Oral Connections

The potential for active periodontal inflammation to affect overall health, including cardiovascular disease and stroke, has initiated research to further study linkages between oral health and systemic disease. A special report published in Scientific American and a supplement to the Journal of the American Dental Association explored potential links between oral infections and systemic relationships; however, the causality of the relationship has yet to be fully determined.⁴⁷ Such potential relationships afford unprecedented opportunities for oral health care professionals to collaborate with the medical profession in addressing the management of systemic disease.

Associations between hyperlipidemia, hyperglycemias, and periodontal disease and CVD and stroke have been documented.^48,49 Periodontal and cardiovascular diseases share many risk factors, such as age, educational level, sex/gender, income level, smoking and drinking habits, hypertension, stress, depression, and diabetes.⁵⁰ Researchers suggest specific bacterial inflammatory responses trigger CVD and CVA events. It is now clear from the epidemiologic studies that a potential link does exist between PD and CVD.⁵¹ In a recent hospital based study in stroke and TIA patients, there was no link between high periodontal disease and recurrent vascular episodes.⁵²

While precise links and causal factors between CVD, stroke and periodontal disease continue to be researched, oral concerns commonly associated with medications are well-documented.⁵³ With numerous reports in medical and dental journals substantiating a periodontal-systemic relationship, the role of oral health care professionals to risk assess patients demonstrating inflammatory burdens, recognize oral adverse reactions often encountered from medications, and educate patients about the benefits from daily self-care regimens will improve oral health outcomes and further establish oral health as an essential component necessary for overall health. With a yearly estimate of 15 million people worldwide suffering from stroke, recognition and treatment for gingival and inflammatory periodontal diseases can potentially minimize further risk for systemic disorders. Oral healthcare professionals can identify patients who are unaware of their risk of developing serious complications as a result of CVD, who are in need of medical intervention, and provide appropriate referrals.