At the heart of the matter

Could oral indicators of CVD improve preventive healthcare?

We all know that oral and heart health are linked. There has been much research on the topic over the years, though more is needed to determine the exact mechanisms involved. I was interested to read recently about how a mouth rinse could be used to assess a patient’s risk of heart problems.

The concept is based on a study[i] that explored the oral inflammatory load and whether this could predict vascular function in young adults. The cross-sectional and correlational analysis looked at 28 systemically healthy 18 to 30-year-olds. Mouth rinse samples were collected from each participant and tested for oral neutrophils – white blood cells – which are a validated measure of oral inflammatory load. Researchers also tested participants for blood pressure, arterial stiffness and endothelial function (brachial artery flow-mediated dilation), which is a known early risk factor for cardiovascular disease (CVD).

The study found a link between high oral neutrophil counts in the mouth rinse sample and impaired endothelial function. This suggests that testing for oral neutrophils in mouth rinse could indicate risk of heart problems in the future.

Of course, this line of research requires further study before it can be reliably implemented within the dental or healthcare workflow. For a start this was a small-scale study and the first of its kind as far as I’m aware. However, it offers an exciting new way of supporting the preventive healthcare we professionals dream of. It is the latest in a line of scientific findings that show just how important the mouth is for the health of the entire body. It’s also another way to integrate dental and general healthcare, promoting a truly holistic approach.

Such a risk assessment could also prove useful for patient education – especially if it works from such a young age as 18. If we have a quantitative measure that clearly defines a patient’s risk of CVD, this offers gravitas for our professional recommendations and may help to persuade patients of the need to make and maintain positive lifestyle changes. As this year’s World Heart Day campaign promotes, is it essential for patients to know their own hearts and how to keep them healthy.

Until such a time when this or a similar test becomes available to dental professionals, it remains our duty to help patients achieve and maintain high standards of oral health for the good of their mind and body. With regards to optimising heart health in particular, this includes avoiding or treating gingival diseases through excellent plaque control and regular dental or dental hygiene appointments. A thorough at-home oral hygiene routine with clinically proven products and professional support as necessary remains the gold standard for all patients.

For further information please call EndoCare on 020 7224 0999 or visit

Author: Dr Michael Sultan BDS MSc DFO FICD is a Specialist in Endodontics and the Clinical Director of EndoCare


[i] Ker-Yung H, Avin G, Yixue M, Jennifer WS, Dina A, Forsyth J, Kevin W, Wyeld T, Chunxiang S, Glogauer M, King TJ. Oral inflammatory load predicts vascular function in a young adult population: a pilot study. Frontiers in Oral Health. 2023;4. DOI=10.3389/froh.2023.1233881   

Live, hands-on EndoPerfection education is back

EndoPerfection is delighted to announce that its live training events are back on. ‘Hands-On Rotary Endo Training’ is a one-day, hands-on endo session using a combination of lectures and live instruction.

The day includes:

  • Introduction to modern concepts of endo, including safe irrigation techniques
  • Easy rubber dam placement
  • Identifying the myths of apex locators and an easy way to use them confidently
  • Hands-on rotary training, using Endoperfection’s VaryFlex files
  • Training carried out on 3D printed replicas of actual teeth that feel just like the real thing
  • Use of a state-of-the-art rotary and reciprocating cordless motor
  • Up-to-the-minute obturation techniques with warm obturation units available to try
  • The latest in bioceramic sealants and repair materials.

Upcoming events are planned for:

  • 7 May in Birmingham
  • 20 May in Newcastle
  • 9 June in Cardiff
  • 25 June in Leeds
  • 2 July in Central London.

For further information and to book your place, visit