Journal of Pediatrics Review

Published by: Kowsar

Periodontal Diseases and Possible Future Cardiovascular Events, Are they Related? An Overview

Shahryar Karami 1 , Nazanin Ghobadi 1 , Amirhossein Pakravan 2 , Mojdeh Dabirian 3 , * and Farhad Sobouti 4
Authors Information
1 Department of Dentistry, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran
2 Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran
3 Cardiologist, Clinical Research Development Unit of Bou-Ali Sina Hospital, Mazandaran university of Medical Sciences, Sari, Iran
4 Orthodontic Department, Dental Faculty, Mazandaran University of Medical Sciences, Sari, Iran
Article information
  • Journal of Pediatrics Review: January 2018, 6 (1); e11144
  • Published Online: October 8, 2017
  • Article Type: Review Article
  • Received: February 23, 2017
  • Revised: June 12, 2017
  • Accepted: July 8, 2017
  • DOI: 10.5812/jpr.11144

To Cite: Karami S, Ghobadi N, Pakravan A, Dabirian M, Sobouti F. et al. Periodontal Diseases and Possible Future Cardiovascular Events, Are they Related? An Overview, J Pediatr Rev. 2018 ;6(1):e11144. doi: 10.5812/jpr.11144.

Copyright © 2017, Journal of Pediatrics Review. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
1. Context
2. Evidence Acquisition
3. Results
4. Conclusions
  • 1. Murray CJ, Lopez AD. Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study. Lancet. 1997;349(9063):1436-42. doi: 10.1016/S0140-6736(96)07495-8. [PubMed: 9164317].
  • 2. Blaizot A, Vergnes JN, Nuwwareh S, Amar J, Sixou M. Periodontal diseases and cardiovascular events: meta-analysis of observational studies. Int Dent J. 2009;59(4):197-209. [PubMed: 19774803].
  • 3. Zipes DP, Libby P, Bonow RO, Braunwald E. A textbook of cardiovascular medicine. pp858. Philadelphia: Saunders; 2005.
  • 4. Eke PI, Dye BA, Wei L, Thornton-Evans GO, Genco RJ, Cdc Periodontal Disease Surveillance workgroup: James Beck GDRP. Prevalence of periodontitis in adults in the United States: 2009 and 2010. J Dent Res. 2012;91(10):914-20. doi: 10.1177/0022034512457373. [PubMed: 22935673].
  • 5. Tonetti MS, Van Dyke TE, Working group 1 of the joint E. Periodontitis and atherosclerotic cardiovascular disease: consensus report of the Joint EFP/AAP Workshop on Periodontitis and Systemic Diseases. J Clin Periodontol. 2013;40 Suppl 14:S24-9. doi: 10.1111/jcpe.12089. [PubMed: 23627332].
  • 6. Tang WH, Hazen SL. Microbiome, trimethylamine N-oxide, and cardiometabolic disease. Transl Res. 2017;179:108-15. doi: 10.1016/j.trsl.2016.07.007. [PubMed: 27490453].
  • 7. Suzuki J, Aoyama N, Ogawa M, Hirata Y, Izumi Y, Nagai R, et al. Periodontitis and cardiovascular diseases. Expert Opin Ther Targets. 2010;14(10):1023-7. doi: 10.1517/14728222.2010.511616. [PubMed: 20678026].
  • 8. Ridker PM, Hennekens CH, Buring JE, Rifai N. C-reactive protein and other markers of inflammation in the prediction of cardiovascular disease in women. N Engl J Med. 2000;342(12):836-43. doi: 10.1056/NEJM200003233421202. [PubMed: 10733371].
  • 9. Tzorbatzoglou ID, Sfyroeras GS, Giannoukas AD. Periodontitis and carotid atheroma: is there a causal relationship?. Int Angiol. 2010;29(1):27-9. [PubMed: 20224528].
  • 10. Demmer RT, Desvarieux M. Periodontal infections and cardiovascular disease: the heart of the matter. J Am Dent Assoc. 2006;137 Suppl:14S-20S. quiz 38S. [PubMed: 17012731].
  • 11. Heaton B, Applebaum KM, Rothman KJ, Brooks DR, Heeren T, Dietrich T, et al. The influence of prevalent cohort bias in the association between periodontal disease progression and incident coronary heart disease. Ann Epidemiol. 2014;24(10):741-6. doi: 10.1016/j.annepidem.2014.07.006. [PubMed: 25169680].
  • 12. Hyvarinen K, Mantyla P, Buhlin K, Paju S, Nieminen MS, Sinisalo J, et al. A common periodontal pathogen has an adverse association with both acute and stable coronary artery disease. Atherosclerosis. 2012;223(2):478-84. doi: 10.1016/j.atherosclerosis.2012.05.021. [PubMed: 22704805].
  • 13. Lockhart PB, Bolger AF, Papapanou PN, Osinbowale O, Trevisan M, Levison ME, et al. Periodontal disease and atherosclerotic vascular disease: does the evidence support an independent association?: a scientific statement from the American Heart Association. Circulation. 2012;125(20):2520-44. doi: 10.1161/CIR.0b013e31825719f3. [PubMed: 22514251].
  • 14. Cotti E, Dessì C, Piras A, Mercuro G. Can a chronic dental infection be considered a cause of cardiovascular disease? A review of the literature. Int J Cardiol. 2011;148(1):4-10.
  • 15. Howell TH, Ridker PM, Ajani UA, Christen WG, Hennekens CH. Periodontal disease and risk of subsequent cardiovascular disease in U.S. male physicians. J Am College Cardiol. 2001;37(2):445-50. doi: 10.1016/s0735-1097(00)01130-x.
