From Mouth to Heart: Understanding the Oral link to Infective Endocarditis
- Aiman Saleem
- Jul 6
- 2 min read
Infective endocarditis is a rare but serious infection of the inner lining of the heart, mostly affecting the heart valves. The condition occurs when microorganisms enter the bloodstream and adhere to the endocardium, including the heart lining, valves, or blood vessels. Although the disease is uncommon, individuals with underlying cardiac conditions such as previous heart valve surgeries and congenital heart disease are at a greater risk of complications if they develop infective endocarditis. While multiple health and lifestyle factors contribute to the development of infective endocarditis, oral health is a key consideration due to its role in the introduction of bacteria into the blood.
The oral microbiome contains over 700 different bacterial species, some of which can enter the body following mucosal or gingival trauma. This can occur in both healthy individuals and those at risk; however, individuals with predisposing cardiac conditions may have a higher likelihood of infection following episodes of trauma. Gingival or mucosal trauma may occur during dental procedures such as extractions, apical or periodontal surgery, caries removal, dental prophylaxis, and endodontic treatments (Bumm & Folwaczny, 2021). In addition to procedure related trauma, daily oral activities such as tooth brushing, flossing, and chewing may also introduce bacteria into the bloodstream, classified as bacteremia.
Although bacteremia associated with both dental procedures and daily oral activities is typically harmless in healthy individuals, poor oral hygiene and periodontal disease can increase both the frequency and magnitude of bacterial entry into the bloodstream. Dental related inflammatory conditions such as plaque accumulation, dental caries, gingivitis, and periodontitis therefore increase overall exposure of bacteria and may contribute to the development of infective endocarditis (Bumm & Folwaczny, 2021). The oral cavity is also an important indicator of systemic health, with poor oral health, including untreated dental caries (tooth decay), being associated with cardiovascular disease. One study found that individuals with a higher prevalence of dental caries were more likely to have a history of cardiovascular disease (Roberts et al., 2025).
Due to its high complication risk if left untreated, it is crucial to educate patients about preventative measures which includes maintaining good oral hygiene and attending regular dental check-ups. In addition, to prevent endocarditis, patients with certain cardiac conditions who are at risk may receive antibiotic treatment from their dentist prior to all dental procedures that may require the manipulation of gingival tissue or the perforation of the oral mucosa.
Good oral hygiene practices and regular dental visits significantly reduce the risk of bacterial load in the oral cavity, ultimately promoting better overall health. Positively managing and maintaining good oral health can not only prevent individuals from further health complications, but also increase quality of life and reduce the incidences of other chronic diseases (Fu et al., 2025).
References:
Bumm, C. V., & Folwaczny, M. (2021). Infective endocarditis and oral health—a Narrative Review. Cardiovascular Diagnosis and Therapy, 11(6), 1403–1415. https://doi.org/10.21037/cdt-20-908
Fu, D., Shu, X., Zhou, G., Ji, M., Liao, G., & Zou, L. (2025). Connection between oral health and chronic diseases. MedComm, 6(1). https://doi.org/10.1002/mco2.70052
Roberts, C., Baxter, D. J., Napierala, D., & Bezamat, M. (2025). Higher dental caries rates and increased cardiovascular disease risk. Frontiers in Oral Health, 6.
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