When we travel unexplored roads in our careers, we may discover scenic viewpoints. Following my professional interests as a registered dental hygienist introduced me to the field of cardiac rehabilitation. One of my greatest career honors was being able to spend time with individuals navigating recovery after a cardiac event or procedure.

During cardiac recovery, the care team aims to improve adherence to medications and follow-up care, while promoting physical activity, healthy eating, stress management, mental well-being, and other health-promoting behaviors.¹ What I found is that the oral health discussion was mostly missing from this conversation. And if we’re caring for the whole person during heart recovery, oral health deserves to be a part of that conversation too.

The science

To back this observation with science, I looked to a recent American Heart Association Scientific Statement that examined periodontal disease and atherosclerotic cardiovascular disease. Atherosclerotic cardiovascular disease is the leading cause of death globally.² This disease involves plaque buildup inside the arteries and can contribute to events such as heart attack and stroke. To be clear, arterial plaque is not the same as dental plaque. Arterial plaque is a buildup of fats, cholesterol, and other substances.³ Evidence supports an association between atherosclerotic cardiovascular disease and periodontal disease.²

Researchers are investigating possible biological pathways that may help explain the association. Chronic inflammation from periodontal disease is a potential biological pathway that may contribute to the body’s overall inflammatory burden. Inflammation also plays an important role in cardiovascular disease, especially atherosclerosis. Another possible biological pathway involves bacteria from the mouth entering the bloodstream, something we call bacteremia. Once those bacteria or their components enter circulation, they may interact with the immune system and blood vessels.

Furthermore, atherosclerotic cardiovascular disease and periodontal disease share several risk factors. Age, smoking, obesity, diabetes, high blood pressure, and social or economic determinants can affect both periodontal health and cardiovascular health.² Together, these potential biological pathways and shared risk factors may help explain the observed association, but they do not establish causation.

Interdisciplinary collaboration

Now that we’ve covered some of the science, let’s bring this back to the person who’s recovering from a cardiac event. The American Heart Association’s recent Scientific Statement explicitly states: “Interdisciplinary collaboration among cardiologists, periodontists, epidemiologists, geneticists, radiologists, and other health care professionals is essential for developing integrated care models addressing both oral and cardiovascular health. Evaluating the effectiveness of patient education and public health initiatives in reducing the burden of periodontal disease and its potential effect on cardiovascular health is crucial.”²

Where the RDH fits in

Dental hygienists are versatile professionals who can not only provide preventive oral care and treatment but educate patients on healthier lifestyles and discuss their diagnosed conditions. This makes us well suited to interact with patients working toward lifestyle modifications as part of their cardiac recovery.

In my experience working with a cardiac rehabilitation program, I witnessed dieticians holding classes about nutrition. What if we incorporated a registered dental hygienist leading recurring classes about basic dental education, practical oral-care instruction, conversations about dry mouth, and dental access? Establishing referral pathways between cardiac rehabilitation programs and local dental providers is an excellent example of interdisciplinary care.

Related: The advantages of discussing nutrition in the dental setting

A dental hygienist in this role may provide health education, promote disease prevention, coordinate care, and connect patients to resources such as transportation, food assistance, and health-care providers. Additionally, incorporating dental education programming and program evaluation may enhance opportunities for future research.

Oral health: A vital component

Working with patients during cardiac recovery reminded me how many challenges they are balancing at once. Oral health is one of the interconnected pieces of that recovery. Integrating dental hygienists into cardiac rehabilitation could expand patient education and strengthen connections to dental care. Programs could evaluate this model through pre- and postprogram knowledge surveys, referral tracking, and documentation of barriers such as cost, transportation, and limited access to providers.

These measurements would not establish a reduction in cardiovascular events, but they could show whether patients leave rehabilitation better informed and better connected to oral care. That is a meaningful place to begin.

Author’s note: This article was written with the assistance of artificial intelligence.

Editor’s note: This article first appeared in RDH eVillage newsletter, a publication of the Endeavor Business Media Dental Group. Read more articles and subscribe.

References

1. How cardiac rehabilitation can help heal your heart. Centers for Disease Control and Prevention. May 24, 2024. Accessed September 13, 2026. https://www.cdc.gov/heart-disease/about/cardiac-rehabilitation-treatment.html
2. Tran AH, Zaidi AH, Bolger AF, et al. Periodontal disease and atherosclerotic cardiovascular disease: a scientific statement from the American Heart Association. Circulation. 2026;153(6):e73-e88. doi:10.1161/CIR.0000000000001390
3. Atherosclerosis. National Heart, Lung, and Blood Institute. Updated October 28, 2024. Accessed September 13, 2026. https://www.nhlbi.nih.gov/health/atherosclerosis