Association Between Periodontal Disease and Atherosclerotic Cardiovascular Diseases: Revisited

Abstract

Atherosclerotic cardiovascular disease (ACVD) is an inflammatory disease of the coronary arteries associated with atheroma formation, which can cause disability and often death. Periodontitis is ranked as the sixth most prevalent disease affecting humans affecting 740 million people worldwide. In the last few decades, researchers have focused on the effect of periodontal disease (PD) on cardiovascular disease. The aim of this review was to investigate the association between these two diseases. PD is a potential risk factor that may initiate the development, maturation, and instability of atheroma in the arteries. Two mechanisms were proposed to explain such association, either periodontal pathogens directly invade bloodstream or indirectly by increasing systemic level of inflammatory mediators. Interestingly, it has been suggested that improvement in the condition of one disease positively impact the condition of the other one. Highlighting the association between these two diseases, the importance of early diagnosis and treatment of PD and its impact on cardiovascular status may be of great value in reducing the complications associated with ACVDs. Further in vitro and in vivo studies with longer follow up are necessary to confirm the causal relationship between PD and ACVDs.

Connection between Periodontitis-Induced Low-Grade Endotoxemia and Systemic Diseases: Neutrophils as Protagonists and Targets

“…Increasing the periodontitis severity carries a proportionally higher risk of coronary artery disease [ 72 ]. The relationship between periodontitis and coronary artery calcification indicates that periodontitis correlates positively and linearly with the presence of coronary artery calcification [ 73 ].…”

Effect of Periodontal Disease on Long-Term Outcomes After Percutaneous Coronary Intervention for De Novo Coronary Lesions in Non-Smokers

“…When local and systemic inflammatory reactions are stimulated, inflammatory cytokines, such as interleukin (IL)-6 and tumor necrosis factor (TNF)-α, are increasingly released into circulation, 33-35 which may potentially trigger further inflammation in coronary arteries by affecting endothelial function, lipid metabolism, or oxidative stress. 36 This mechanism may explain the pan-vascular atherosclerosis represented by more frequent non-TLR in the PD group than in the non-PD group in the present study.…”

Dental Care Use, Edentulism, and Systemic Health among Older Adults

“…Better information about the association between dental care use, oral health problems, and chronic disease among the elderly could also inform clinical practice guidelines. However, the development of guidelines must be based on a solid scientific foundation, and although progress is being made on the mechanistic role of oral bacteria and systemic inflammation in the relationship between poor oral health and both cardiovascular and cerebrovascular diseases, further study is necessary to confirm the precise causal links (Patrakka et al 2019;Zardawi et al 2021). Such research could inform the development of targeted dental interventions as well as systemic treatments for dental and other diseases.…”