What the research does and does not say

Gum disease is a chronic bacterial infection that keeps the immune system switched on. The same inflammatory markers that rise with gum disease are associated with heart disease. Bacteria from the mouth have been found in arterial plaque.

What has not been shown is that treating gums prevents heart attacks. So I describe it this way: gum disease is one more source of inflammation your body is carrying, and it is one you can remove.

What I watch for at a cleaning

Frank measures all of this at every cleaning. For patients with heart conditions, diabetes, or on certain medications, I read the same numbers with less tolerance for "a little bleeding."

• Bleeding on probing, the earliest sign of active inflammation
• Pocket depths above 3 mm, and whether they are getting deeper
• Recession and bone changes on X-rays
• Loose teeth or a bite that has shifted

Why heart patients get a closer look

Some heart medications dry the mouth or cause gum overgrowth, which makes gum disease more likely. Some heart histories still require antibiotics before certain dental procedures. And if you are on blood thinners, gum treatment is planned with that in mind. None of that changes the welcome. It changes the plan.

When gum disease is advanced, our periodontist Dr. Shah sees patients here at mend, with the same records Frank and I use.

Tell us about each other

Tell your cardiologist you are being treated for gum disease. Tell us about any heart condition, stent, valve, or medication change. If a physician asks for a dental clearance before a heart procedure, we can usually do that visit within days. Most PPO plans cover gum measurements, deep cleanings and periodontal maintenance; we verify first.