502,387 UK Biobank participants showed heart failure patients had more self-reported oral health problems than controls—51% versus 40%—with a 1.6-fold unadjusted increase and an adjusted odds ratio of 1.18.
17,356 participants with heart failure were more likely to report dentures, painful gums and toothache, even after accounting for age, cardiovascular comorbidities, inflammation, lifestyle and socioeconomic factors.
10 weeks after pressure-overload surgery in mice, worsening left-ventricular ejection fraction tracked with expansion of the maxillary periodontal ligament space, suggesting heart failure can directly disrupt periodontal remodeling.
TNF-α expression in maxillary gingiva rose to 5.71 from 1.37 in heart-failure mice, while mandibular tissue showed no similar inflammatory pattern, pointing to site-specific oral effects.
The findings challenge the common view that oral disease mainly drives cardiovascular illness, instead positioning heart failure itself as an upstream cause of periodontal damage.