Evidence summary: the relationship between oral and cardiovascular disease

• Published in: British dental journal 2017-03, Vol.222 (5), p.381-385
• Main Authors: Dietrich, T., Webb, I., Stenhouse, L., Pattni, A., Ready, D., Wanyonyi, K. L., White, S., Gallagher, J. E.
• Format: Article
• Language: English
• Subjects: 692/4019/592/75; 692/499; 692/700/3032/3086/3088; 692/700/3032/3149/3029; Angina pectoris; Atherosclerosis; Bacterial infections; Cardiac arrhythmia; Cardiomyopathy; Cardiovascular disease; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - etiology; Dental caries; Dental insurance; Dentistry; Endocarditis; Gum disease; Heart failure; Hospitals; Humans; Maxillofacial surgery; Medicine; Mortality; Mouth Diseases - complications; Oral hygiene; Pathogens; Patients; Periodontitis - complications; Public health; Stroke
• ISSN: 0007-0610; 1476-5373
• DOI: 10.1038/sj.bdj.2017.224

Key Points Demonstrates a firm association between oral health and atherosclerotic cardiovascular disease. Suggests periodontal therapy is associated with reductions in surrogate markers of atherosclerotic cardiovascular disease. Proposes that oral health promotion improves oral health-related quality of life measures in stroke patients. Aim This paper reports on one review of four rapid reviews undertaken to explore the relationships between oral health and general medical conditions, in order to support teams within Public Health England, health practitioners and policy makers. This review aimed to explore the most contemporary evidence on whether poor oral health and cardiovascular disease occurs in the same individuals or populations, to outline the nature of the relationship between these two health outcomes and to discuss the implication of any findings for health services and future research. Methods The review was undertaken by a group comprising consultant clinicians from medicine and dentistry, trainees, public health and academics. The methodology involved a streamlined rapid review process and synthesis of the data. Results The results identified a number of systematic reviews of low to high quality, which suggests that there is: (1) fairly robust evidence of an increased risk of atherosclerotic vascular disease (ASVD) amongst individuals with chronic periodontitis, independent of other established cardiovascular risk factors; (2) there is some evidence that the incidence of caries and tooth loss is higher in patients with cardiovascular disease; and (3) that orofacial pain can presents as the sole symptom of stroke in some patients. The findings are discussed in relation to implications for service and future research. Conclusion There is high quality evidence to support an association between cardiovascular disease and oral health. This evidence is mainly related to the association between chronic periodontitis and atherosclerotic heart disease, and is independent of confounding factors as drawn from epidemiological observational studies.