Increasing Evidence for an Association Between Periodontitis and Cardiovascular Disease
Periodontitis is a chronic inflammatory disease caused by bacterial colonisation, which results in destruction of the tissues between the tooth surface and gingiva, loss of connective tissue attachment, erosion of alveolar bone and tooth loss.1 Periodontitis is common and increases with age. In a US survey about half of adults aged over 30 years have some periodontitis and almost 10% have severe disease.2 Evidence for an association between periodontitis and atherosclerotic vascular disease, including stroke, myocardial infarction, peripheral vascular disease, abdominal aortic aneurysm, coronary heart disease and cardiovascular death, comes from more than 50 prospective cohort and case control studies undertaken during the last 25 years.3-6 More recent analyses from large cohort studies suggest new onset as well as prevalent periodontitis is associated with increased coronary heart disease risk,7 and there is a graded association between tooth loss and stroke, cardiovascular death, and all-cause mortality in patients with stable coronary artery disease.8 If causal, these associations would be of great importance because of the potential that preventing or treating periodontal disease could reduce the risk of major adverse cardiovascular events.
- Received December 30, 2015.
- Accepted January 4, 2016.