It should be noted that no evidence yet exists which shows that periodontal disease CAUSES coronary disease (heart disease). However there are links between them that are concerning. In 2006 the magazine Scientific American published  a special edition titled “Oral-Systemic Disease: The Whole Body Truth?.  It stated- 

Heart disease and periodontal disease have several things in common. One of them is inflammation, which both narrows the coronary arteries and breaks down the tissues that hold teeth in place. Research suggests that there may be links between the two conditions. Animal studies in particular offer provocative evidence that certain biologic pathways might allow one disease to influence the other. Periodontal bacteria are found in the plaque deposits that narrow coronary arteries; inducing periodontal disease in rabbits causes plaque accumulations in their coronary arteries.

Other evidence comes from observational human studies. The largest such study, the National Health and Nutrition Examination Survey (NHANES, involved 10,000 Americans between the ages of 18 and 74. It found that people with periodontal disease were much more likely to be diagnosed with heart disease than those without periodontal disease.

Not only are there links to heart disease, but also premature births, diabetes  and other whole body conditions.  These links are now being explored and there is an explosion of interest and knowledge in this area.  The involvement of the inflammatory process is now becoming clearer. There appears to be a relationship  between all diseases in the body. They are linked and influenced by one another by the root cause: inflammation. This means that the presence of unresolved or chronic inflammation in one part of the body (such as chronic or longstanding periodontal disease) is likely to increase the susceptibility or severity of inflammation in another part of the body.


Demmer, R, T., & Desvarieux, M. (2006). Periodontal infections and cardiovascular disease. The heart of the matter. Journal of American Dental Association, 137, 14S-20S. doi:10.14219/jada.archive.2006.0402

Abstract

Background. Oral infection models have emerged as useful tools to study the hypothesis that infection is a cardiovascular disease (CVD) risk factor. Periodontal infections are a leading culprit, with studies reporting associations between periodontal disease and CVD. The results, however, have varied, and it often is unclear what conclusions can be drawn from these data.

Summary. An association exists between periodontal disease and CVD. It is unknown, however, whether this relationship is causal or coincidental. Early studies predominantly used nonspecific clinical and radiographic definitions of periodontal disease as surrogates for infectious exposure. While most studies demonstrated positive associations between periodontal disease and CVD, not all studies were positive, and substantial variations in results were evident. More recent studies have enhanced the specificity of infectious exposure definitions by measuring systemic antibodies to selected periodontal pathogens or by directly measuring and quantifying oral microbiota from subgingival dental plaque. Results from these studies have shown positive associations between periodontal disease and CVD.

Conclusions. Evidence continues to support an association among periodontal infections, atherosclerosis and vascular disease. Ongoing observational and focused pilot intervention studies may inform the design of large scale clinical intervention studies. Recommending periodontal treatment for the prevention of atherosclerotic CVD is not warranted based on scientific evidence. Periodontal treatment must be recommended on the basis of the value of its benefits for the oral health of patients, recognizing that patients are not healthy without good oral health. However, the emergence of periodontal

infections as a potential risk factor for CVD is leading to a convergence in oral and medical care that can only benefit the patients and public health.


Teles, R., & Wang C. Y. (2011). Mechanisms involved in the association between periodontal diseases and cardiovascular disease. Oral Diseases, 17, 450–461. doi:10.1111/j.1601-0825.2010.01784.x

Abstract

It is now well accepted that besides the cholesterol associated mechanisms of atherogenesis, inflammation plays a crucial role in all stages of the development of the atherosclerotic lesion. This ‘inflammation hypothesis’ raises the possibility that through systemic elevations of pro-inflammatory cytokines, periodontal diseases might also contribute to systemic inflammation and, therefore, to atherogenesis. In fact, there is evidence that periodontal diseases are associated with higher systemic levels of high-sensitivity C-reactive protein and a low grade systemic inflammation. This phenomenon has been explained based on mechanisms associated with either the infectious or the inflammatory nature of periodontal diseases. The purposes of this article were to review (1) the evidence suggesting a role for oral bacterial species, particularly periodontal pathogens, in atherogenesis; (2) the potential mechanisms explaining an etiological role for oral bacteria in atherosclerosis; (3) the evidence suggesting that periodontal infections are accompanied by a heightened state of systemic inflammation; (4) the potential sources of systemic inflammatory biomarkers associated with periodontal diseases; and (5) the effects of periodontal therapy on systemic inflammatory biomarkers and cardiovascular risk.


The University of Adelaide. Heart Diseases – Association between cardiovascular diseases and periodontal disease – what do we know? Colgate Dental Education programs, Special Topic No. 8. Retrieved from http://www.adelaide.edu.au/arcpoh/dperu/special/heart%20diseases/Heart_Diseases_A3.pdf

Abstract

There has been a growing body of research on periodontal disease carried out over the past five decades, and three distinctive phases of this research, namely the aetiopathologic phase, the risk factor phase and the periodontal disease–systemic health phase, have been identified1. More recently the focus has been on the third phase, where the influence of periodontal disease on systemic diseases has been considerably explored. Consequently, the emerging evidence may point to a significant association between periodontal disease and certain systemic diseases and conditions including cardiovascular diseases2,3, respiratory diseases4, diabetes and complications of diabetes5,6 and adverse pregnancy outcomes7. Of these, cardiovascular diseases are regarded as the leading cause of mortality in Australians, accounting for not only over 16% of all deaths but also 16% of the total disease burden in 20078. The aim of this information sheet is to update dental professionals on the cardiovascular–periodontal disease relationship.