How Gum Disease and Coronary Artery Calcification Are Linked—And What You Can Do About It

If you’re in your mid-50s to late 60s and have been told your cholesterol levels—including LDL—are “normal,” you might assume your heart health is on solid ground. But emerging science shows that gum disease and coronary artery calcification can be quietly connected—even when traditional risk markers look fine. This link isn’t about plaque buildup from fat alone; it’s about low-grade, persistent inflammation that starts in the gums and travels through your bloodstream, gently but steadily encouraging calcium deposits in your coronary arteries. For adults aged 55–69, this process may progress faster than expected—not because of what’s in your diet or genes alone, but because of what’s happening in your mouth.

A common misconception is that gum disease is just about loose teeth or bad breath—that it’s “cosmetic” or “not serious.” Another is that if your LDL cholesterol is under 100 mg/dL and you don’t have high blood pressure, your arteries are likely safe. Neither is fully true. In fact, studies show that adults with moderate-to-severe periodontitis have up to a 20% higher likelihood of developing coronary artery calcification over five years—even with normal LDL.

Why Gum Disease and Coronary Artery Calcification Go Hand-in-Hand

Chronic gum disease (periodontitis) isn’t just localized infection—it’s a source of systemic inflammation. When bacteria like Porphyromonas gingivalis thrive below the gumline, they trigger immune cells to release inflammatory signals, including interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hs-CRP). These molecules circulate widely and can activate vascular smooth muscle cells in coronary arteries, prompting them to take up calcium and form microcalcifications. Over time—and especially with age-related changes in immune regulation—these deposits accumulate, stiffening arteries and raising long-term cardiovascular risk.

Importantly, this process doesn’t always raise blood pressure right away, nor does it reliably elevate LDL. That’s why it’s often missed in routine checkups. Yet coronary artery calcification (CAC), measured by a simple, non-invasive CT scan, is one of the strongest predictors of future heart events—more reliable than many standard lab tests for people in this age group.

How to Measure and Monitor the Connection

Dentists and primary care providers now have practical tools to assess risk earlier:

• Dental screening: A periodontal exam measuring pocket depth (>4 mm), bleeding on probing, and bone loss on X-rays helps identify active, chronic gum disease.
• Blood biomarkers: hs-CRP above 2.0 mg/L and IL-6 >2.5 pg/mL—especially alongside elevated fibrinogen—suggest ongoing systemic inflammation tied to oral sources.
• Cardiac imaging: A coronary artery calcium (CAC) score is recommended for asymptomatic adults aged 55–69 with at least one additional risk factor (e.g., hypertension, smoking history, or family history of early heart disease). A score >100 Agatston units signals moderate plaque burden—even with normal LDL.

Notably, research shows that treating gum disease reduces hs-CRP by an average of 30% within six months—underscoring how impactful oral care truly is.

Who Should Pay Special Attention?

Adults aged 55–69 who have any of the following should consider a closer look at both oral and heart health:

• A history of gum recession, frequent gum bleeding, or tooth loss (especially multiple teeth)
• Elevated hs-CRP or unexplained fatigue, joint aches, or “brain fog”
• Type 2 diabetes or prediabetes (which amplifies both gum inflammation and arterial calcification)
• A family history of early heart disease (before age 60)

Women in this age group also deserve special attention: hormonal shifts after menopause can reduce gum tissue resilience and alter immune responses, making the oral-systemic connection even more relevant.

Practical Steps You Can Take—Starting Today

You don’t need drastic changes—just consistent, gentle habits:

• Brush twice daily with fluoride toothpaste and clean between teeth daily—floss, interdental brushes, or water flossers all help reduce bacterial load.
• See your dentist every 3–4 months if you’ve had gum disease before—more frequent cleanings significantly lower inflammatory burden.
• Ask about hs-CRP testing at your next physical, especially if you’ve had persistent gum issues or unexplained fatigue.
• Eat whole foods rich in polyphenols and omega-3s, like berries, leafy greens, walnuts, and fatty fish—these support both gum and vascular health.
• Stay hydrated and manage stress, since both influence oral microbiome balance and systemic inflammation.

Tracking your blood pressure trends can help you and your doctor make better decisions. Consider keeping a daily log or using a monitoring tool to stay informed.
If you notice persistent gum swelling, bleeding that doesn’t improve after 10 days of careful cleaning, shortness of breath with mild exertion, or unexplained chest tightness—even briefly—please see your doctor or dentist promptly.

The good news? This pathway is modifiable. With early awareness and consistent care, you can slow—or even pause—this silent progression. If you're unsure, talking to your doctor is always a good idea.

FAQ

#### Does gum disease cause coronary artery calcification directly?

Not alone—but chronic gum disease contributes to systemic inflammation (elevated IL-6 and hs-CRP), which promotes calcium deposition in coronary arteries over time. It’s one important piece of the puzzle, especially in adults with otherwise normal LDL.

#### Can gum disease and coronary artery calcification be reversed?

While existing calcium deposits aren’t removed by treating gum disease, studies show that reducing oral inflammation slows further progression of coronary artery calcification—and improves endothelial function.

#### Is there a test that links gum disease and coronary artery calcification?

No single test connects them directly, but combining a periodontal assessment + hs-CRP blood test + CAC scoring gives clinicians a powerful, integrated picture of risk.

#### How often should adults 55–69 get screened for gum disease and coronary artery calcification?

Annual dental exams are ideal—and more frequent visits (every 3–4 months) if you have a history of gum disease. A baseline CAC scan is reasonable for those aged 55–69 with additional risk factors, typically repeated every 5 years if initial score is low.

#### Does flossing really affect heart health?

Yes—consistently removing plaque between teeth lowers bacterial load and associated inflammation. Population studies link regular interdental cleaning with lower hs-CRP and slower CAC progression over time.