Managing Inflammation: What The Mouth Can Tell Us About Cardiovascular Disease

Inflammation is the body's natural defense mechanism, vital for healing wounds and fighting infections by activating immune cells to protect us. But when inflammation becomes chronic, it transforms into a hidden driver of various conditions, like cardiovascular disease (CVD), autoimmune diseases, and oral health disorders.

While acute inflammation helps heal, chronic inflammation persists over time, often silently, leading to widespread damage. This includes triggering the formation of plaques in arteries, restricting blood flow, and increasing health risks.

As physicians, we have to recognize that chronic inflammation doesn’t just impact one area of the body. In fact, its reach can extend from the mouth, where inflammation might originate in the gums, to the heart, increasing the risk of cardiovascular issues. This inflammation may trigger autoimmune diseases, damage the heart muscle, and overburden the immune system, leading to a variety of health problems.

By taking a holistic, person-centered approach, we can not only manage the symptoms of chronic inflammation but also address the root causes—leading to improved cardiovascular health, better oral health, and, ultimately, more comprehensive and lasting wellness for our patients. This approach ensures we reduce the risk of conditions like heart disease, prevent blood clots, and help maintain a balanced immune response which supports the entire body's interconnected systems.

Understanding Inflammation: From Acute to Chronic

Inflammation is a complex biological process. When the body encounters an infection or injury, it releases white blood cells and inflammatory chemicals to protect the affected area. This is known as acute inflammation—a beneficial, short-term response that aids in healing.

When the immune response becomes dysregulated or persists due to ongoing stressors such as poor diet, sedentary lifestyle, or environmental toxins, it becomes chronic. This state of chronic inflammation silently undermines the body’s systems and creates fertile ground for the development of chronic diseases like CVD and periodontal disease.

As healthcare providers, we are all too familiar with the damage caused by chronic inflammation. Yet, new research continues to reveal its deeper connection to systemic health, emphasizing the need for holistic strategies that go beyond traditional protocols.

Chronic Inflammation and Cardiovascular Disease (CVD)

Cardiovascular disease remains the leading cause of death globally, and inflammation is increasingly recognized as a central factor in its progression. While conventional CVD risk factors such as high blood pressure, high cholesterol, and smoking are well understood, chronic inflammation plays a more subtle role. 

Atherosclerosis

The inflammatory process is a key driver in developing atherosclerosis, where plaques form along the walls of arteries. Over time, these plaques harden and narrow the arteries, reducing blood flow and increasing the risk of heart attacks and strokes.

Endothelial Dysfunction

Inflammation damages the endothelium, the thin layer of cells that line blood vessels. This dysfunction makes the blood vessels less flexible and impairs their ability to regulate blood pressure and leads to hypertension.

Oxidative Stress

Prolonged inflammation leads to oxidative stress which leads to cellular damage and accelerates the buildup of arterial plaques. Oxidative stress also weakens the immune system and allows the inflammation to continue unchecked.

Blood Clots

Inflammatory responses can make the blood more prone to clotting. This raises the risk of thrombosis, which can block blood flow and cause heart attacks or strokes.

Research, such as the findings from the CANTOS (Canakinumab Anti-inflammatory Thrombosis Outcomes Study), has provided evidence on the role of inflammation in heart disease. The CANTOS study demonstrated that reducing inflammation without affecting cholesterol levels significantly lowers the risk of recurrent cardiovascular events. This represents a shift in our understanding, confirming that addressing inflammation directly can benefit CVD outcomes, not just focusing on traditional risk factors.

The Oral-Systemic Connection: How Oral Health Influences Cardiovascular Health

One of the most compelling areas of new research in inflammation is the link between oral health and systemic diseases, particularly cardiovascular disease. Historically, dentistry and cardiovascular care were considered separate fields, but we now understand that the mouth is far more than an isolated system. It’s a gateway to the rest of the body, and poor oral health can have serious repercussions for overall health.

The oral cavity is home to billions of bacteria, both beneficial and harmful. When the balance of these bacteria (the oral microbiome) is disrupted—due to poor oral hygiene, diet, or other factors—it can lead to gum diseases such as gingivitis and periodontitis. These conditions cause localized inflammation in the gums, but the effects don’t stop there.

Chronic oral inflammation can enter the bloodstream and lead to widespread blood vessel inflammation, contributing to cardiovascular conditions and heart disease. Elevated levels of C-reactive protein (CRP) have been found in patients with both gum disease and heart issues, indicating inflammation’s role as a critical risk factor.

Inflammation of blood vessels can promote the formation of plaques, increasing the likelihood of blood clots and raising the risk of heart attacks and even heart failure. The immune cells activated by chronic inflammation also damage the heart muscle over time, further increasing the chances of serious cardiovascular events. Managing inflammation in the mouth is essential for reducing systemic inflammation and safeguarding heart health.

Periodontal Disease and Inflammation: In diseases like periodontitis, the inflammatory response triggered in the gums releases pro-inflammatory molecules which enter the bloodstream. This not only worsens oral health but also exacerbates inflammation throughout the body and increases the risk of cardiovascular problems.

Oral Microbiome Dysbiosis: The bacteria in the mouth are linked to systemic health. A shift towards pathogenic bacteria (oral dysbiosis) may increase inflammation levels and lead to conditions like atherosclerosis. Studies have found that people with severe gum disease are significantly more likely to suffer from cardiovascular events.

As functional medicine practitioners, it's important to consider oral health when creating your client history. Asking about oral health can give us a clearer picture of what’s going on in the body, especially since chronic inflammation often starts in the mouth. By looking at oral health as part of a bigger picture, we can create more effective plans that address both oral and cardiovascular health, helping our clients manage inflammation at its root.

