedback.
Speaker 1 (20:28):
But I have nephews and they are first of all adorable,
but they weren't super motivated to brush their teeth, and
so I showed them pictures of what happens when you
put teeth in coca cola for like extended periods of time,
and now they they basically brush their teeth twice a day,
(20:50):
like without fail, totally take them out. I don't know
if that was like extreme, but I basically was like
if you if you eat these foods and you don't
brush your teeth, like this is what's gonna happen to
your teeth. And it totally works. Now they brush their teeth.
They don't argue at all, Like it's over amazing.
Speaker 2 (21:09):
Most cental experts recommend that you floss before you brush,
because it will help dislodge any food in plaque from
between teeth and will allow fluoride from your toothpaste to
reach teeth surfaces better. Now, floss before you brush.
Speaker 1 (21:24):
I mean, let's I'll be honest. I forget to do this.
I do it after I brush.
Speaker 2 (21:29):
Well, I think most of us don't floss. I mean
that's the problem, Like the idea of before you brush.
You're like like I don't floss consistently. It's terrible. I'm like, ah,
this is so time consuming.
Speaker 1 (21:41):
Really, see, I find satisfaction out of like finding little
pieces of food come out.
Speaker 3 (21:48):
Like to me, it's like I'm winning at life.
Speaker 1 (21:51):
I'm telling you this is my relationship with my teeth
is like the world may be falling apart, but at
least I can do this.
Speaker 2 (22:00):
Parents have all their teeth, and it's like, Okay, genetics
is helping me because if I did not have good genetics,
God knows what would be happening right now.
Speaker 3 (22:07):
So do they brush twice a day and floss? Do
they do all these things?
Speaker 2 (22:11):
They brush towye today, I've never asked them if they
f lost. I don't know. You think you know a person,
but I really have. I don't know if I mean, especially.
Speaker 1 (22:22):
If they have all their teeth, then they don't have problems. Yeah,
I love to know what their their recipe is.
Speaker 2 (22:28):
Yeah, Like I mean, I do think there's a genetic component,
which is another reason why you don't know what your
genetics are with regards to teeth. Sometimes, so you better off,
like be safe and do the whole thing. Yeah, like
brush for the two minutes, make sure you floss, like
all of it. Yeah.
Speaker 1 (22:45):
Now when you brush and you floss again. The goal
is to remove as much plaque as you can that
coats your teeth, because, believe it or not, there's more
than seven hundred different microbes that make up the plaque
on your teeth. So I mean, it's like a whole
ecosystem in there, and you got to disrupt that.
Speaker 2 (23:03):
Now, this is a question that I have thought about
because as growing up in an Indian household, tongue scrapers
were a phenomenon, right, the idea that you have a
little like a little piece of metal and it scrapes
all the gunk off your tongue like after you brush,
and that's supposed to promote clean health, and it's supposed
to prevent bacteria from going inside your body. Tongue scraping
(23:27):
can freshen breath, enhance taste, and reduce bacteria. But be
gentle to not irritate the tongue or injured taste buds
or gag.
Speaker 3 (23:37):
You don't want to gag either if you go too
far back.
Speaker 2 (23:39):
Right exactly, and proceed with caution, because some early studies
have found that certain microbes that live on the back
portion of the tongue are beneficial to the heart and
circulatory health. So, yeah, clean your tongue, but not all
the way there.
Speaker 1 (23:57):
Yeah, And I would just say the most compelling evidence
for tongue scraping is for bad breath. Yeah, I don't
really do much of the scrape. I'm not a big
tongue scrap Do.
Speaker 2 (24:09):
You do tongue scrape with my toothbrush? But I don't know.
Speaker 3 (24:12):
Oh with your toothbrush? Oh, but that's so like, isn't
it so rough?
Speaker 2 (24:16):
It's a little rough. It's not the best feeling in
the world. But I do a little bit of that.
And like I probably, I don't know. My parents are
really pushing the tongue scrapers on me and my kid.
I love that, really want us to be using tongue scrapers.
Speaker 3 (24:31):
Here's the thing.
Speaker 1 (24:32):
You know, you can do all this stuff at home,
but sometimes the plaque still remains, and what happens is
that it gets really hard and it turns into tartar,
and dental tartar.
Speaker 3 (24:45):
You can't remove it at home.
Speaker 1 (24:47):
This is where your dental cleaning really comes in. When
I go see the dentist, they always show me like
before and after photos of for the cleaning, after the cleaning,
sort of like proof of concept work, like see I
did help you kind of stuff, which in the beginning,
(25:08):
when I first started going to them, the before pictures weren't.
Speaker 3 (25:12):
Really embarrassing, like can we put this away?
Speaker 1 (25:17):
But fortunately, with regular cleaning, I've like I've made a
lot of progress. Let me just put it that way.
The recommendation is to get dental cleaning twice year. But
if you developed tarder, that's what gets the bacteria to
really get beneath your gum line, and that's when it's
(25:37):
going to cause problems like inflammation and then eventually infection.
Because once you have inflammation in your gums, if it
gets into your blood stream, now it could potentially affect
your blood vessels and your heart.
