The Link Between Periodontitis and Cardiovascular Disease
Dr. Adrian-Florin Gabără & Dr. Silviu Stanciu
Abstract
Periodontal disease (PD) is a prevalent chronic inflammatory condition that causes
progressive destruction of tooth-supporting structures. Increasing evidence suggests
that PD may play a contributory role in systemic diseases, particularly cardiovascular
disorders such as atherosclerosis and infective endocarditis. Both PD and
atherosclerosis share inflammatory and immune-mediated pathways, indicating a
potential bidirectional relationship.
This narrative review aimed to synthesize current data on the biological and clinical
links between PD, atherosclerosis, and endocarditis. A systematic search of PubMed
and the Cochrane Library (2010–2024) identified approximately 500 articles, of which
41 met the inclusion criteria, supplemented by three seminal earlier publications.
Findings indicate consistent associations between PD and increased risk of adverse
cardiac events, stroke, and cardiovascular mortality. Two main mechanisms have
been proposed: direct infection of endothelial cells by periodontal pathogens and
systemic inflammation triggered by chronic periodontitis. Moreover, PD may act as a
cofactor in the development of infective endocarditis in predisposed individuals.
Further prospective, large-scale studies are required to confirm causality and define
the clinical benefits of periodontal therapy in reducing cardiovascular risk.
Standardized diagnostic criteria for PD and harmonized outcome measures are
essential for future research.
Learning Objectives
- Understand the biological and clinical mechanisms linking periodontal disease
with atherosclerosis and infective endocarditis. - Recognize the current evidence supporting the association between
periodontal inflammation and cardiovascular morbidity and mortality. - Evaluate the limitations of existing research and the need for standardized
methodologies to clarify causality and clinical implications.