The Perio and Heart Disease Link

Literature Update:

Association Between Periodontal Disease and Cardiovascular Health

Increasing evidence points to periodontal disease as a contributor to cardiovascular disease. Higashi and other pointed out that endothelial dysfunction is an initial step in the development of atherosclerosis. Dysfunction of the endothelium (inner lining of the blood vessels) may be caused, in part, by inflammation. By promoting systemic inflammation, periodontal disease may lead to endothelial dysfunction and cardiovascuslar disease. Treatment of periodontal disease has been reported to improve endothelial function in patients without overt coronary disease.

Another study conducted by Oe, Soejima and others supported earlier findings that chronic periodontitis was associated with incidence of coronary artery disease among men under the age of 60. Researched also found a trend toward reduced periodontal risk in patients using statins. This supports findings that statin use was associated with fewer periodontal pockets. Additional research is needed to evaluate the potential impact of statins on periodontal health.

Doctors at the University of Alabama studied the relationship between periodontal disease and stroke. Given that artherosclerosis is a systemic disease and periodontal disease may promote atherosclerosis, periodontal disease may also be associated with an increased risk of stroke. They hypothesized that tooth loss would also be associated with higher levels of inflammation and stroke. The study reinforced the association between periodontal disease (as measured by tooth loss) and inflammation and supports an association between periodontal disease and stroke.

Oral infection-inflammatory pathway, periodontitis, is a risk factor for endothelial dysfunction in patients with coronary artery disease. Higashi Y, Goto C et al. Department of Cardiovascular Physiology and Medicine, Hiroshima University, Graduate School of Biomedical Sciences, Hiroshima, Japan. 2009 Oct;206(2):604-10.

Significant association between score of periodontal disease and coronary artery disease. Oe Y.et al. Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Honjo, Kumamoto, Japan.2009 Mar;24(2):103-7.

Tooth loss, systemic inflammation, and prevalent stroke among participants in the reasons for geographic and racial difference in stroke study. You Z et al. Department of Biostatistics, University of Alabama at Birmingham. 2009 Apr;203(2):615-9. Epub 2008 Aug 8.

Pi Dental Center, Fort Washington, PA