The Perio-Cardio Connection, Relationship Between Heart Disease and Gum Disease
February 19th, 2010
By Dr. Edgard El Chaar
Gum (periodontal) diseases are chronic bacterial infections that affect the gums and supporting structures of the teeth and, if left untreated, can lead to serious health problems including heart disease.
When the link between cardiovascular heart disease and periodontal disease was identified and debated in the 1990’s, there were many skeptics who dismissed it entirely.
However, as more patient cases surfaced and were evaluated through epidemiological studies, the more the correlation became evident among the medical community. Approximately 80 percent of American adults have some form of gum disease.
There have been multiple scientific explanations proposed for the perio-cardio correlation. Mainly inflammation markers (C-Reactive protein, White blood cells count, Fibrinogen).
These markers of inflammation were found to be elevated in patients with periodontal disease.
Once these patients were treated with non surgical periodontal therapy (deep scaling and root planning) the levels of these markers decreased significantly (21-40%).
Researchers have found that people with periodontal disease are twice as likely to suffer from coronary artery disease compared to those without periodontal disease.
Recently a consensus paper on the relationship between heart disease and gum disease was published to address the scientific evidence that links periodontal disease and cardiovascular disease and explain the underlying biologic and inflammatory mechanisms that may be the basis for the connection.
This paper also provided clinical recommendations for medical and dental professionals to use in managing patients living with, or who are at risk for, either disease.
Heart disease is not the only health risk associated with periodontal disease. Clinical studies have linked gum disease to respiratory conditions, premature births and diabetes due to the bacteria in the mouth traveling throughout the body.
In my opinion, there are still more questions to be answered and clinical research to be conducted, specifically to determine:
1. If periodontal disease (periodontitis) is an independent risk factor for atherosclerotic cardio vascular disease?
2. If periodontitis is an independent factor, what is the mechanics of their relationship?
New York City periodontist, Dr. Edgard El Chaar, DDS, MS, specializes in the prevention and treatment of gum disease and is an active advocate in educating patients about the perio-cardio connection and new treatment guidelines.