A new scientific statement from the American Heart Association published in its flagship journal Circulation provides updated evidence linking periodontal disease to atherosclerotic cardiovascular disease. The statement indicates that effective prevention and treatment of gum disease could potentially decrease the burden of cardiovascular disease, which remains the leading cause of death globally.
The statement, titled "Periodontal Disease and Atherosclerotic Cardiovascular Disease," features new data supporting an association between the two conditions and updates the Association's 2012 scientific statement. Andrew H. Tran, M.D., M.P.H., M.S., FAHA, chair of the scientific statement writing group, emphasized the connection between oral and cardiovascular health, noting that gum disease and poor oral hygiene can allow bacteria to enter the bloodstream, causing inflammation that may damage blood vessels and increase heart disease risk.
Periodontal disease is a chronic inflammatory condition affecting over 40% of U.S. adults over age 30. The condition progresses from gingivitis to periodontitis, where gums pull away from teeth, forming pockets that trap bacteria and lead to infection. Severe periodontitis involves extensive damage to bones supporting teeth and often requires surgical intervention. The prevalence is higher among individuals with poor oral hygiene and cardiovascular disease risk factors including high blood pressure, overweight or obesity, diabetes, and smoking.
Although periodontal disease and atherosclerotic cardiovascular disease share common risk factors, emerging data indicates an independent association between the conditions. Potential biological mechanisms include direct pathways such as bacteria in the blood and vascular infections, as well as indirect pathways involving chronic systemic inflammation. Numerous studies have found periodontal disease associated with increased risk of heart attack, stroke, atrial fibrillation, heart failure, peripheral artery disease, chronic kidney disease, and cardiac death.
While a cause-and-effect relationship has not been confirmed, and there is no direct evidence that periodontal treatment will help prevent cardiovascular disease, treatments that reduce lifetime exposure to inflammation appear beneficial for reducing atherosclerotic cardiovascular disease risk. People with cardiovascular disease risk factors may benefit from regular dental screenings and targeted periodontal care to address chronic inflammation. Previous studies have found more frequent tooth brushing associated with lower 10-year atherosclerotic cardiovascular disease risk and reduced inflammatory markers.
The statement calls for more research, including long-term studies and randomized controlled trials, to determine whether periodontal treatment can impact atherosclerotic cardiovascular disease progression and outcomes. Additionally, the role of socioeconomic status, access to dental care, and other social factors that adversely affect health should be explored to develop targeted prevention and treatment strategies. The scientific statement was prepared by a volunteer writing group representing multiple American Heart Association councils and committees. Financial information about the Association is available here.