One of the most compelling areas of new research in inflammation is the link between oral health and systemic diseases, particularly cardiovascular disease. Historically, dentistry and cardiovascular care were considered separate fields, but we now understand that the mouth is far more than an isolated system. It’s a gateway to the rest of the body, and poor oral health can have serious repercussions for overall health.

The oral cavity is home to billions of bacteria, both beneficial and harmful. When the balance of these bacteria (the oral microbiome) is disrupted—due to poor oral hygiene, diet, or other factors—it can lead to gum diseases such as gingivitis and periodontitis. These conditions cause localized inflammation in the gums, but the effects don’t stop there.

Chronic oral inflammation can enter the bloodstream and lead to widespread blood vessel inflammation, contributing to cardiovascular conditions and heart disease. Elevated levels of C-reactive protein (CRP) have been found in patients with both gum disease and heart issues, indicating inflammation’s role as a critical risk factor.

Inflammation of blood vessels can promote the formation of plaques, increasing the likelihood of blood clots and raising the risk of heart attacks and even heart failure. The immune cells activated by chronic inflammation also damage the heart muscle over time, further increasing the chances of serious cardiovascular events. Managing inflammation in the mouth is essential for reducing systemic inflammation and safeguarding heart health.

Periodontal Disease and Inflammation: In diseases like periodontitis, the inflammatory response triggered in the gums releases pro-inflammatory molecules which enter the bloodstream. This not only worsens oral health but also exacerbates inflammation throughout the body and increases the risk of cardiovascular problems.

Oral Microbiome Dysbiosis: The bacteria in the mouth are linked to systemic health. A shift towards pathogenic bacteria (oral dysbiosis) may increase inflammation levels and lead to conditions like atherosclerosis. Studies have found that people with severe gum disease are significantly more likely to suffer from cardiovascular events.

As functional medicine practitioners, it's important to consider oral health when creating your client history. Asking about oral health can give us a clearer picture of what’s going on in the body, especially since chronic inflammation often starts in the mouth. By looking at oral health as part of a bigger picture, we can create more effective plans that address both oral and cardiovascular health, helping our clients manage inflammation at its root.

Functional Medicine's Approach to Managing Inflammation

The key to managing inflammation is addressing the root causes. While pharmaceutical interventions may be necessary at times for acute conditions, they rarely address the lifestyle factors that drive inflammation in the first place. 

Functional medicine physicians can use a range of strategies that help clients reduce inflammation and improve their overall health. 

• Dietary Interventions: A whole-food, plant-based diet rich in antioxidants, omega-3 fatty acids, and colorful, anti-inflammatory foods is one of the most powerful tools we have. Research shows that diets high in fruits, vegetables, and healthy fats can dramatically lower inflammation levels. A  diet high in fiber and colorful plant foods has been shown to reduce markers of inflammation and decrease the risk of CVD.

• Lifestyle Modifications: Encouraging regular physical activity, stress management techniques, and improving sleep quality can all help to lower inflammation. Chronic stress is one of the most potent drivers of inflammation, so helping patients build resilience through stress-reduction practices that they can use daily is critical.

• Supplements: Targeted supplementation with anti-inflammatory agents such as curcumin, omega-3s, and probiotics can be beneficial in reducing inflammation. Curcumin, for instance, has been extensively studied for its ability to modulate inflammatory pathways and offers a natural alternative to pharmaceutical anti-inflammatories.

• Oral Health as a Systemic Indicator: Integrating oral health into cardiovascular care is essential. Teaching clients about the importance of oral hygiene, regular dental check-ups, daily flossing, benefits the whole body including their cardiovascular health. 

• Oral Microbiome Testing: By looking at the health of the oral microbiome, we can pinpoint harmful bacteria and better understand how they’re affecting things like heart health and chronic inflammation. This kind of testing allows us to create more personalized care plans—whether it’s suggesting specific probiotics or adjusting oral care routines—to help bring balance back and reduce inflammation at its source.

Teach your clients to eat anti-inflammatory heart-nourishing foods like this Arugula Slaw with Tahini Dressing.

Genetics and Personalized Care

No two people are the same, which is why personalized care over protocols is the foundation of functional medicine. Genetic predispositions can influence how a person’s body responds to inflammation, which is especially important when considering serious conditions like cardiovascular disease.

Inflammation in the mouth can spread to the blood stream which can weaken the artery walls, leading to plaque buildup and increasing the risk of blood clots. These clots can restrict blood flow and potentially trigger a heart attack or cause chest pain as a warning sign.

Understanding these genetic factors allows us to be proactive and tailor strategies more effectively to create positive change. For example, individuals with certain genetic variants may be more prone to chronic inflammation or may metabolize specific nutrients differently. Functional medicine practitioners can use genetic testing to identify these risks and create personalized plans that support the unique needs of their client, helping to reduce inflammation and ultimately lower the risk of cardiovascular events.

Importance of Understanding Inflammation

Chronic inflammation is the common thread between CVD and oral health problems. Functional practitioners have a unique opportunity to address this underlying issue through holistic, client-centered approaches that go beyond cardiovascular testing and simply using protocols.

By looking at the whole body and integrating lifestyle modifications, dietary changes, and personalized interventions, we empower our patients to take control of their health, reducing the silent threat of chronic inflammation. This proactive approach can prevent not only cardiovascular events but also improve oral health and foster a sense of overall well-being.

For a deeper look at the oral-cardiovascular connection, listen to our podcast episode with Dr. Ellie Campbell titled “The Link Between Oral Health and Cardiovascular Disease.” Dr. Campbell was a key speaker at our SHINE Online Conference, Genetics, Assessments, and Nutritional Strategies for Optimal Cardiovascular Function, where she shared how to assess and manage those at risk for cardiovascular disease, particularly through the lens of oral health. To get those recordings, click here.