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(Circulation. 2004;109:1076-1078.)
© 2004 American Heart Association, Inc.

Focused Perspectives

Dental Disease, Coronary Heart Disease and Stroke, and Inflammatory Markers

What Are the Associations, and What Do They Mean?

Gordon D.O. Lowe, MD, FRCP, FFPH

Section of Vascular Medicine, University of Glasgow, United Kingdom.

Correspondence to Prof G.D.O. Lowe, University Department of Medicine, Royal Infirmary, 10 Alexandra Parade, Glasgow, G31 2ER, UK. E-mail gdl1j@clinmed.gla.ac.uk

Key Words: Focused Perspectives • coronary disease • inflammation • risk factors

An extract of the first 250 words of the full text is provided, because this article has no abstract.

In addition to "classical" risk factors for coronary heart disease (CHD) and stroke, "emerging" risk predictors (which may also play roles in pathogenesis) include measures of chronic infections and of chronic, low-grade activation of inflammation and of hemostasis.^1,2 As all dental healthcare professionals know (but probably fewer medical practitioners and their patients), the oral cavity is a major site of chronic infection and inflammation, particularly periodontal disease. In recent years there has been increasing interest in the "periodontal-systemic connection" between dental health parameters and the risks of cardiovascular disease, respiratory disease, diabetes mellitus, osteoporosis, and adverse pregnancy outcomes.³ Given that poor oral health, coronary heart disease, and stroke are major worldwide health problems, their associations are potentially important. In particular, two practical questions are of mutual interest to dental and medical healthcare practitioners and their patients. First, should dental health scores be used (in addition to classical risk factors) to predict an individual’s risk of CHD and stroke? Second, does treatment of poor dental health reduce such risk?

See p 1095

Answering the first question requires a rigorous assessment of epidemiological studies that have examined the associations between dental health parameters, CHD and stroke. The initial reports of positive associations, by Mattila et al from Finland, came from case-control studies of myocardial infarction⁴ and coronary atherosclerosis.⁵ Similar findings have been reported from other case-control studies of myocardial infarction^6,7 and stroke⁸ and from cross-sectional studies of myocardial infarction,⁴ stroke,⁹ and cardiovascular disease (CHD, stroke, or claudication).¹⁰ Although in general these reported . . . [Full Text of this Article]

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