AsianScientist (Feb. 09, 2023) – Do you brush your teeth at least twice a day, floss daily and get regular dental check-ups? If not, you might be at risk of developing periodontitis, a common infectious and inflammatory gum disease. When left untreated, periodontitis can destroy the bone supporting the teeth and cause them to loosen or fall out altogether. Now, latest research from Japan’s Hiroshima University suggests that the harm caused by periodontitis may extend to your heart.
The study published in JACC: Clinical Electrophysiology found a significant correlation between periodontitis, and fibrosis—scarring of an appendage of the heart’s left atrium that can lead to an irregular heartbeat, a medical condition called atrial fibrillation (AF). (An atrium receives oxygen-rich blood from the lungs and then passes it to the left ventricle, which pumps blood out of the heart and into the circulatory system.) Several studies have revealed an association between periodontitis and atrial fibrillation (AF). However, the mechanisms linking AF, AF-related stroke, and periodontitis are still not very clear.
Atrial fibrillation is commonly associated with congestive heart failure (CHF), a chronic condition in which the heart struggles to pump blood effectively, increasing the risk of stroke, heart failure, and other complications.
The researchers explain that if proper oral hygiene practices are not maintained, bacteria in the mouth form a sticky film called plaque. With time, plaque hardens into calcified deposits or tartar over teeth and gums. The tartar can spread below the gum line, making it difficult to clean between teeth. With time, this build-up causes gingivitis, an inflammatory but mild gum disease. If left untreated, it can progress to periodontitis.
Periodontitis also aggravates diseases like diabetes, fat build-up in the arteries, rheumatoid arthritis and affects the heart and brain blood vessels. “Periodontitis is associated with a long-standing inflammation, and inflammation plays a key role in atrial fibrosis progression and atrial fibrillation pathogenesis,” said Shunsuke Miyauchi, assistant professor with Hiroshima University’s Health Service Center, who is the first author of the study
All the study participants, with a mean age of 71.7 years, underwent cardiac surgery called Left Atrial Appendage (LAA) excision. They had an oral examination three days before surgery, in which the researchers measured parameters such as plaque index, bleeding on probing, and marginal bone loss. The researchers then established a correlation between gum disease severity and atrial fibrosis.
According to their findings, atrial fibrosis was worse when periodontitis was more severe.
“This study provides basic evidence that periodontitis can aggravate atrial fibrosis and can be a novel modifiable risk factor for atrial fibrillation,” said corresponding author Yukiko Nakano, professor of cardiovascular medicine at Hiroshima University’s Graduate School of Biomedical and Health Sciences.
However, she pointed out that the study has not conclusively proven that the link was causal, meaning that periodontal disease does not necessarily cause atrial fibrosis.
“One of our goals is to confirm that periodontitis is a modifiable risk factor for atrial fibrillation and to promote dental specialists’ participation in comprehensive atrial fibrillation management,” said Nakano.
Nakano suggested that improving other risk factors, such as weight, physical activity and tobacco and alcohol use in addition to dental care to aid in comprehensive AF management. She added that periodontitis is an easily adjustable target with a lower cost among known atrial fibrillation risk factors. In future clinical trials, the researchers hope to confirm whether periodontal treatment reduces atrial fibrillation.
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Source: Hiroshima University ; Image: Yipei Lieu/ Asian Scientist Magazine
The article can be found at: Relationship Between Periodontitis and Atrial Fibrosis in Atrial Fibrillation: Histological Evaluation of Left Atrial Appendages
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