Gum diseases, known as periodontitis, are among the most common oral and dental problems and affect more than half of adults. Chronic gum inflammation not only leads to bone loss and tooth loss, but recent studies have shown a strong connection between it and cardiovascular diseases. In the following, we discuss the impact of gum disease on heart health. **Definition of gum disease** Gum disease begins with the accumulation of microbial plaque on the surface of the teeth, which if not cleaned, causes inflammation and infection of the tissue that supports the tooth. In the initial stages, this disease turns into gingivitis (inflammation of the gums without bone loss) and if it progresses, it becomes periodontitis (inflammation with bone loss). The main symptoms include bleeding gums when brushing, swelling and discoloration of the gums. ### **prevalence and risk factors** Periodontitis is very common in people over the age of 35 and is usually more severe in those who do not have good oral hygiene or who smoke. In addition, uncontrolled diabetes, chronic stress, and certain systemic diseases (such as rheumatoid arthritis) increase the risk. These common factors between gum disease and heart disease can play a synergistic role in worsening the condition. **What is the connection between gum disease and heart disease?** Several studies have shown that people with periodontitis are twice as likely to develop cardiovascular diseases than the general population. Continuous gum inflammation is associated with an increase in the level of inflammatory molecules (such as CRP and interleukins) in the body, and these inflammatory factors can damage blood vessels and accelerate the process of atherosclerosis. **Effect of gum disease on heart health** 1. Entering microbes into the blood: bacteria that cause periodontitis can enter the bloodstream through gum wounds and settle in the walls of blood vessels. 2. **Systemic inflammation:** The body's immune response to the presence of these microbes increases the secretion of inflammatory mediators, and local gum inflammation leads to general inflammation throughout the body. 3. **Formation of vascular plaque:** Chronic inflammation accelerates the density of fat and cholesterol plaque in the walls of the vessels, which leads to narrowing of the arteries and a decrease in heart blood flow. **Relation between periodontitis and heart diseases** Extensive studies have shown that people with severe periodontitis are 20% more likely to have a heart attack within 10 years. This increased risk is independent of other known factors (such as smoking or diabetes) and is directly related to the severity of gingivitis. **Cardiac complications caused by gum disease** - Atherosclerosis and clogging of arteries, systemic inflammation and gum bacteria causes fat deposition in the walls of coronary arteries and aggravates the narrowing of arteries. - Increased risk of heart attack. People with severe periodontitis are twice as prone to acute heart attack and cardiac ischemia. Heart attack is one of the most common direct effects of gingivitis. - Infective endocarditis Gum bacteria may reach the inner lining of the heart (endocardium) and cause inflammation of the inner layers of the heart, especially in people with damaged heart valves, this risk is more serious. - Failure and rhythm disorders, chronic inflammation and frequent gum infections can disrupt the electrical function of the heart and lead to congestive failure or arrhythmia in the long run. ** Ways to prevent and control gum diseases ** To prevent and control gum diseases, we must do things that strengthen and improve the gums and keep the gums away from any disease. 1. ### **daily oral care** To maintain the health of the gums and prevent the formation of bacterial plaque, it is necessary to observe oral hygiene at home: - Brushing your teeth at least twice a day with fluoride toothpaste and a soft brush - Daily use of dental floss or interdental toothbrush to clean the interdental spaces - Rinsing the mouth with an antiseptic mouthwash for the gums to reduce the microbial load 2. ### **Professional examinations and cleaning** Even with careful home hygiene, bacterial plaque and tartar can deposit below the gum line. To remove these sediments and detect problems in time: - Regular visits to the dentist every 4 to 6 months - Specialized scaling and polishing for complete cleaning of tooth surfaces and under gums - Assessing the health of the gum tissue (measurement of the depth of periodontal pockets) and performing additional treatments if needed 3. ### **control of systemic and environmental risk factors** Some general habits and diseases can increase the risk of gingivitis. Managing these factors helps make treatments more effective. - Quitting smoking and avoiding tobacco (cigarettes, hookah) to reduce the inflammatory response of the gums. - Limiting the consumption of sugar and simple carbohydrates to reduce the nutrition of harmful bacteria. - Diabetes control with regular monitoring of blood sugar and appropriate diet. - Stress management through relaxation techniques (meditation, breathing exercises) to reduce the level of inflammatory hormones. **Key tips to maintain gum health** 1. Learning the correct brushing and flossing technique 2. Replacing the toothbrush brush every 2 to 3 months 3. Regular gum self-examination (check for redness, swelling and bleeding) 4. Reducing the use of hookah and smoking along with fundamental withdrawal 5. See a dentist immediately if you see any warning signs