When you think of heart-healthy habits, what comes to mind? Weight control? A regular workout routine? A nutritious diet? All of these details play an important role in protecting your ticker, but there’s another factor you might not have considered: your teeth.

“When you don’t take care of your oral health, especially your gums, you may end up with infection and inflammation,” says Eugene Gamble, BDS, MClinDent, a dental periodontist and member of the Royal College of Surgeons of Edinburgh. That inflammation can then “interfere with the control of blood sugar,” he explains, which could increase your risk of a heart attack or stroke in the long run if it remains unaddressed.

Put another way: “The bacteria in your mouth doesn’t just stay there,” says Tiffanie Garrison-Jeter, DMD, owner of Definition Dental Studio. “It can travel in your bloodstream when you have gum inflammation and bleeding, triggering inflammation in heart vessels” and, over time, the growth of plaque in your arteries that can contribute to blood clots, heart attacks, and strokes.

The Vicious Cycle Between Blood Sugar Levels and Oral Health

The relationship between dental health and blood sugar “isn’t a one-way street,” says Dr. Gamble. “We know that poorly controlled blood sugar can also increase the likelihood of dental issues,” he explains.

Why? Saliva contains glucose, and when your blood sugar levels are out of range, high glucose levels in your mouth can help harmful bacteria grow, especially as they combine with food to form plaque—which, by the way, tends to thrive more easily when you’re eating sugary and starchy foods. When left unchecked, plaque can cause tooth decay, cavities, bad breath, and even gum disease (the latter of which can take more time to heal if you have diabetes).

Bottom line: Poor oral health and high blood sugar can essentially feed off of one another, creating a “vicious cycle” wherein each one exacerbates the other the longer they’re both unmanaged, explains Paul Springs, DMD, prosthodontist and co-owner of Dr. Mondshine & Associates.

What Your Mouth Can Tell You About Your Heart Health

For starters, dry mouth is a common concern that can be caused by a variety of factors, including certain medications (particularly those that help manage high blood pressure) and cancer treatments, as well as some chronic conditions, such as diabetes. The exact relationship between diabetes and dry mouth isn’t fully understood, but some researchers point to the fact that people with diabetes often deal with dehydration, while others theorize that blood sugar levels may play a role, too.

In addition to dry mouth, glossitis (a.k.a. inflammation of the tongue), excessive gum bleeding, bone loss around the teeth, and angular cheilitis (a.k.a. inflammation at the angles of the lips) can all be potential signs of uncontrolled diabetes, among other conditions, says Dr. Gamble.

Diabetes aside, though, if your gums are constantly tender, puffy, and bleeding, that might also be a sign that it's time to double-check your blood pressure. A recent study published in Hypertension, a journal of the American Heart Association (AHA), found that periodontitis (a.k.a. severe gum disease) is linked to high blood pressure in otherwise healthy people.

For the study, researchers looked at 250 adults with severe gum disease and a control group of 250 people without gum disease, all of whom were otherwise healthy. Each person underwent a comprehensive dental exam and three blood pressure readings to ensure accuracy. Results showed that those with gum disease were about twice as likely to have high blood pressure compared to people with healthy gums, regardless of cardiovascular risk factors like family history of disease, smoking, physical activity levels, and age.

Plus, if you already have hypertension, some research suggests that a lack of oral care might affect your ability to manage your blood pressure. In a 2018 study published in Hypertension, researchers reviewed medical and dental records from over 3,600 people with high blood pressure and found that those with gum disease were 20% less likely to reach healthy blood pressure ranges compared to people without gum disease.

Despite these findings, “we don’t fully understand the relationship between gum disease and blood pressure,” says Dr. Gamble. “One theory is that the gum inflammation reaction creates free radicals [unstable atoms that can damage cells and lead to illness] that can then affect a person’s blood pressure,” he explains. But overall, many studies on the subject have had inconsistent designs and methodologies, so there’s a lot more to learn before we can come to any conclusions.

Heart-Healthy Habits That Your Teeth Will Love, Too

In many ways, taking care of your teeth means taking care of your heart—and vice versa.

You’ve probably heard the usual dental care advice ad nauseam: brush your teeth at least twice a day, floss at least once a day, and see your dentist every six months. But considering how little you see your dentist, home dental care is arguably even more important than cleanings and check-ups, says Dr. Garrison-Jeter.

So, what can you do at home to take the best possible care of both your teeth and your heart? Here are a few expert-approved tips.

• First, address underlying chronic conditions. Now that you know your blood pressure and blood sugar could be related to your oral health, take whatever steps you need to manage these numbers, whether that means making certain lifestyle changes or considering a new medication, says Dr. Gamble. “Taking corrective action with the underlying systemic condition will have the dual benefit of assisting both general and oral health,” he explains. (Find out how One Drop’s blood pressure insights and glucose forecasts can help you spot trends and proactively reduce your risk of complications.)
• Stay hydrated. Drinking water throughout the day is always a good idea, but it’s an especially important part of oral care. Proper hydration strengthens your teeth, keeps your mouth clean, and it can help fight dry mouth by “neutralizing acid buildup in the mouth, which can cause inflammation and caries [tooth decay],” explains Christine Songco, a registered dental hygienist (RDH) and certified health and wellness coach in California.
• Avoid rinsing after brushing your teeth. Water is your friend, but not necessarily right after brushing your teeth. Rinsing your mouth after brushing “is a common mistake,” says Dr. Gamble. “By rinsing, you remove the protective ingredient that’s present in toothpaste,” he explains. Instead, spit out the excess toothpaste and wait at least 30 minutes before doing a full rinse.

• Focus on whole foods over refined carbs and processed sugar. Reminder: Starchy, sugary, and carb-heavy foods can wreak havoc on your blood sugar levels and your teeth (that includes sugary drinks, by the way!). Songco recommends incorporating more whole foods (think: whole grains, fresh fruits and veggies, lean meat) into your meals whenever you can. As always, though, talk to your doctor before changing up your diet to make sure it’s right for your body.

This article has been clinically reviewed by Jamillah Hoy-Rosas, MPH, RDN, CDCES, and VP of clinical operations at One Drop.