The evidence for an association between cardiovascular diseases and periodontitis is as follows:
- Plausibility – periodontitis leads to entry of bacteria into the blood stream. The bacteria activate the host’s inflammatory-immune response by multiple mechanisms. Several animal models have demonstrated the host’s inflammatory response favors atheroma formation, maturation and exacerbation.
- Epidemiological data – there is consistent epidemiological evidence that periodontitis imparts increased risk for future cardiovascular disease, independently of other confounding factors.
- Intervention studies – there is moderate evidence periodontal treatment reduces systemic inflammation as evidenced by reductions in C-reactive protein (CRP) and oxidative stress, and leads to improvements of surrogate clinical and biochemical measures of vascular endothelial function.