Guide to gums and health
Gum disease and heart disease: what is known about the link to heart attacks
Gum disease and heart disease are statistically linked. In studies, people with periodontitis, the advanced form of gum disease, have more cardiovascular disease and more heart attacks. It has not been proven, however, that inflammation in the mouth causes these problems.
This guide explains what is known and what heart patients should bear in mind at the dentist.
Key points at a glance
- The link is well established: people with periodontitis have cardiovascular disease more often, even allowing for smoking and diabetes.
- Whether periodontitis causes heart disease is an open question.
- Treatment lowers inflammation markers in the blood. It has not been shown to protect against a heart attack.
- If you have a heart condition, tell us about your medicines before any dental treatment. Never stop blood thinners on your own.
What periodontitis is
When gum inflammation reaches the bone
Periodontitis usually starts as gingivitis, inflamed gums caused by bacterial plaque along the gum line. Gingivitis can heal again. If it persists, it can spread to the tissues that hold the teeth in place: that is periodontitis. Gum pockets form, and the bone around the teeth breaks down. Periodontitis does not heal on its own. Early detection can stop it getting that far.
Why periodontitis can go unnoticed for years
Periodontitis usually progresses slowly, often over years, and causes no pain for a long time. Symptoms often appear only late. Our guide to gum health explains the signs of gum disease. If you have sudden pain or swelling in your gums, please contact us straight away.
How gum disease and heart disease may be connected
Research on periodontitis and heart disease discusses three pathways. They explain why a link is possible. They do not prove it.
Bacteria from inflamed gums can enter the bloodstream
Bacteria from inflamed gums can get into the bloodstream. This happens in everyday life, for example when chewing or brushing your teeth. With periodontitis, it happens more often and lasts longer. Researchers have found traces of mouth bacteria in deposits inside blood vessels.
Inflammation that reaches beyond the mouth
Periodontitis is a chronic inflammation. It raises inflammation markers in the blood, such as C-reactive protein (CRP). In this way, it probably also puts a strain on the inner lining of the blood vessels. That is how gum inflammation could affect the cardiovascular system.
Smoking, diabetes and age as shared risk factors
Periodontitis and cardiovascular disease share risk factors, such as smoking, diabetes and older age. Part of the link probably comes down to these factors.
What studies show about gum disease and heart attacks
On periodontitis and heart attacks, specialist societies draw a clear line between observation and proof.
What is well established
Observational studies find coronary heart disease and heart attacks more often in people with periodontitis, regardless of smoking and diabetes. The European Federation of Periodontology (EFP) and the World Heart Federation said so in 2020. The American Heart Association confirmed this in a new statement at the end of 2025. It also describes the link with stroke, atrial fibrillation and heart failure. In the Swedish PAROKRANK study from 2016, 43 per cent of people who had a first heart attack had periodontitis. In the control group, it was 33 per cent.
What has not been proven
It has not been proven that periodontitis causes heart attacks. Nor is there evidence that treatment prevents them. A Cochrane review from 2022 found only two studies on this, both with a high risk of bias, and reached no conclusion. What is established is narrower: after treatment, inflammation markers such as CRP fall, at least for a while. Short-term studies also show that the inner lining of the blood vessels works better.
Is the link a myth?
No. The link is well documented, but a link is not the same as a cause. Two diseases can occur together without one triggering the other. Smoking, for example, raises the risk of both. Only large studies, in which one group is treated and another is not, can settle the question. Such studies are still missing.
Why oral health and general health are connected
Oral health and general health cannot be neatly separated. This has been studied most closely in diabetes.
Periodontitis and diabetes affect each other
Here the link works both ways. Diabetes makes periodontitis more likely. Conversely, in studies people with diabetes and periodontitis have higher long-term blood sugar levels (HbA1c). After periodontitis treatment, this value falls slightly in the first few months. This is set out in the 2018 consensus report of the EFP and the International Diabetes Federation.
At our clinic, Dr Arno König's longevity medicine looks beyond the mouth. The aim is to detect degenerative diseases before symptoms appear.
What to know about dental treatment if you have a heart condition
The following advice is general and no substitute for talking to your doctor.
Do not stop blood thinners on your own
Never stop blood thinners on your own before dental treatment. Without them, the risk of a blood clot rises. For procedures with a low risk of bleeding, a pause is usually not needed. If one is needed after all, the prescribing doctor decides. Before every treatment, tell us about all the medicines you take.
