What are the symptoms of tooth infection spreading to the heart?

tooth infection spreading to the heart
It all starts with an untreated cavity. It will continue to progress in depth to reach the dental pulp where the tooth vessels and nerves are located.

The problem is that the blood vessels of the tooth are not disconnected from the body. Under certain conditions, a tooth infection can spread in the body and reach our vital organs. The most common and threatening is the heart.

In this article, you will learn 3 heart complications of untreated tooth infection.

Tooth infection and atherosclerosis

What is atherosclerosis?

It is the deposit of a plaque ( called atheroma) made up mainly of lipids and more particularly of LDL (low-density lipoprotein which is the bad cholesterol) inside the arteries.
This can lead to poor or even the obstruction of blood circulation, which can have dramatic consequences.

Different studies have confirmed the relationship between gum disease and atherosclerosis. But the impact of dental infections, especially apical periodontitis which affects the tip of the tooth root, has not been studied much.

How does apical periodontitis appear?
When tooth decay reaches the pulp, as long as the tooth is alive, it will defend itself. Once the pulp is dead (pulp necrosis), the infection will spread to the deep periodontium in the area near the root tip called the periapex and lead to apical periodontitis.

periapical periodontitis

The problem with apical periodontitis is that it can be asymptomatic, meaning that you can have apical periodontitis without feeling anything. Hence the need to see your doctor regularly, an X-ray examination can easily reveal these lesions allowing us to treat them from their initial stage. Sometimes apical periodontitis can produce symptoms, among them:

  • Continuous and radiating pain towards the jaws, the temporomandibular joint, and the ear.
  • Sensitivity to hot food.
  • Long tooth feeling.
  • Bad breath and bad taste.
  • The appearance of an abscess near the tip of the root.
  • Swelling of the cheeks and glands of the neck.
  • Fever.

Apical periodontitis and gum disease have many bacteria in common including Actinobacillus actinomycetemcomitans (Aa) and Porphyromonas gingivalis (Pg) which are strongly involved in atherosclerosis.

But how does atherosclerosis occur?

how does atherosclerosis occur

The bad cholesterol circulating in the blood will accumulate in certain arterial sites, forming a lipid mass. Gradually, this cholesterol will oxidize and become inflammatory. The immune cells trying to eliminate this mass will absorb this cholesterol and become bulky.

These cells eventually die and accumulate to form what we call atheromatous plaque.
In some cases, substances will be released that can damage these plaques. This will result in their rupture and the formation of a blood clot within the arteries which can block the blood flow and lead to fatal complications.

So how is this related to dental infection?
Bacteria from tooth infections can reach the general circulation and attach to atheromatous plaque.

Because of their ability to penetrate and survive in these plaques, they will attract immune cells and cause inflammation in this area. They will then promote the rupture of the plaque and the appearance of serious complications including heart attack (if the coronary artery is affected) or stroke (if the carotid artery is concerned).

In addition, tooth infection will increase the inflammation level of the body which can indirectly promote the development of atherosclerosis.
Although inflammation is supposed to have a protective effect, if it lasts too long, it can lead to more serious complications. Among them:

  • Increased oxidative stress
  • Decrease in the anti-oxidant capacity of HDL (good cholesterol)
  • Increased formation and rupture of atherosclerotic plaques
  • High blood pressure

Tooth infection and acute coronary syndrome

What is acute coronary syndrome?

Acute coronary syndrome refers to any situation where the blood supply to any part of your heart is suddenly reduced or blocked. It is an emergency that requires immediate treatment.

According to a study published in the medical journal Journal of Dental Research, people with apical periodontitis have a 2.7 higher risk of being affected by the acute coronary syndrome.

The study was carried out in Finland with 508 patients with an average age of 62 years who had a heart problem.

X-rays examinations revealed that 33% of the patients had a heart problem and 58% of them had apical periodontitis.

