Periodontal and General Health

Periodontal disease has been shown to be associated with several health conditions, including type 2 diabetes, cardiovascular disease, and pregnancy.  “Association” does not mean “cause,” and the relationship of periodontal disease to these general health issues is controversial.

Cardiovascular Disease

There are two reasons why periodontal disease is thought to be related to cardiovascular disease, according to a systematic review of studies from the Cochrane database (Chunjie, 2014).

1. Levels of inflammation in the body increase when periodontitis is present, and molecules responsible for driving the inflammatory response decrease after periodontal treatment. 

2. Periodontal bacteria may enter the bloodstream and invade the cardiovascular system. Periodontal microorganisms have been identified in atheromas (abnormal masses of fatty tissue in the wall of an artery), and may play a role in the buildup of plaque in the coronary arteries.

Also, the two diseases share risk factors like smoking, diabetes, obesity, and hypertension.  The association of these two diseases has been proved by clinical trials.

An interesting retrospective cohort study, by reviewing medical insurance records, found that treatment for periodontal disease significantly reduced insurance-covered medical costs and inpatient hospital admissions for type 2 diabetes, cardiovascular disease, and pregnancy.  However, it is not clear that medical treatment costs are an accurate surrogate measure for disease severity.  In this study, no details were provided regarding the severity of periodontal disease in the study participants. 

The review by Chunjie noted above is a review of multiple studies investigating the effect of periodontal therapy on the prevention and management of cardiovascular disease, and concluded that “We found very low quality evidence that was insufficient to determine the effect of periodontal treatment on cardiovascular disease in patients with chronic periodontitis.”  Although the impact of periodontal disease on general health remains controversial, it is clearly very important to identify and treat periodontitis.