Speaker 2 (25:52):
And just like with anything, really early detection is best
consistent effort to stop the progression of gums disease. Like
you want to be on top of it, Yeah, says
man who goes to dentists maybe once yearly.
Speaker 1 (26:05):
I mean, do you think after researching for this episode
you might change.
Speaker 2 (26:10):
Your habits terrifying this look. I don't want to scare
the listeners, but there are certainly things while we're doing
the research that worried me as somebody who has a
history of heart issues in their family. Immediately I started
to think, oh, this is going to be something I
need to be more mindful of, because if I already
have heart issues in my family, I am already dealing
(26:33):
with the genetic part of it. I better be on
top of making sure like the oral health part doesn't
add more trouble. Yeah, exactly.
Speaker 3 (26:41):
Let's eliminate the things that are in your.
Speaker 2 (26:43):
Control kind of thing, right, Yes, that's right.
Speaker 1 (26:45):
I think in order to really appreciate like the impact
of gum disease on heart disease, let's first break down
heart disease after sclerotic cardiovascular disease.
Speaker 3 (26:55):
Aka the hardening of your arteries.
Speaker 1 (26:58):
So plaque builds up in the walls of your arteries,
and it's this plaque build up that then can eventually
cause your heart attacks and your strokes.
Speaker 2 (27:07):
It's a different type of plaque than the plaque on
your teeth.
Speaker 1 (27:10):
Well, yes and no. Yes, yes, it is different fundamentally.
But what I think is really crazy is that when
they looked at the bacteria in people's mouths, specifically it
was specific strands of strep. That they then looked at
the bacteria on plaques in people's hearts and they found
(27:33):
the same kind of strap.
Speaker 2 (27:34):
Uh. That's not fun to hear.
Speaker 1 (27:37):
Yeah, So if the bacteria in your mouth is what's
also in your arteries. There seems to be some sort
of significant association, and I think the fact that it
is the strep species of bacteria is significant. I think
that bacterial species matters because when you have exposure to
(27:58):
this specific type of strap Streptococcus, it actually activates platelets,
which are blood clotting factors, which then creates the development
of a blood clot which then turns into a plaque.
So when your artery is hardened, it basically reduces blood
(28:19):
flow and now you're at a risk of heart attacker strokes.
Speaker 2 (28:22):
Right, genetics obviously is a part of this high blood pressure,
bad cholesterol, that's LDL if you've ever seen that on
your health reports, LDL cholesterol, chronic health conditions like diabetes,
the amount of exercise you have, whether you're smoking. People
with one or more cardiovascular disease risk factors may benefit
(28:44):
from regular dental screenings and targeted periodontal care to address
chronic inflammation. If you're already dealing with this all these
other factors, why add another one with something you could prevent?
Speaker 3 (28:55):
Yeah, one hundred.
Speaker 1 (29:00):
After this break, what exactly is the link between gum
disease and heart disease. Well, we know, based off of
the established data that people who have gum disease they
also tend to have higher levels of cholesterol and triglycerides
(29:21):
than people with healthy gums. They've also found that people
with gum disease are significantly more likely to have a
heart attack, and those with severe gum disease have double
the risk of developing coronary artery disease.
Speaker 2 (29:39):
That correlation, I think is a little scary and again
is a reminder of why you have to take care
of your teeth and also another reason why it's absurd
that health insurance doesn't cover dentistry.
Speaker 1 (29:53):
Yeah, it certainly makes a case for it. Here's an
interesting study that I came across. They took people who
have high blood pressure, which we know is a risk
factor for heart disease, and they found that those who
would get their teeth cleaned more often had about a
ten point reduction in their blood pressure numbers compared to
(30:16):
those that weren't getting their teeth cleaned regularly. Wow. Yeah,
And there's also this other study I came across, like
a few looking at heart arrhythmias like atrial fibrillation, which
is a risk factor for stroke. They found that people
that brush their teeth three times a day have a
lower risk of atrial fibrillation than those that brush their
(30:37):
teeth once or twice a day.
Speaker 2 (30:39):
I mean, people with periandentitis have twice the risk of
a stroke compared to those without gum disease.
Speaker 1 (30:46):
And the goal here is not to for the listeners,
Like if you're listening and you're freaking out, the goal
here is not to scare you with this data. Remember,
severe gum disease takes time to develop and there are
interventions that can prevent it from developing. Like we know,
severe gum disease is linked to overall higher risk of
(31:07):
death because of the chronic inflammation that's in the mouth
therefore in the body. It's putting strain on the whole system.
But again we're sharing this information with the hopes that
you'll understand that dental cleaning, keeping your teeth clean, having
good oral hygiene is something very much that is in
one's control to prevent the progression of advanced gum disease.
(31:32):
If there's any healthcare providers listening, it's just a reminder,
right if you see a patient in your clinic and
they have heart disease, they have high blood pressure, they
have evidence of inflammation.
Speaker 3 (31:46):
Don't forget to ask them about their teeth.
Speaker 1 (31:49):
Ask them, you know, are they getting their teeth cleaned
regularly or if they're having access issues to a dentist.