Artificial heart valves and antibiotic prophylaxis
Endocarditis is an inflammation of the inner lining of the heart, often affecting the valves. People with an artificial heart valve, previous endocarditis or certain congenital heart defects are at particularly high risk. Under the 2021 Swiss recommendations, only this group takes an antibiotic before certain dental treatments and dental hygiene. Your doctor fills in the endocarditis card (Endokarditis-Ausweis) for this. Bring it to every appointment.
Tell your GP and cardiologist about gum disease
The consensus report of the EFP and the World Heart Federation recommends that doctors and dentists coordinate with each other. So tell your GP or cardiologist if you have periodontitis. And tell us if you have a heart condition.
If you suspect a heart attack, call 144 straight away
Severe pressure or burning pain in the chest can be a sign of a heart attack. This is especially true if it lasts longer than 15 minutes. In women, older people and people with diabetes, the signs are sometimes different. They include shortness of breath, nausea and pressure in the back or abdomen. In that case, call 144, the Swiss ambulance number, at once and stay on the line.
What we offer for inflamed gums
We work out which treatment you need at the examination. Three of our services matter most here.
- Check-up: an examination picks up gum disease early, often before it hurts. Read more about early detection at a dental check-up.
- Dental hygiene: ultrasound loosens plaque and tartar, including below the gum line. AirFlow removes stains. Find out what happens during dental hygiene and what it costs.
- Laser: once the gum pockets have been cleaned with ultrasound, the laser kills bacteria. There is hardly any bleeding. More on how the laser treats inflamed gum pockets.
Frequently asked questions about gum disease and heart disease
Is your question not listed? Call us or send us an email.
+41 44 915 17 77Can gum disease cause a heart attack?
That has not been proven. People with periodontitis do have more heart attacks, even allowing for smoking. But studies have not yet shown that inflammation in the mouth triggers them.
Does treating gum disease lower the risk of heart disease?
There is no reliable evidence for this. All that is proven is that inflammation markers in the blood fall for a while after treatment. Treatment is worthwhile for your teeth and gums anyway.
Can a gum infection spread to the heart?
In everyday life, mouth bacteria repeatedly enter the blood for a short time, more often when the gums are inflamed. They settle more easily on a damaged or artificial heart valve. That is why people at high risk carry an endocarditis card.
Do I need antibiotics before dental treatment if I have a heart condition?
Only if you are in the high-risk group, for example with an artificial heart valve or after endocarditis. Your endocarditis card then names the antibiotic for certain treatments. For everyone else, Swiss specialist societies do not recommend one before dental treatment.
Should I stop taking blood thinners before dental treatment?
Not on your own. For many procedures with a low risk of bleeding, you keep taking your medicines as usual. The doctor who prescribed them decides whether a pause is needed.
Does Swiss basic health insurance pay for gum disease treatment if I have a heart condition?
Usually not: the KLV, the ordinance on what basic health insurance (Grundversicherung) covers, does not list periodontitis in adults as such. An exception applies if dental treatment is needed to support medical treatment, for example when a heart valve is replaced or in endocarditis (KLV Article 19). Ask your health insurer first. We bill transparently under the Dentotar tariff, with our tax point value (Taxpunktwert) of CHF 1.13.
Should my GP or cardiologist know that I have gum disease?
Yes. The 2020 consensus report recommends that doctors ask people with heart disease about periodontitis. Your doctors and dentists can then coordinate medicines and dental procedures better.
Have your gums checked
A check-up at Zahnklinik Küsnacht shows whether your gums are inflamed. If you have a heart condition, please bring your list of medicines and your endocarditis card, if you have one.
Sources and last update
This article does not replace a medical or dental examination. It is based on the following sources, as of September 2026.
- Consensus report on periodontitis and cardiovascular diseases, EFP and World Heart Federation, 2020
- Scientific statement on periodontal disease and atherosclerosis, American Heart Association, 2025 (replaces the 2012 version)
- PAROKRANK study on first heart attacks, Circulation, 2016
- Review of periodontal treatment and cardiovascular disease, Cochrane, 2022
- Consensus report on periodontitis and diabetes, EFP and International Diabetes Federation, 2018
- Recommendations on endocarditis prophylaxis, Swiss specialist societies, 2021
- Endocarditis and emergency advice, Swiss Heart Foundation (Schweizerische Herzstiftung)
- Gingivitis and periodontitis, Swiss Dental Association (SSO)
- Swiss health insurance benefits ordinance (Krankenpflege-Leistungsverordnung, KLV), Articles 17 to 19
Related pages
- Causes and warning signs of bleeding gums
How to recognise inflamed gums.
- Check-ups and prevention for teeth and gums
What we examine at a check-up.
- Dental hygiene for plaque below the gum line
Ultrasound, AirFlow and the costs.
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