Image by Rafael Zajczewski from Pixabay

The big picture philosophy of naturopathic medicine boils down to this: identify and remove obstacles to healing, give the body the building blocks it needs to heal, and (when necessary, when it’s suppressed,) stimulate the body’s own vitality toward healing. It’s a simple enough formula, but it’s not always easy to employ. One of the challenges can be identifying those obstacles to cure… or in some cases, you might have an idea what they are, but it can be difficult to objectively identify them. 

Dental infections fall into this category. You’d think that routine x-ray imaging at the dentist’s offices would be sufficient, but in practice that’s not always the case – there are a variety of challenges in definitively using such images to make a diagnosis of a dental infection, and often dentists will disagree on their interpretation of an image. 

It appears, though, that a simple blood test, otherwise associated with heart disease, can help suggest the diagnosis. 

The Heart Disease and Periodontal Disease Connection

For decades now, studies have consistently shown a correlation between heart disease and periodontal (gum) disease, though the exact relationship between them is still unclear. 

Some speculate that the correlation might be due to shared risk factors that trigger inflammation, like a poor diet or smoking—and it’s the inflammation that in turn leads to both gum disease and heart disease. 

We do know, however, that bacteria responsible for dental caries can access the bloodstream during dental procedures, leading primarily to heart complications—and we likewise know that dental infections can spread to surrounding tissues. So it’s not too far of a stretch to suppose that dental infections might be an independent risk factor for heart disease in general. 

Dental Infections and the LP-PLA2 Connection

I wrote here on Lp-PLA2 as a marker for cardiovascular disease. Interestingly enough, and strengthening the connection between heart disease and periodontal disease, Lp-PLA2 appears to be a marker for periodontitis too. 

There is also a correlation between antibodies against bacteria responsible for dental infections in the bloodstream, and Lp-PLA2 levels.

This study attempted to tease out the difference between the two, enrolling one group without periodontitis but with high cholesterol (the study’s marker for heart disease), one group with periodontitis and normal cholesterol, and one control group with neither. They found that Lp-PLA2 levels were high in both the high cholesterol and the periodontitis groups compared to the control group. 

I’m not convinced that this necessarily means Lp-PLA2 can be a marker for either heart disease or periodontal disease, though—it’s still possible in my mind that those with periodontal disease also have heart disease, but normal cholesterol ester levels, since serum cholesterol is not the best marker for heart disease. As I wrote here, I wonder whether those with periodontal disease but normal cholesterol might have still had high Lp(a), or even high oxLDL. 

Until that study is done, though, the studies we do have clearly indicate that high Lp-PLA2 levels might at least indicate a possible dental infection. 

Lp-PLA2 Decreases With Dental Treatment 

Even more interesting: once the dental infection is treated, Lp-PLA2 levels go down.

Studies seem to show this consistently.

This suggests that not only can Lp-PLA2 be used to track resolution of a potential dental infection, but it also implies that those with cardiovascular disease might be able to limit future risk by taking good care of their teeth. 

The Upshot

Imaging can sometimes find occult dental infections that might be a root cause for chronic illness, but not always. 

Lp-PLA2 isn’t an absolute either, but it does appear that if elevated, it’s worth looking at dental imaging again.