"Oral health as a fundamental human right and an integrated part of general health and well-being"
FDI World Dental Federation
Heart Disease has been associated with periodontal disease for quite some time in key studies, along with other conditions such as Diabetes, Hypertension and Adverse Pregnancy Outcomes.
These links are helpful in identifying potential risk factors in patients and providing a more holistic approach to oral health care.
- Chronic infections, such as periodontal disease, are associated with an increased risk for heart disease. Heart disease prevalence is highest in people with periodontal disease who also have elevated levels of C-reactive protein (CRP)
- Studies suggest periodontal disease is a risk factor for heart disease patients who present a systemic inflammatory and immune response reaction to the infection
- Periodontitis leads to the entry of bacteria into the bloodstream. The bacteria activate the host’s inflammatory-immune response by multiple mechanisms. Several animal models have demonstrated that the host’s inflammatory response favors atheroma formation, maturation, and exacerbation.
- While it’s important to be aware of the link, there are no clinical studies that have demonstrated a causal association between periodontal infections and heart disease. Research continues in this area and in the meantime, early detection of disease and early identification of risk factors remains a proactive approach that can be taken by all health professionals.
What can dental professionals do?
The European Federation of Periodontology (EFP) has developed guidelines for oral health professionals in the management of periodontal diseases in relation to systemic conditions. Its advice on heart disease and the role of the dentist is summarised here:
- Periodontal disease patients with other risk factors for heart disease, such as hypertension, overweight/obesity, smoking, etc. who have not seen a physician within the last year, should be referred for medical examination
- In the future, non-invasive testing for elevated levels of C-reactive protein will be recommended for high-risk patients
- Geneticists are hunting for genes that predispose some people to chronic inflammation and atherosclerosis so they can seek more aggressive monitoring and treatment