Can Myocardial Infarction Be Triggered by "Infection"? Oral Care That Goes Beyond Brushing: An Invisible Bacterial Barrier as the "Final Push"

A study published in JAHA in August 2025 indicated that oral bacteria such as Streptococcus viridans can form biofilms within atherosclerotic plaques and remain dormant. Upon certain stimuli, fragments or bacteria may be released, activating immune responses (such as TLR2), leading to plaque rupture, thrombus formation, and potentially resulting in myocardial infarction. Numerous instances of bacterial DNA and immune positivity were confirmed in autopsy cases and surgical specimens, suggesting a correlation with disease severity and mortality. However, causality and the effects of interventions remain unclear, and the indiscriminate use of antibiotics for prevention is not recommended. While there is a growing call on social media for enhanced oral care, the research community is engaged in debates over distinguishing correlation from causation and the specificity of methods. Practically, it is reasonable to adopt a "dual approach" by combining traditional cardiovascular risk management with periodontal disease prevention.