New research is reinforcing the longstanding belief that a connection exists between periodontal disease, or severe gum inflammation, and cardiovascular disease. But according to Moise Desvarieux, MD, PhD, infectious disease epidemiologist in the Department of Epidemiology at Columbia University's Mailman School of Public Health, the nature of the relationship is still unclear and patients cannot rely only on good oral hygiene as a way to reduce their risk for heart disease--they must manage other risk factors for the disease as well.
Cardiovascular diseases remain the biggest cause of deaths worldwide, though over the last two decades, cardiovascular mortality rates have declined in many high-income countries but have increased at an astonishingly fast rate in low- and middle-income countries. The percentage of premature deaths from cardiovascular disease range from 4% in high-income countries to 42% in low-income countries. More than 17 million people died from cardiovascular diseases in 2008. Each year, heart disease kills more Americans than cancer. In recent years, cardiovascular risk in women has been increasing and has killed more women than breast cancer. (PDAY) showed vascular injury accumulates from adolescence, making primary prevention efforts necessary from childhood.
"It appears a relationship exists, but we don't know exactly what it is and if it is a causal relationship.Therefore, we can't make recommendations for people with periodontal disease in respect to cardiovascular disease," said Dr. Desvarieux, whose team studies periodontal disease in relation to atherosclerosis, or hardening of the arteries, "To reduce their risk for cardiovascular disease, patients must manage all their risk factors, including smoking, diabetes, and weight."
Most research to date has been specifically on the clinical level, explained Dr. Desvarieux. Using a manual probe, dentists measure for signs of periodontal disease, including gum inflammation, gum pocket depth, or spacing around each tooth and tooth-bone attachment loss and compare these data to ultrasound measurements of the carotid artery. If cholesterol or fatty buildup is detected on the wall of the artery, there's a good chance the patient has atherosclerosis, a direct link to future stroke and cardiovascular disease.
"If we determine that there is a causal relationship between periodontal disease and cardiovascular disease, patients at risk will have to manage their oral health in addition to their other risk factors. The periodontal disease-cardiovascular disease connection won't negate their diabetes, weight or smoking habit. Individually, each contributes to the disease and the more risk factors, the more likely that one will have an episode."
But Dr. Desvarieux stressed that even though the exact relationship has not been discovered, it doesn't mean patients should neglect their oral health. "It is hard for anyone to be against good oral health" he said. "If a causal relationship is found, you'll already be ahead of the game in regards to your heart health. If there is no relationship, you'll have a healthy mouth that will benefit your overall well-being."