Gum disease and Heart Disease

There have been several studies to date which have shown that patients with periodontal disease have an increased risk for cardiovascular disease. Both diseases are inflammatory processes. Chronic inflammation of one area of the body, may cause untoward effects on other systems. Both diseases are very common. Cardiovascular disease is the leading cause of death in the US and Periodontal disease is the most common cause of adult tooth loss.

A consensus paper is being published online by the American Academy of Periodontology and the American Journal of Cardiology. In the paper the two societies make the following recommendations:

• Patients with periodontitis who have 1 known major atherosclerotic CVD risk factor such as smoking, immediate family history for CVD, or history of dyslipidemia should consider a medical evaluation if they have not done so within the past 12 months.
• A periodontal evaluation should be considered in patients with atherosclerotic CVD who have: signs or symptoms of gingival disease; significant tooth loss, and unexplained elevation of hs-CRP or other inflammatory biomarkers.
• A periodontal evaluation of patients with atherosclerotic CVD should include a comprehensive examination of periodontal tissues, as assessed by visual signs of inflammation and bleeding on probing; loss of connective tissue attachment detected by periodontal probing measurements; and bone loss assessed radiographically. If patients have untreated or uncontrolled periodontitis, they should be treated with a focus on reducing and controlling the bacterial accumulations and eliminating inflammation.
• When periodontitis is newly diagnosed in patients with atherosclerotic CVD, periodontists and physicians managing patients' CVD should closely collaborate in order to optimize CVD risk reduction and periodontal care.

I am very interested in following the science behind this association. Is the relationship between heart disease and periodontal disease a causal one (does one disease truly cause the other disease) or a casual one ( is it just that patients with one disease are more likely to have the other disease too).

I will keep you updated as more research is reported.