Periodontitis and Cardiovascular Diseases

Author: Gum Specialist Dr Chandni

There has been a lot of recognition recently that the mouth can be linked to the rest of the body. Periodontitis can be a severe gum infection where a biofilm is created leading to dysbiosis in the body. This results in unresolved chronic inflammation, which then can lead to bone loss around the teeth.

This inflammation may also affect other systemic diseases, for example cardiovascular disease. Cardiovascular diseases are very important as they can have significant consequences on the quality of life. In this short article, let’s discuss this a little further.

There has been a lot of recognition recently that the mouth can be linked to the rest of the body. Periodontitis can be a severe gum infection where a biofilm is created leading to dysbiosis in the body. This results in unresolved chronic inflammation, which then can lead to bone loss around the teeth. This inflammation may also affect other systemic diseases, for example cardiovascular disease. Cardiovascular diseases are very important as they can have significant consequences on the quality of life. In this short article, let’s discuss this a little further.

Could there be a link between periodontitis and cardiovascular disease?

The link between periodontitis and cardiovascular could be through direct or indirect mechanisms. The pathogens found in periodontitis could directly enter the body through the blood stream which can then go to the heart. Indirectly, it may be possible that the continuous inflammation caused by periodontitis affects the rest of the body leading to systemic diseases. For example, this inflammation may result in the rupture of plaques found in arteries, which can lead to a blood clot and thrombosis. This obstructs the blood flow through the circulatory system, and can lead to unstable angina, myocardial infarction (MI), ischaemic stroke, critical limb ischaemia and cardiovascular death. However, it is important to also be aware that there are some cross overs between the risk factors found in cardiovascular diseases and periodontitis, which may also contribute towards the link.

Does any evidence support this link?

There have been numerous studies within the research, e.g. Sanz et al 2020 found that there is strong evidence that periodontitis can lead to an increased risk for cardiovascular disease. We can see from this article that those who brushed less than once a day exhibited the highest incidence of cardiovascular events. Not only this, but several oral health interventions including oral hygiene habits and periodontal treatment had a reduction in the incidence of cardiovascular events.

What does this mean for us in the dental practice?

We have more and more emerging evidence to suggest that there may be a link between the two diseases. It highlights that treating periodontitis can be beneficial for patients for their systemic health. It is important that this is explained to our patients to help increase their awareness and improve not only their oral health but also their general health. By managing periodontal diseases, we may be able to reduce the risk of systemic conditions. The following would be recommended:

1. Recognise periodontitis as a potential risk factor to general health and increase awareness within the dental profession about these links, so that more patients can be advised.
2. Identify patients with systemic health conditions and periodontitis, such as cardiovascular diseases, and help educate them about the potential link between the two diseases.
3. Liaise with patient’s general practitioners where needed (especially if there are risk factors suggesting an increased risk of cardiovascular diseases and periodontitis).
4. Regular dental visits would be advised.
5. Educate the importance of good oral hygiene and periodontal care.
6. Refer for periodontal management to specialists, where needed, so that these patients are being cared for appropriately.

The mouth is so often considered as a separate speciality to the body, but it is not. Ideally, doctors and dentists need to be working together, raising awareness to patients and treating them to the highest standard that we possibly can.