Oral Microbiome Triggers Atherosclerosis

It doesn’t start with chest pain. Not with an EKG. Not with the first heart attack but much earlier, and in a completely unspectacular way: while chewing. While swallowing. With plaque building up between the molars. Because that’s where it lives: the oral microbiome. A world of its own. Billions of bacteria—most harmless, some not. And it’s precisely those few Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola that can lead to far bigger problems down the line.

Because they don’t stay in the mouth. They take any opportunity to enter the body. Small inflammations, microscopic tears in the gums that’s all it takes. And then? The process begins.

Once in the bloodstream, these bacteria trigger an immunological chain reaction. The body recognizes them as foreign as it should. But it overreacts. Chronic inflammatory processes develop. And they act exactly where they shouldn't: in the walls of blood vessels.

Atherosclerosis meaning the hardening and narrowing of the arteries is not just a fat problem. It is an inflammatory disease. And this is where oral bacteria come into play. They activate immune cells, destabilize plaques, promote the buildup of deposits, and even alter gene expression in the endothelium.

In short: what many consider purely a cholesterol issue is also a bacterial one often originating in the mouth. And it travels unchecked through the circulatory system, straight to the heart. Or the brain.

The research is clear: oral bacteria have been directly identified in atherosclerotic plaque material. And yet few cardiologists ask about dental status, and few dentists think about vascular health.

But this is where a new form of prevention could begin non-invasive, low-cost, and above all: interdisciplinary. The dentist as a vascular protector. The cardiologist as a microbiome expert.

Because the next heart attack might not start on your plate but on your toothbrush.