Periodontal Disease Not a Likely Cause of Vascular Disease

Healthy gums have not been proven to prevent atherosclerotic vascular disease (ASVD), nor will treating periodontal disease (PD) clearly reduce risk of heart attack or stroke, according to a new scientific statement.

The statement, released by the American Heart Association (AHA; Dallas, TX, USA), is the result of a systematic review by a group of cardiologists, dentists, and infectious disease specialists to assess whether available data support an independent association between ASVD and PD, and whether PD treatment might modify ASVD risks or outcomes. The statement was endorsed by the American Dental Association (ADA, Chicago, IL, USA), and the World Heart Federation (Geneva, Switzerland).

The statement addresses concerns about possible links between PD and ASVD, which has recently intensified, driving an active field of investigation into possible association and causality, since the two disorders share several common risk factors, including smoking and diabetes mellitus (DM). As a result, both patients and providers are increasingly presented with claims that periodontal treatment strategies offer ASVD protection, claims that are often actively endorsed by professional and industrial stakeholders.

The researchers reviewed 537 studies on the topic, most observational in design. The studies did not provide consistent results on the impact of PD treatment on specific inflammatory markers, and failed to establish a durable benefit. They then discussed the correlation of PD with ASVD outcomes, as well as the correlation of response to PD therapy with ASVD event rates. The researchers found that the studies to date support an association between the two, independent of known confounders; they do not, however, support a causative relationship. The statement was published early online on April 18, 2012, in Circulation.

“Although a contribution of periodontal disease to atherosclerotic vascular disease is biologically plausible, periodontal and cardiovascular diseases share multiple risk factors that are prevalent and powerful promoters of disease, including tobacco use, diabetes mellitus, and age,” stated lead author Peter Lockhart, DDS. “Although periodontal interventions result in a reduction in systemic inflammation and endothelial dysfunction in short-term studies, there is no evidence that they prevent ASVD or modify its outcomes.”

Related Links:
American Heart Association
American Dental Association
World Heart Federation