Dr Child's Casebook: Heartfelt Connections - Dental Decay and Heart Disease
All roads lead to the heart, they say, including the route ferrying oral bacteria from the mouth. And, as the bacteria travel through the blood stream, trouble may be in store. Many medical studies have proven a link between oral hygiene and heart disease, specifically bacterial infections which jeopardise the heart valve. Of course, an already compromised heart valve is at heightened risk, as a patient recently discovered when speaking to Dr Child.
Q: During lockdown, I have lost a filling in one of my molars for the third time, and was wondering if this required emergency treatment or if I could wait. I have a floppy heart valve, and my brother who also had Marfan syndrome died in hospital of heart trouble secondary to tooth problems.
A: As we all know, Fibrillin deficiency in Marfan syndrome affects the whole body in various ways. Infected teeth are a prime source of bacteria, which enter the blood stream and end up on the heart valve. If the valve is abnormal, and has extra folds as in a floppy leaking heart valve, then the bacteria land on the valve, and grow. The infected valve becomes scarred and shrinks, and develops a larger leak. Also, small emboli (parcels of infected material) can break off and travel elsewhere in the body.
This infection is called endocarditits, and should be prevented by good oral hygiene and regular dental treatment. This patient was advised to contact her dentist’s surgery, explain that she was at high risk of heart infection, and ask to be referred for emergency dental treatment during lockdown.
It is not uncommon for a dentist to be the first person to suspect a diagnosis of Marfan syndrome. Frequent problems are a high arched palate, with crowded teeth, prominent lower jaw, and a tendency for the lower jaw to sublux or dislocate. Marfan syndrome patients also have a tendency to periodontal recession and infection.
Further information can be obtained from our Dental Guide to Marfan Syndrome. These pamphlets can be taken to your dentist to explain the increased need for regular dental check-up.