Cardiovascular disease and periodontitis: an update on the associations and risk

• Published in: Journal of clinical periodontology 2008-09, Vol.35 (s8), p.362-379
• Main Authors: Persson, Gösta Rutger, Persson, Rigmor Elisabeth
• Format: Article
• Language: English
• Subjects: acute coronary syndrome; atherosclerosis; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Biomarkers - blood; Blood and lymphatic vessels; Brachial Artery - physiopathology; Cardiology. Vascular system; Cardiovascular Diseases - blood; Cardiovascular Diseases - epidemiology; Carotid Arteries - pathology; Coronary heart disease; Dentistry; Disease Susceptibility; Europe - epidemiology; Heart; Humans; infection; inflammation; Medical sciences; Neurology; periodontitis; Periodontitis - blood; Periodontitis - epidemiology; Periodontitis - therapy; Prevalence; Regional Blood Flow - physiology; review; Risk Factors; stroke; therapy; Tunica Media - pathology; Vascular diseases and vascular malformations of the nervous system; Vasodilation - physiology
• ISSN: 0303-6979; 1600-051X
• DOI: 10.1111/j.1600-051X.2008.01281.x

Background: Associations between periodontitis and cardiovascular diseases have been recognized. Material and Methods: New literature since the last European Workshop on Periodontology has been reviewed. Results: The lack of reliable epidemiological data on disease prevalence makes an assessment of the associations and risks between periodontitis and cardiovascular diseases difficult. Two recent meta‐analysis reports have identified associations between periodontitis and cardiovascular diseases (odds ratios: 1.1–2.2). Different surrogate markers for both disease entities, including serum biomarkers, have been investigated. Brachial artery flow‐mediated dilatation, and carotid intima media thickness have in some studies been linked to periodontitis. Studies are needed to confirm early results of improvements of such surrogate markers following periodontal therapy. While intensive periodontal therapy may enhance inflammatory responses and impair vascular functions, studies are needed to assess the outcome of periodontal therapies in subjects with confirmed cardiovascular conditions. Tooth eradication may also reduce the systemic inflammatory burden of individuals with severe periodontitis. The role of confounders remain unclear. Conclusions: Periodontitis may contribute to cardiovascular disease and stroke in susceptible subjects. Properly powered longitudinal case–control and intervention trials are needed to identify how periodontitis and periodontal interventions may have an impact on cardiovascular diseases.