My cardiologist never asks about my teeth. Should I bring it up?

Yes, and the question is worth asking directly. Dental visit frequency, history of periodontal disease, and gum health are not on standard cardiovascular risk assessment forms. They are not included in the Framingham score, the ASCVD risk calculator, or any major risk prediction tool. But they represent one of the four most common reversible drivers of elevated hs-CRP in otherwise healthy-appearing men, and a cardiologist who does not ask about dental health has a systematic gap in their inflammatory risk assessment.

The specific conversation worth initiating: "I recently read that periodontal disease is one of the reversible causes of elevated hs-CRP, and I haven't been to a dentist in about two years. Should I have a periodontal evaluation before we decide how to address my CRP?" This question is clinically well-founded and forces the conversation that the standard appointment structure does not. Most cardiologists will be receptive to it, and the ones who are not will at least have had their documentation updated with a dental history note. (Lockhart et al., Circulation, 2012)

Cardiologist's calibrated position, Solid (1) for asking about oral health as part of cardiovascular risk management. I ask this question routinely.

What to do: At your next cardiology or primary care visit, proactively report your dental visit history and any known gum disease history. If your hs-CRP is elevated and your physician has not asked about dental health, raise it yourself.

For the full picture, read The Appointment You've Been Skipping Is Protecting Your Heart.