How the bacteria behind gum disease can affect heart health

For this study, researchers used several methods, including human heart tissue and a mouse model, to search for a potential link between periodontitis and CAVS.

“CAVS is the most common valvular heart disease in older adults, affecting approximately 2%–7% of people over the age of 65,” Chenyang Li, MD, a PhD candidate in the Department of Cardiology in Fuwai Hospital at the National Center for Cardiovascular Diseases at the Chinese Academy of Medical Sciences and Peking Union Medical College in China, and co-first author of this study, told Medical News Today.

“Currently, no medications have been proven to prevent or slow its progression, and once severe stenosis develops, valve replacement is often the only effective treatment. Therefore, identifying modifiable risk factors and understanding the mechanisms driving valve calcification could open new opportunities for prevention and early intervention, potentially reducing the need for invasive procedures.”
—Chenyang Li, MD

Li said he and his team decided to look for a potential link between periodontitis and CAVS, as chronic inflammation is recognized as a key driver of CAVS.

“Porphyromonas gingivalis (P. gingivalis), one of the major bacteria responsible for periodontal disease, can enter the bloodstream during routine activities such as brushing or chewing in people with poor oral health, and has been associated with several cardiovascular diseases,” he explained.

“Previous studies detected P. gingivalis DNA in calcified human aortic valves, but whether this bacterium directly contributes to valve calcification remained unclear. “We wanted to investigate this potential biological connection,” he said.

At the study’s conclusion, researchers found that repeated exposure of live P. gingivalis in mice led to bacterial accumulation in the aortic valves and increased valve calcification and symptoms of aortic stenosis. Additionally, the P. gingivalis prevented the effects from being reduced when antibiotics were administered.

“Our findings suggest that repeated systemic exposure to P. gingivalis may actively contribute to the development of CAVS rather than simply being an incidental finding. “We also observed that preventive antibiotic treatment reduced bacterial accumulation in the aortic valves and attenuated valve calcification, further supporting the possibility that bacterial infection promotes disease progression.”
—Chenyang Li, MD

“However, our study was conducted in animal models, so these findings should not be interpreted as evidence that antibiotics can prevent CAVS in humans,” Li continued. “Instead, they suggest that infection-related inflammation may represent a potential therapeutic target that warrants further investigation.”

“Our next step is to validate these findings in larger clinical cohorts,” he added. “We also plan to explore whether interventions targeting infection-related inflammatory pathways, particularly IL-1β signaling, may represent a promising strategy for preventing or slowing the progression of calcific aortic valve disease.”

MNT spoke with Yu-Ming Ni, MD, a board certified cardiologist and lipidologist at MemorialCare Heart and Vascular Institute at Orange Coast Medical Center in Fountain Valley, CA, who was not involved in this study.

Ni commented that these findings are consistent with what we already know about the connection between oral health and cardiovascular disease.

“Periodontal (gum) disease has long been associated with a higher risk of atherosclerosis, the buildup of plaque in the arteries, largely due to chronic inflammation. Over time, this inflammation can accelerate the deposition of fatty material in artery walls, increasing the risk of serious events like heart attack and stroke.”
—Yu-Ming Ni, MD

“What makes this study especially compelling is the potential link between gum disease and CAVS,” Ni continued.

“While this connection may sound surprising, it aligns with the broader understanding that inflammation plays a central role in many forms of cardiovascular disease. Compared to conditions like heart attack and stroke, we still have far less guidance on how to prevent valve disease,” he said.

Jason M. Auerbach, DDS, an oral and maxillofacial surgeon at Riverside Oral Surgery in New Jersey, and founder and CEO of MAX Surgical Specialty Management, who was also not involved in this research, said his first reaction to the findings was that this could make sense.

“We’ve known for years that the mouth isn’t separate from the rest of the body,” Auerbach explained. “Gum disease creates chronic inflammation, and we’re continuing to uncover how inflammation can affect overall health.”

“What’s interesting about this study is that it suggests a possible pathway linking the bacteria that causes periodontal disease to calcification of the aortic valve,” he continued.

“It’s still really early research, so I wouldn’t and can’t say that gum disease causes valve disease, but it is another reminder that taking care of your mouth is about much more than keeping your teeth,” he said.

MNT also spoke with Craig Basman, MD, an interventional cardiologist at Hackensack University Medical Center, who was not involved in this study, who said that this research opens several exciting avenues for future research.

“Mainly: can we establish causation between P. gingivalis and the progression of CAVS in a diverse human population?” I have detailed. “And if so, does treatment — whether antibiotics or anti-inflammatory IL-1β inhibition — prevent that progression?”

“We need larger, long-term observational studies to confirm the association between P. gingivalis and the progression of CAVS in a diverse human population,” Basman continued.

“The most exciting prospect is the potential for new treatments. I would be very interested in clinical trials investigating whether aggressive treatment of periodontal disease, perhaps even with targeted antibiotic therapy against P. gingivaliscan slow down or prevent the development of aortic stenosis in at-risk patients,” he told MNT.

For readers looking to improve their oral health to prevent periodontitis, Ana Becil Giglio, DDS, president of the American Academy of Periodontology (AAP), who was not involved in this study, said the AAP recommends five methods for preventing periodontal disease:

• Brush your teeth, gums, and tongue after meals, or at least twice daily, to remove food debris, plaque, and bacteria.
• Clean between your teeth daily using floss or another interdental cleaning aid.
• Swish with an antibacterial mouthwash.
• Know your risk factors: age, smoking, diabetes, diet, and genetics can all increase your risk for periodontal disease.
• Get an annual comprehensive periodontal evaluation from a periodontist to detect gum disease early.

“While these findings are preliminary and do not prove cause and effect in humans, they reinforce an important message: periodontal disease is a chronic inflammatory disease that affects more than the mouth,” Giglio said.

“As periodontists, we are uniquely trained to diagnose and treat this inflammation, helping patients preserve both their oral health and potentially their overall health,” she added.