Researchers have for decades been investigating the correlations between gum disease and a variety of conditions including stroke, hypertension and cardiovascular disease. A new study is now reporting the results of a randomized pilot trial that found a plaque-identifying toothpaste can potentially lower levels of systemic inflammation by improving a person’s brushing efficacy.
A large volume of epidemiological studies have long identified a correlation between poor oral hygiene and cardiovascular disease, stroke and hypertension. Some researchers suggest this link is not causal, but instead indicates the presence of certain lifestyle factors that can lead to general disease. So periodontal disease instead may be a signpost of poor health and hygiene behaviors that subsequently increase a person’s risk for developing heart disease.
One hypothetical mechanism by which gum disease may directly contribute to cardiovascular disease is by increasing systemic inflammation. An effective biomarker of systemic inflammation in a human body is elevated levels of C-reactive protein (CRP), and high CRP levels have been cited as an independent risk factor for cardiovascular disease. Studies have also clearly shown periodontal disease to contribute to increases in CRP levels.
So, all this goes to at least present a hypothetical mechanism through which gum disease can be linked to general health via elevations in systemic inflammation.
This new study, published in The American Journal of Medicine, explored what effect a particular plaque-identyfying toothpaste had on reducing CRP levels, compared to a regular toothpaste. Plaque HD was the novel toothpaste tested in the study for its unique ability to highlight plaque while a person is cleaning their teeth. The maker of the toothpaste claims PlaqueHD is twice as effective at removing plaque as conventional toothpaste, making it a useful product to evaluate the link between more effective teeth cleaning and CRP levels.
The trial recruited around 100 subjects, randomized into two groups, one using the PlaqueHD toothpaste for 30 days, and the other acting as placebo using conventional toothpaste for 30 days. CRP levels were evaluated at the beginning and end of the trial period.
The results interestingly found statistically significant decreases in CRP levels in the PlaqueHD group compared to placebo, only in subjects displaying elevated CRP levels at baseline. This suggests more effective teeth cleaning may reduce CRP levels, but only in those already showing high levels of systemic inflammation.
All this study essentially tells us is that better teeth cleaning can possibly lower levels of a biomarker linked to systemic inflammation. Charles Hennekens, from Florida Atlantic University and senior author on the new study, notes any further claims suggesting this particular toothpaste could reduce risk of heart attack or stroke would need more specific research.
"Whether this plaque-identifying toothpaste decreases heart attacks or strokes requires a large-scale randomized trial of sufficient size and duration,” says Hennekens. “These results provide a stronger rationale to conduct such trials. If positive, the results of these trials would have significant potential clinical and public health implications."
Despite this study’s focus on a very particular brand of plaque-identifying toothpaste, the researchers do clearly state the research is independent and not funded by the toothpaste company.
“Neither the funding source nor the distributor of the toothpaste had any role in the design, conduct, analysis, interpretation, preparation of the manuscript, or in the decision where to submit,” the study is clear to note.
Planning is underway to conduct a trial specifically focused on investigating whether the PlaqueHD toothpaste can directly reduce progression of atherosclerosis in the coronary and carotid arteries. This research will certainly hope to add to the growing connections between oral hygiene and heart disease.
The new research was published in the American Journal of Medicine.
Source: Florida Atlantic University