Just remind them to brush their teeth at least twice
a day for two minutes, because that is a very
cost effective way of lowering someone's cardiovascular risk.
Speaker 2 (32:08):
What is inflammation exactly, It's just your body is reacting
to bacteria or a foreign body like what exactly.
Speaker 1 (32:19):
In medical school we learn about the four classic signs
of inflammation and it comes from these Latin words rubor
two more, color and dolar. So rubor is redness, tumor
is like a tumor, swelling, color is heat so temperature,
(32:40):
and dolar is pain. And those are the qualities that
make up inflammation. So on a cellular level, what's happening
is inflammatory activity means there's some type of swelling or
redness or painful activity have being on a cellular level.
(33:01):
So in heart disease, right, the formation of a plaque, right,
how does a platform there's some sort of break in
the vessel. Then platelets go to that break and they're
trying to fix it, and they're trying to heal it,
and in the process they're creating a lot of inflammation
and swelling and redness, and then eventually it forms a plaque,
(33:22):
which really is your body's way of trying to treat
that inflammation. And so when this is happening on like
a massive scale, you know, then we're talking like total
body inflammation. And this can happen from injury or infection,
and it's basically your body's response to this. Your body's
trying to heal it in its own way, but unfortunately,
(33:45):
over time it leads to tissue changes or the formation
of new blood vessels. I mean, cancer is a process
that's rooted in inflammation, and so heart disease is similarly
a process like that, and gum disease too.
Speaker 2 (34:02):
Now, in order to manage inflammation, there's a few things
that can be done. Follow a healthy diet, brush and
floss every day, aim for at least one hundred and
fifty minutes of moderate intensity exercise per week, Drink less alcohol,
quit smoking, get a good night's sleep. So a lot
(34:22):
of the things that you would want to do for
a healthy, healthy living generally speaking, anyway, is the same
thing that's going to help with inflammation generally.
Speaker 1 (34:31):
Yeah, and I would also add keep your stress levels
as low as possible because that can also raise inflammation.
So bottom line here for today's episode is number one,
there is a link between gum disease, periodontal disease, and
(34:51):
chronic inflammation in the body, which is then associated with
cardiovascular disease. The exact cause and effect is not solidly
established in the literature, but we've discussed some underlying theories
around why that could be happening. And I just want
to say that there's so many different types of treatments
(35:13):
that exist out there for gum disease, but remember the
best treatment is really prevention.
Speaker 2 (35:20):
You know, follow the two to two two rule to
maintain good oral health. Brush twice a day for two minutes,
and visit your dentist twice a year unless.
Speaker 3 (35:30):
You're neurotic, like man, you go three times?
Speaker 2 (35:32):
Do you go three times a year? I like it,
I need it. I need it.
Speaker 3 (35:39):
It's like the only thing that makes me feel okay
in the current situation we're in.
Speaker 1 (35:45):
So now that we've gone over this, what do you think,
do you think you'll change anything.
Speaker 2 (35:51):
Uh, I'll probably change something for the week, and hopefully
that will carry over to the next week and so forth.
I feel like whenever I get this new information, immediately
A'm like, like yesterday when I was reading this stuff,
I'm like, I'm gonna brush my teeth again. I feel
like brushing my teeth right now. So it's really just
trying to be consistent with it, or as consistent as
(36:12):
you can, just because you know, especially if you're someone
like me that worries about heart health pretty consistently, I
don't want to make it even more, make myself even
more vulnerable with something that is preventable.
Speaker 1 (36:25):
Yeah, to me, this seems like the analogy is low
bearing fruit that you can pick to kind of optimize things.
One thing, you know, for me, when my dentist first
told me you have to brush for at least two minutes,
I remember being like, what, that's crazy.
Speaker 3 (36:41):
That's so long.
Speaker 1 (36:41):
I don't do that, And so I actually bought a
sand dial. I bought a two minutes sand dial, and
I would flip it and then when the sand would
get all the way down, I'd be like, Okay, now
you've done your too much.
Speaker 2 (36:54):
You actually do two minutes.
Speaker 1 (36:56):
Oh, I definitely do two minutes now. And I'll tell
you I noticed a dramatic improvement in just the development
of plaque and tartar. There was like less tartar the
next time I showed up. So the two minute thing
definitely it works for sure.
Speaker 2 (37:14):
Amazing, amazing. Yeah, please like and subscribe you know wherever
you listen to your podcast. We would love the support
to keep this thing alive. So we appreciate it.
Speaker 1 (37:24):
And if you don't like the podcast, send it to
all your enemies and have.
Speaker 2 (37:27):
Them like it. Tell exactly.
Speaker 1 (37:35):
Health Stuff is a production of iHeart Podcasts. The show
is hosted by me, doctor preancle Wally, and Harrikondebolu. Producers
are Rebecca Eisenberg, Jenna Cagel, Christina Loranger, Maya Howard, and
Katrina Norvel. Our researcher is Maria Tremarki and our intern
is Katya sobel Leayala. To send us a question, you
(37:56):
can email us a voice memo at health Stuff Podcasts
at gmail. Thanks so much for listening.
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