By Kat Procyk
Caption: A series of research papers from a group of researchers at Pitt’s Schools of Medicine and Dental Medicine are trying to understand what connects oral and heart health and—if identified—how to develop prevention and predictive strategies.
It’s long been understood that cardiovascular and oral health are intertwined. Research shows that poor oral health, like gum disease and tooth decay, is linked to heart disease through inflammation and bacteria entering the bloodstream.
But a group of researchers from the University of Pittsburgh Schools of Medicine and Dental Medicine are investigating whether there’s more to this connection at the biological level. If they can find that potential biomarker, they believe it could lead to better prevention and eventually a predictive tool.
The research team, led by Mariana Bezamat, assistant professor, School of Dental Medicine, published a series of studies in 2025 that found that while a genetic link is unclear, a shared biological marker, known as sphingomyelin metabolite, is associated with healthier gums and lower signs of atherosclerosis, a key contributor to heart disease.
“Dental health is often overlooked, yet its influence extends far beyond the mouth,” Bezamat said. “While oral diseases and atherosclerosis may have distinct genetic roots, overlapping metabolites reveal a link between oral and cardiovascular health. Understanding this connection could elevate the importance of oral health interventions and has the potential to transform public health policies and health care costs.”
Bezamat’s research focuses on determining the relationship between oral and overall health, with a particular interest in atherosclerotic cardiovascular disease. These efforts are supported by a team of collaborators and mentors, including Mary Marazita, Distinguished Professor of Oral Biology, School of Dental Medicine; Steven Reis, vice chancellor for multidisciplinary innovations, health sciences, and Distinguished Service Professor of Medicine, School of Medicine; and Anum Saeed, assistant professor of medicine (Division of Cardiology), School of Medicine. Marazita worked with Reis and Saeed on the Heart SCORE study, which follows a cohort of 2,000 research participants enrolled more than 20 years ago who undergo extensive annual testing to uncover early risk factors for cardiovascular disease. Marazita leads a sub study known as Dental SCORE, for which many Heart SCORE participants contributed blood samples and underwent detailed oral examinations. Data collected in these studies provided the backbone for their most recent research. It involved assessing participants’ dental health—including tooth decay, tooth loss or fillings—as well as heart screening that measured calcium buildup in their heart arteries and the thickness of carotid artery walls.
“Our goal is to find a predictive tool,” Saeed said. “I think we can confidently say that if a patient has a lot of oral inflammation or gingivitis, that patient has a correlation with a higher risk of subclinical cardiovascular disease, but from a prospective way, we’re still pursuing more findings by continually looking at new biomarkers from our original samples.”
With the lack of a clear genetic influence, researchers are turning their attention to other, more manageable influences—factors that can be addressed through affordable and practical changes. Bezamat noted that behavioral and environmental lifestyle interventions may hold promise, offering opportunities for oral health care professionals to contribute not only to better oral outcomes but also to improved cardiac health.