While studies have shown links between periodontal and heart disease in humans and dogs, exactly how one leads disease to the other needs further investigation. Researchers have proposed that bacteremia. (bacteria in the bloodstream) is the main cause. There are more than 700 species of bacteria that can live in the mouth, and some of these bacteria can move from the mouth into the blood. The tongue, palate, cheeks, and teeth each have their own diverse range of bacteria. Due to the high numbers and variety of bacteria in the mouth, bacteremia occurs naturally as a result of tooth brushing and chewing. Normally, these bacteria are cleared from the blood by the immune system and no infection develops. However, in people with severe periodontal disease, the gums (also called gingiva.) become inflamed, resulting in a condition called gingivitis. Gingivitis can often be treated with good mouth care and help from dentists, but the inflammation can enable oral bacteria to be released directly into the bloodstream, increasing the risk of bacteremia.

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