Patients with gum disease ‘should be assessed for heart disease’

MedWire News: Patients with moderate-to-severe gum disease (periodontitis) should receive evaluation of, and possibly treatment to reduce, their risk of atherosclerotic cardiovascular disease, say experts.

Periodontitis is a chronic inflammatory disease of the gums that is caused by bacteria and results in the loss of connective tissue and bone that support the teeth. It is a common condition, with mild-to-moderate periodontitis affecting 30–50% of US adults and moderate-to-severe periodontitis affecting 5–15%.

In a consensus statement published jointly in the American Journal of Cardiology and the Journal of Peridontology, the editors of these publications say that there is now strong evidence to show that people with periodontitis are at increased risk of atherosclerotic cardiovascular disease – the build-up of fatty deposits inside arteries. Atherosclerosis causes arteries to narrow resulting in an increased risk of heart attacks and strokes.

The reason for the link between periodontitis and atherosclerotic cardiovascular disease is not clear, but it is thought that inflammation, which is now recognised as a significant factor in many chronic diseases, may play a major role. Other possible risk factors in the link between periodontitis and atherosclerotic cardiovascular disease include smoking, diabetes, genetics, mental anxiety, depression, obesity and physical inactivity.

Whatever the reasons for the link between the two disorders, the expert panel says that evidence is now strong enough to recommend that doctors assess patients with periodontitis for atherosclerotic cardiovascular disease. 

They say that patients with moderate-to-severe periodontitis should be informed that they may be at increased risk of atherosclerotic cardiovascular disease.

Furthermore, periodontitis patients with one or more known major risk factor for atherosclerotic cardiovascular disease should consider a medical evaluation if they have not done so in the past 12 months.

David Dionne, executive publisher of the American Journal of Cardiology, concluded: “This consensus paper is important because it will draw attention to the fact that patients with periodontitis, especially moderate and severe forms of the disease, can have increased risk for coronary disease.”