Recently, the question has been asked, “how much does gum and bone disease (periodontal disease) affect blood vessels and contribute to heart attacks and strokes?” It is well established that systemic inflammatory diseases, periodontal disease and infected teeth contribute to the potential for artenial plaque rupture/erosions which create thrombotic events (strokes and heart attacks). These events result in plaque growth patterns that manifest with end stage diseases such as peripheral vascular disease or major symptomatic events such as heart attacks and strokes.
Current research shows that periodontal disease (PD) has a variety of and continuum of inflammatory conditions. The literature confirms that the inflammation resulting from periodontal disease contributes to the systemic vascular burden of inflammation, as documented by various biomakers; highly sensitive C – reactive protein (hsCRP), lipoprotein-associated phospholipase A-2 (Lp-PLA2), fibrinogen and myeloperoxidase (MPO). Not surprisingly as a result, there is data substantiating a strong association of periodontal disease with myocardial infarction (heart attack) and stroke. After reviewing all this data, they concluded there is a Level A evidence that PD is independently associated with CVD.
A recent American Heart Association (AHA) review of the literature does indicate that periodontal disease is associated with atheriosclerosis independent of known co-founders. The AHA meta-analysis cited that 8 of 8 studies that assessed periodontal disease (as documented by clinical exam) were positively associated with higher risk of heart attacks (myocardial infarction). An association between periodontal disease and atherosclerosis is supported by Level A evidence (given that the data is derived from multiple randomized clinical trials).
Research shows that a strong association of periodontal disease and vascular disease exists and that reducing systemic inflammation will improve blood vessel health when effective periodontal therapy is achieved. I recommend that the evaluation and treatment of periodontal disease along with appropriate medical care (smoking, alcohol consumption, lipid panels) be included in any strategy for the prevention of cardiovascular disease.
Today, most dentists are trained in the diagnosis and treatment of periodontal disease. Advanced periodontal disease problems are managed through a thorough diagnosis and a treatment plan. Emphasis is placed on the patient’s maintenance cleaning at home, frequent and thorough professional cleanings and in specific situations, periodontal surgery and/or strategic extractions. For teeth requiring extractions, dental implants are a predictable replacement.