Additional research is called for and patients with moderate to severe periodontitis should receive evaluation and possible treatment to reduce their risk of atherosclerotic cardiovascular disease (CVD), according to a special consensus paper by editors of The American Journal of Cardiology and Journal of Peridontology.
Periodontitis, a bacterially-induced, localized, chronic inflammatory disease, destroys connective tissue and bone that support the teeth. Periodontitis is common, with mild to moderate forms affecting 30 to 50% of adults and the severe generalized form affecting 5 to 15% of all adults in the USA. In addition, there is now strong evidence that people with periodontitis are at increased risk of atherosclerotic CVD — the accumulation of lipid products within the arterial vascular wall.
The explanation for the link between periodontitis and atherosclerotic CVD is not yet clear, but a leading candidate is inflammation caused by the immune system. In recent years the inflammation is now recognized as a significant active participant in many chronic diseases. Other explanations for periodontitis and atherosclerotic CVD are common risk factors such as smoking, diabetes mellitus, genetics, mental anxiety, depression, obesity, and physical inactivity.
Regardless of the cause, the expert panel believes that the current evidence is strong enough to recommend that doctors assess atherosclerotic CVD in their patients with periodontitis. The research recommends that patients with moderate to severe periodontitis should be informed that there may be an increased risk of atherosclerotic CVD associated with periodontitis, and those patients with one or more known major risk factor for atherosclerotic CVD should consider a medical evaluation if they have not done so in the past 12 months.
"This consensus paper is important because it will draw attention to the fact that patients with periodontitis, especially moderate and severe forms of the disease, can have increased risk for coronary disease," commented to David Dionne, Executive Publisher of The American Journal of Cardiology.
- Vincent E. Friedewald, MD, Kenneth S. Kornman, DDS, PhD, James D. Beck, PhD, Robert Genco, DDS, PhD, Allison Goldfine, MD, Peter Libby, MD, Steven Offenbacher, DDS, PhD, MMsc, Paul M. Ridker, MD, MPH, Thomas E. Van Dyke, DDS, PhD , and William C. Roberts, MD. The American Journal of Cardiology and Journal of Periodontology Editors' Consensus: Periodontitis and Atherosclerotic Cardiovascular Disease. American Journal of Cardiology, Volume 104, Issue 1 (July 1, 2009)
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