Mouthwash may reveal risk of cardiovascular disease

Franziska Beier, Dental Tribune International

Fri. 25 August 2023

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HAMILTON, Ontario, Canada: The link between periodontitis and cardiovascular disease is well established. However, most research in this area concerns older patients, and little is known about whether mild oral inflammation—which occurs commonly in young and apparently healthy individuals—has an impact on cardiovascular health. Using a simple saliva test, a team consisting of researchers from different institutions in Canada set out to determine whether lower levels of oral inflammation can be clinically relevant to cardiovascular function.

Previous research on oral inflammation that precedes periodontitis has found that higher inflammation, reflected in a higher concentration of white blood cells in saliva, is associated with fewer healthy arteries and a potentially higher risk of cardiovascular disease.

“Even in young healthy adults, low levels of oral inflammatory load may have an impact on cardiovascular health—one of the leading causes of death in North America,” said co-author Dr Trevor King from McMaster University in Hamilton and Mount Royal University in Calgary in Alberta.

For their study, the researchers worked with 28 individuals aged between 18 and 30 who were non-smokers, showed no risk factors for cardiovascular health and had no reported history of periodontal disease. The team used a simple oral mouthwash to determine whether the concentration of white blood cells in the saliva could be associated with a higher risk of cardiovascular disease. As key indicators of cardiovascular risk, the team chose flow-mediated dilation, a measure of how well arteries can dilate to allow more blood flow, and pulse wave velocity, which measures arterial stiffness.

The researchers found that oral inflammation is a predictor of reduced flow-mediated dilation, which is an indication of a possible risk of developing cardiovascular disease. They suggested that inflammation that reaches the vascular system from the mouth might have an impact on the ability of arteries to produce the nitric oxide that allows them to respond to changes in blood flow.

However, they observed no link between oral inflammation and pulse wave velocity, indicating that a long-term impact of oral inflammation on the artery structure had not occurred. This observation is in line with findings of previous studies that included older individuals.

“We are starting to see more relationships between oral health and risk of cardiovascular disease,” said lead author Ker-Yung Hong from McMaster University. “If we are seeing that oral health may have an impact on the risk of developing cardiovascular disease even in young healthy individuals, this holistic approach can be implemented earlier on.”

“The mouthrinse test could be used at your annual check-up at the family doctors or the dentist,” said co-author Dr Michael Glogauer from the University of Toronto. “It is easy to implement as an oral inflammation measuring tool in any clinic.”

The researchers concluded that their study provides evidence that oral health may impact cardiovascular disease, even in young and healthy individuals. According to Dr King, the researchers hope to conduct further studies with larger study populations and more individuals with gingivitis and periodontitis that is more advanced in order to better understand the connection between different levels of oral inflammation and cardiovascular status.

The study, titled “Oral inflammatory load predicts vascular function in a young adult population: A pilot study”, was published online on 18 August 2023 in Frontiers in Oral Health.