Periodontitis, blood lipids and lipoproteins

Periodontitis, one of the most common chronic infections in adults, is characterized by the accumulation of dental plaque and infection by Gram-negative pathogenic bacteria, which further lead to the destruction of periodontal tissues. A relationship between chronic periodontitis and abnormalities in lipid and/or lipoprotein metabolism is not well understood yet. Periodontitis is associated with elevated proatherogenic plasma lipids, including small dense LDL, while oxidized LDL may act as an inflammatory stimulant in periodontitis. Periodontal pathogens may directly modify lipoprotein, including protective characteristics of HDL, and contribute to development of metabolic syndrome, Type 2 diabetes mellitus and coronary atherosclerosis. On the other hand, periodontal treatment is associated with modest HDL-C increases, LDL-C decreases and consequently lower cardiometabolic risk. Thus, oral check-ups and improved oral hygiene may reduce metabolic risk and antibodies against periodontal pathogens. Identification and monitoring of patients at high risk for periodontitis may help to prevent and/or reduce CV events.