(By Dr. Joseph D. Lim and Dr. Kenneth Lester Lim, BS-MMG, DDM, MSc-OI)
THERE could be a link between a gum disease and a heart condition, a new study suggests.
The gum disease is periodontitis. The heart condition is fibrosis, a scarring to an appendage of the heart’s left atrium that can lead to an irregular heartbeat called atrial fibrillation.
A research team at Hiroshima University has found a significant correlation between periodontitis and atrial fibrosis in a sample of 76 patients with cardiac disease.
“Periodontitis is associated with a long-standing inflammation, and inflammation plays a key role in atrial fibrosis progression and atrial fibrillation pathogenesis,” says Shunsuke Miyauchi, an Assistant Professor at Hiroshima University’s Health Service Center and the first author of the study published in the journal JACC: Clinical Electrophysiology.
“We hypothesized that periodontitis exacerbates atrial fibrosis,” says Dr. Miyauchi who is also affiliated with the university’s Graduate School of Biomedical and Health Sciences. The study of the left atrial appendages aimed to clarify the relationship between clinical periodontitis status and degree of atrial fibrosis, he explains.
The researchers found that the worse the periodontitis, the worse the fibrosis, suggesting that the inflammation of gums may intensify inflammation and disease in the heart, according to a press statement from the university.
One of the researchers – corresponding author Yukiko Nakano, Professor of Cardiovascular Medicine in Hiroshima University’s Graduate School of Biomedical and Health Sciences – cautioned that the study did not establish a causal relationship, meaning that while gum disease and atrial fibrosis degrees of severity appear connected. Researchers have not found that one definitively leads to the other.
“Further evidence is required for establishing that periodontitis contributes to the atrial fibrosis in a causal manner and that periodontal care can alter fibrosis,” Nakano says.
“This study provides basic evidence that periodontitis can aggravate atrial fibrosis and can be a novel modifiable risk factor for atrial fibrillation,” she says.
Periodontal care could aid in comprehensive atrial fibrillation management, in addition to improving other risk factors such as controlling weight, increasing physical activity, and limiting if not eliminating tobacco and alcohol use, says Nakano.
One of the study’s goals was to confirm that periodontitis is a modifiable risk factor for atrial fibrillation and to promote the participation of dental specialists in comprehensive atrial fibrillation management.
Periodontitis is an easy modifiable target with lower cost among known atrial fibrillation risk factors. “The achievement of this study series may bring benefits for many people worldwide,” Nakano says
The next step for the researchers is to conduct future clinical trials to clarify if periodontal intervention reduces atrial fibrillation occurrence and improves patient outcomes.
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Dr. Joseph D. Lim, Ed. D., is the former Associate Dean of the College of Dentistry, University of the East; former Dean, College of Dentistry, National University; Past President and Honorary Fellow of the Asian Oral Implant Academy; Honorary Fellow of the Japan College of Oral Implantologists; Honorary Life Member of the Thai Association of Dental Implantology; and Founding Chairman of the Philippine College of Oral Implantologists. For questions on dental health, e-mail jdlim2008@gmail.com or text 0917-8591515.
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Dr. Kenneth Lester Lim, BS-MMG, DDM, MSc-OI, graduated Doctor of Dental Medicine, University of the Philippines, College of Dentistry, Manila, 2011; Bachelor of Science in Marketing Management, De la Salle University, Manila, 2002; and Master of Science (MSc.) in Oral Implantology, Goethe University, Frankfurt, Germany, 2019. He is an Associate Professor; Fellow, International Congress of Oral Implantologists; Member, American Academy of Implant Dentistry and Fellow, Philippine College of Oral Implantologists. For questions on dental health, e-mail limdentalcenter@gmail.com./PN
