Kowolik

Leading a team of researchers from IU’s schools of dentistry and medicine, Dr. Michael Kowolik will use a $1.3 million grant from the National Institutes of Health to study dental plaque accumulation as a risk factor for heart disease.

Kowolik’s research comes at a time when chronic infections in the body are under increasing investigation for the role they may play in the development of a number of health problems, including heart disease.

Three years ago, Kowolik published a study showing that this same accumulation of plaque on teeth, which leads to gingivitis, produced a systemic response from the body’s main line of defense to infections: the white blood cell.

“If you get an infection anywhere in the body, these cells come pouring out of your bone marrow to defend you,” Kowolik said. “I had an idea that if we allowed plaque to accumulate on teeth, the white blood cells would respond. Lo and behold, they did and you can measure this.”

The new study, involving 140 Indianapolis area volunteers, takes that idea one step further. Half of the volunteers that will be recruited for the research will be African-Americans, marking the first time, as far as is known, that African-Americans will be included in such a study.

Cardiologists have known for 20 years that one of the principal risk factors for a heart attack is an elevated white blood cell count, Kowolik said. “We will study whether allowing plaque to accumulate is sufficient to raise the white blood cell count to the point it could become a risk factor for heart disease.”

In addition to studying white blood cell counts, the research team will also look for other well established inflammatory markers that are known to occur in people who have chronic infections.

“We’re not talking about people with advanced periodontal disease,” Kowolik said. “We are talking about healthy people who simply neglect oral hygiene.”

The notion that what goes on in the mouth probably affects the rest of the body isn’t new, Kowolik said.

“In the early 1900s, some well informed physicians harangued dentists for the fact that they were focused on the cosmetic repair of mouths and much less on the health of the populace,” he said. The research findings in the 1960s justified the profession of dental hygiene and the practice of preventive dentistry, he noted, because they demonstrated a definitive cause and effect relationship between plaque buildup and gingivitis.

This latest study will not definitively prove that neglecting oral hygiene leads to heart disease, but the body of evidence that dentistry plays an important role in a preventive health program for the rest of the body is getting stronger, Kowolik said.