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Oral Infections, Heart Disease & Stroke

The link between periodontal disease and cardiovascular disease (CVD) is considered serious. CVD accounts for 29% of deaths worldwide and is the second leading cause of death. Atherosclerosis (hardening and clogging of the arteries) is a major component of cardiovascular disease and affects one in four individuals. Family history and changes in diet and lifestyle do not fully account for the development of atherosclerosis. We know now that inflammation is also involved.

Patients who have pockets 4mm or greater in 15% of the teeth are more prone to have a heart attack than those whose tissues are healthy. Further, anaerobic infection was almost 4 times higher in those individuals who were hospitalized for cardiovascular disease than healthy individuals with no history of CVD.

Rubenfire, M.; Grossman, N.S.; Kaciroti, N.; Apsey, D.J.; and Loesche, WJ.: Anaerobic dental flora and the acute coronary syndrome. Coronary Artery Disease. 18(20):111-116, 2007.

Perhaps the most significant recommendation comes from Friedewald et al. The incidence of atherosclerotic CVD events increases in patients with chronic inflammatory diseases such as periodontal disease.

The authors state that cardiologists and periodontists are in agreement that patients with moderate to severe periodontal disease should be informed that there may be an increased risk for atherosclerotic CVD associated with periodontitis.

Further, when periodontal disease is newly diagnosed in patients with atherosclerotic CVD, dentists and physicians should closely collaborate to optimize CVD risk reduction and periodontal care.

"Patients with moderate to severe periodontitis should be informed that there may be an increased risk to atherosclerotic CVD associated with periodontitis."

Friedewald, Vincent et al. The American Journal of Cardiology and Journal of Periodontology. Editors Consensus: Periodontitis and Atherosclertic Cardiovascular Disease. American Journal of Cardiology. 2009: 104: 59-68. Published simultaneously in the Journal of Periodontology, July, 2009.

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