Periodontal disease, a risk factor for atherosclerotic cardiovascular disease

Cardiovascular disease is recognized as the leading cause of death and disability in the world. The majority of these deaths can be attributed to atherosclerotic disease and thromboembolic events leading to ischemic heart disease and stroke. The role of inflammation is well recognized in the pathogenesis of atherosclerosis and atherothrombosis. Increasing number of studies support the hypothesis that periodontal disease, specifically periodontitis, is a potential risk factor for atherosclerosis and thus cardiovascular disease. Chronic infections of periodontal pockets act as reservoirs for pathogenic microorganisms, their toxins and degradation products, raising the overall systemic inflammatory burden. Entering the circulation and atherosclerotic lesions themselves, they lead to further local and systemic inflammatory response, in all contributing to atherosclerosis progression, potentially increasing cardiovascular risk. Along these lines, good oral health in general and the periodontal treatment in more severe cases may play a role in cardiovascular risk reduction, primary and secondary prevention. The present review summarizes the possible pathophysiological mechanisms linking periodontal and cardiovascular pathology, lists clinical evidence between periodontitis and specific forms of cardiovascular disease and looks forward at the potential role of periodontal treatment in cardiovascular disease prevention and treatment.