Gum Disease & Heart Disease
The Systemic Connection

We begin every new patient visit with a thorough medical and medication history review. For patients with cardiovascular disease, this includes current anticoagulant or antiplatelet medications (warfarin, aspirin, clopidogrel), any history of heart attack, stroke, stent placement, or valve surgery, and whether antibiotic prophylaxis is indicated before dental procedures. This review directly shapes our treatment planning — it is not a form-filling exercise.

We perform comprehensive full-mouth periodontal charting, measuring pocket depths at six points per tooth, recording bleeding on probing, recession, furcation involvement, and tooth mobility. Digital periapical radiographs assess bone levels throughout the mouth. Patients with cardiovascular disease often have an elevated systemic inflammatory burden, and identifying the extent of periodontal infection allows us to quantify how much of that burden originates from the mouth.

Our scaling and root planing protocol for cardiac patients emphasises thorough removal of all subgingival calculus and biofilm using a combination of ultrasonic scalers and hand instruments under local anaesthesia. We are particularly thorough because periodontal pathogens — including Porphyromonas gingivalis and Treponema denticola — are among the bacteria found in atherosclerotic plaques. Effective periodontal treatment reduces the seeding of these bacteria into the bloodstream and lowers systemic CRP levels.

We communicate directly with your cardiologist or primary care physician to share periodontal findings and confirm the appropriate approach to anticoagulant management before any invasive procedures. For patients at risk of infective endocarditis — including those with prosthetic heart valves or a history of prior endocarditis — we confirm prophylactic antibiotic protocols per current AHA guidelines before every surgical or invasive dental appointment.

Cardiac patients are enrolled in a strict 3-month periodontal maintenance schedule. At each visit we update pocket charting, perform targeted debridement, and inquire about any changes in cardiac medications or health status since the last visit. We track systemic inflammation markers where available and note any changes in gum health that may correlate with changes in cardiovascular status. This ongoing monitoring ensures that the mouth never becomes a silent driver of systemic inflammation.