The researchers also found that dental infection was linked to a high level of antibodies in the bloodstream, which explains its overall impact on the body, not just on the teeth.

The risk of coronary disease is explained by the action of a bacterium found in apical periodontitis called Porphyromonas endodontalis.

It increases the level of an inflammatory substance called CRP. Its level in the blood is an important indicator of coronary heart disease.
This bacterium also releases toxins that can alter directly the heart arteries.

Tooth infection and infectious endocarditis

What is infectious endocarditis?

It's an infection affecting the heart valves, which are a kind of gate that prevents the blood pumped by the heart from changing direction. It is caused by bacteria that enter the body through a lesion, circulate through the bloodstream, and attach to the heart.

Oral diseases are the first cause of infective endocarditis (30% of endocarditis cases are caused by mouth bacteria).

These bacteria must first find an entry point to the bloodstream.

The transient reach of the bloodstream by oral bacteria is a natural and daily situation that can occur during chewing or tooth brushing.
In healthy people, they are eliminated effectively by the immune system.

In people with a weakened immune system, these bacteria can travel through the bloodstream and get into the heart. They will stick to the valves and form a bacterial plaque. This can lead to ulceration or even perforation of the valves, causing heart dysfunction with potentially fatal consequences.

How bacteria from a tooth infection can migrate to the heart

The entry of bacteria from a dental infection into the general bloodstream can be caused by an injury that may be due to brushing, chewing or during a surgical procedure such as tooth extraction.

These bacteria will be transported to the heart and, in people at risk, they will attach to it.

Symptoms that indicate a risk of heart complications

Depending on the virulence of the bacteria involved and the resistance of the immune system, several symptoms may signal a risk of heart complications. They can range from a mild fever to general malaise.
Among them:

  • Fever: In tooth infection, a fever that exceeds 38 degrees means that the immune system has been triggered by a bacterium that has reached the bloodstream. It may indicate a potential risk of heart damage.
  • Shortness of breath, headache, and dizziness: When the coronary arteries, the blood vessels that supply oxygen-rich blood to your heart muscle to keep it pumping, are damaged, the heart will not pump enough blood to meet the body's needs. It is a serious health problem that results in, among other things, shortness of breath and fatigue.
  • Swelling: One of the signs of dental infection is a localized swelling on the gum called a dental abscess. Sometimes the swelling can spread to the surrounding tissue and cause cellulitis. In its diffuse form, it can be life-threatening, damaging the heart, lungs, and brain.
  • Feeling Unwell
  • Increased heart and breathing rate
  • Dehydration and stomach pain

Risk factors for heart complications

Heart complications from dental infection are rare, but certain factors increase the risk drastically. Some of them include:

  • Weakened immune system due to diabetes, HIV infection, chemotherapy or radiotherapy, hemopathy.
  • Wearing a heart valve prosthesis
  • History of endocarditis
  • Unoperated congenital heart disease
  • Stress
  • Smoking
  • High cholesterol levels.
  • High blood pressure
  • Overweight

How to prevent heart complications

The best way to prevent cavities and gum disease is to apply oral hygiene measures.
Regular cleaning of the mouth will reduce the bacterial load preventing dental infection and possible heart damage.
Oral hygiene measures include:

  • Brushing twice a day and cleaning between teeth with dental floss or interdental brushes once a day helps remove bacterial plaque, considered the leading cause of cavities and gum disease.
  • Eat healthy not only for good oral health but also for your heart. The most important nutrients for your gums and teeth health are vitamin C, vitamin D, iron, and calcium.
  • Regular visits to your dentist for a check-up and professional dental cleaning help remove tartar build-up and detect dental infections in their early stages.
  • Stop smoking and alcohol abuse. These two factors act synergistically in oral and cardiovascular diseases.
  • If you suffer from heart disease, talk to your dentist about it. Give him/her your medications list and the contact information of your cardiologist. He or she will take the necessary steps to avoid the worst complications.