An inflammation of a wisdom tooth could lead to severe bacterial endocarditis, which nearly killed her in heart failure and eventually led to major open-heart surgery to repair the heart valve. This sounds unbelievable, but it really happened to an 18-year-old girl, Gu Tingting (a pseudonym).
Wang Ningfu, director of the cardiology department at Hangzhou First Hospital, said that oral diseases such as gingivitis and periodontitis may trigger heart diseases such as myocarditis and endocarditis. Especially for people with underlying heart disease and poor resistance, it is important to pay attention to oral health.
Inflammation of wisdom teeth causes serious heart disease
An 18-year-old girl, Gu Tingting, a freshman at a university in Hangzhou, had an inflammation of her left lower jaw wisdom tooth more than two months ago, and the gums around the tooth became red and inflamed. At that time, Tingting was afraid to go to the dentist, so she took some anti-inflammatory drugs. However, after several days, the situation still did not improve.
In this way, Tingting’s gum inflammation lasted for nearly a month, and then she suddenly started to have a fever, with a temperature of 39 degrees Celsius or more, and symptoms of chest tightness and fatigue, much like a cold. It was only when she felt difficulty in breathing one night while sleeping that she woke up her dorm-mates and took her to the hospital overnight.
When she arrived at the hospital emergency room, the doctor briefly inquired about Tingting’s condition and immediately examined her, but found that her heart rate was significantly faster than normal, as high as 120 to 130 beats per minute, and there was a clear heart murmur. Further examination revealed that Tingting’s heart valves were severely corroded and damaged, resulting in incomplete heart valve closure and heart failure, which was eventually diagnosed as bacterial endocarditis.
Before that, Ting had never had any serious illnesses, let alone any underlying heart disease, so why did she suddenly develop bacterial endocarditis? It turned out that it was the inflamed wisdom tooth that was the cause of all this.
Wang Ningfu, director of the cardiology department at Hangzhou First Hospital, said Tingting started with an inflamed wisdom tooth in her left lower jaw and a serious local gum infection. These bacteria entered the bloodstream and reached the heart through blood circulation, leading to bacterial infection and corrosion of the heart valves, which gradually evolved into bacterial endocarditis.
Ting’s condition was so critical that doctors first cut open Ting’s left lower jaw gums to drain the abscessed blood there, and then used high doses of antibiotics to kill the bacteria in the blood. However, the heart valve, which had been damaged, had to be repaired through surgery.
Last month, Ting underwent major open-heart surgery at a city hospital to remove the blood clots and inflammation from the heart lining and then repair the heart valves.
Poor oral health has a high chance of heart disease
Researchers at University College London did a “Scottish Health Survey” with more than 11,000 participants (average age 50 years old). During the 8-year follow-up, 555 participants suffered from serious heart disease, 170 of which were fatal. Experts found that those who never or rarely brushed their teeth were 70% more likely to develop heart disease than those who brushed twice a day.
In addition, poor oral hygiene and bleeding gums can bring more than 700 types of bacteria into the body’s bloodstream and through the bloodstream. Among them are inflammatory factors that produce inflammation in the walls of coronary blood vessels and predispose to the formation of atherosclerosis, which can lead to coronary artery disease. These bacteria also stimulate the immune system and inflame and narrow the walls of the arteries or adhere directly to the fatty deposits in the blood vessels, further blocking them.
”Oral diseases such as gingivitis and periodontitis do not cause heart disease per se, but inflammatory gum infections produce a large number of harmful bacteria in the mouth, such as streptococcal infections, and the inflammatory factors can lead to allergic reactions and induce inflammation of the heart muscle. These bacteria start out just in the mouth and progress to the larynx, triggering tonsillitis, which in turn affects the heart and typically lasts a week to two weeks from the onset of the disease.”
Director Wang Ningfu said that heart disease caused by inflammation of the mouth leading to metaplasia is relatively common, but as long as timely medical attention is sought, the condition is usually not too serious. Repeated episodes of such a condition, however, can also lead to chronic rheumatic heart disease, most of which requires surgical treatment.
”In addition, for some patients whose heart itself is not so good, with cardiomyopathy, cardiovascular malformations, congenital heart disease and other underlying diseases, or people who originally had poor resistance, oral inflammatory infections can bring harmful bacteria into the bloodstream and reach the heart lining through the blood circulation, triggering bacterial endocarditis, which can even lead to heart failure and death in severe cases. “
Once tooth inflammation should be treated before it is too late
”The occurrence of bacterial endocarditis is often related to oral inflammation, and about 50% of bacterial endocarditis, is caused by oral inflammatory infections. Patients like this are seen in nearly 10 cases in the clinic each year, and Ting Ting is a very typical example.”
Director Wang Ningfu said that patients with heart disease caused by oral inflammatory infections tend to be mainly young and middle-aged people, aged between 20 and 40 years old. Because this age group, generally do not pay attention to their oral health status, gingivitis, periodontitis and other oral diseases are more prevalent. Relatively speaking, older people have a relatively small percentage of incidence because of tooth loss and other reasons.
Director Wang Ningfu reminded that once the gums become inflamed and infected, they must be treated in a timely manner. It is especially important to pay attention to inflammation of the gums of the wisdom teeth because they are located from the root of the nose to the two sides of the jaw, a location called the “danger triangle”, where the veins lead directly to the skull. Once the gums in this area become inflamed, harmful bacteria can quickly enter the bloodstream through the intracranial vessels. Moreover, the gum area is harder than other parts of the body and has very little space flexibility, so once an abscess occurs there is no room for growth and the bacteria from inflammation will soon be squeezed into the bloodstream.
Director Wang Ningfu suggests that if wisdom teeth grow in an inclined position, which can easily trigger inflammation and infection in the surrounding gums, they should be extracted before it is too late to avoid an increased risk of heart disease.