  • 16. D'Aiuto F, Nibali L, Parkar M, Suvan J, Tonetti MS. Short-term effects of intensive periodontal therapy on serum inflammatory markers and cholesterol. J Dent Res. 2005;84(3):269-73. doi: 10.1177/154405910508400312. [PubMed: 15723869].
  • 17. Higashi Y, Goto C, Hidaka T, Soga J, Nakamura S, Fujii Y, et al. Oral infection-inflammatory pathway, periodontitis, is a risk factor for endothelial dysfunction in patients with coronary artery disease. Atherosclerosis. 2009;206(2):604-10. doi: 10.1016/j.atherosclerosis.2009.03.037. [PubMed: 19410250].
  • 18. Fong IW. Infections and their role in atherosclerotic vascular disease. J Am Dent Assoc. 2002;133 Suppl:7S-13S. [PubMed: 12085725].
  • 19. Saunders CP, Roberts GJ. Dental attitudes, knowledge, and health practices of parents of children with congenital heart disease. Arch Dis Child. 1997;76(6):539-40. [PubMed: 9245857].
  • 20. Desvarieux M, Demmer RT, Rundek T, Boden-Albala B, Jacobs DJ, Papapanou PN, et al. Relationship between periodontal disease, tooth loss, and carotid artery plaque: the Oral Infections and Vascular Disease Epidemiology Study (INVEST). Stroke. 2003;34(9):2120-5. doi: 10.1161/01.STR.0000085086.50957.22. [PubMed: 12893951].
  • 21. Haraszthy VI, Zambon JJ, Trevisan M, Zeid M, Genco RJ. Identification of periodontal pathogens in atheromatous plaques. J Periodontol. 2000;71(10):1554-60. doi: 10.1902/jop.2000.71.10.1554. [PubMed: 11063387].
  • 22. Mehrani J, Karami H, Karami S, Ghobadi N. Effects of Nutritional Composition on Periodontal Disease. JCE; 2015.
  • 23. Prasad M, Matteson EL, Herrmann J, Gulati R, Rihal CS, Lerman LO, et al. Uric Acid Is Associated With Inflammation, Coronary Microvascular Dysfunction, and Adverse Outcomes in Postmenopausal Women. Hypertension. 2017;69(2):236-42. doi: 10.1161/HYPERTENSIONAHA.116.08436. [PubMed: 27993955].
  • 24. Geerts SO, Legrand V, Charpentier J, Albert A, Rompen EH. Further evidence of the association between periodontal conditions and coronary artery disease. J Periodontol. 2004;75(9):1274-80. doi: 10.1902/jop.2004.75.9.1274. [PubMed: 15515345].
  • 25. Pussinen PJ, Alfthan G, Jousilahti P, Paju S, Tuomilehto J. Systemic exposure to Porphyromonas gingivalis predicts incident stroke. Atherosclerosis. 2007;193(1):222-8. doi: 10.1016/j.atherosclerosis.2006.06.027. [PubMed: 16872615].
  • 26. Pussinen PJ, Alfthan G, Rissanen H, Reunanen A, Asikainen S, Knekt P. Antibodies to periodontal pathogens and stroke risk. Stroke. 2004;35(9):2020-3. doi: 10.1161/01.STR.0000136148.29490.fe. [PubMed: 15232116].
  • 27. Renvert S, Pettersson T, Ohlsson O, Persson GR. Bacterial profile and burden of periodontal infection in subjects with a diagnosis of acute coronary syndrome. J Periodontol. 2006;77(7):1110-9. doi: 10.1902/jop.2006.050336. [PubMed: 16805672].
  • 28. DeStefano F, Anda RF, Kahn HS, Williamson DF, Russell CM. Dental disease and risk of coronary heart disease and mortality. BMJ. 1993;306(6879):688-91. [PubMed: 8471920].
  • 29. Genco RJ, Trevisan M, Wu T, Beck JD. Periodontal disease and risk of coronary heart disease. JAMA. 2001;285(1):40-1. [PubMed: 11150098].
  • 30. Humphrey LL, Fu R, Buckley DI, Freeman M, Helfand M. Periodontal disease and coronary heart disease incidence: a systematic review and meta-analysis. J Gen Intern Med. 2008;23(12):2079-86. doi: 10.1007/s11606-008-0787-6. [PubMed: 18807098].
  • 31. Cueto A, Mesa F, Bravo M, Ocana-Riola R. Periodontitis as risk factor for acute myocardial infarction. A case control study of Spanish adults. J Periodontal Res. 2005;40(1):36-42. doi: 10.1111/j.1600-0765.2004.00766.x. [PubMed: 15613077].
  • 32. Hujoel PP, Drangsholt M, Spiekerman C, DeRouen TA. Periodontal disease and coronary heart disease risk. JAMA. 2000;284(11):1406-10. [PubMed: 10989403].
  • 33. Mendez MV, Scott T, LaMorte W, Vokonas P, Menzoian JO, Garcia R. An association between periodontal disease and peripheral vascular disease. Am J Surg. 1998;176(2):153-7. [PubMed: 9737622].
  • 34. Bahekar AA, Singh S, Saha S, Molnar J, Arora R. The prevalence and incidence of coronary heart disease is significantly increased in periodontitis: a meta-analysis. Am Heart J. 2007;154(5):830-7. doi: 10.1016/j.ahj.2007.06.037. [PubMed: 17967586].
  • 35. Kodovazenitis G, Pitsavos C, Papadimitriou L, Vrotsos IA, Stefanadis C, Madianos PN. Association between periodontitis and acute myocardial infarction: a case-control study of a nondiabetic population. J Periodontal Res. 2014;49(2):246-52. doi: 10.1111/jre.12101. [PubMed: 23713486].
  • 36. Holmlund A, Lind L. Number of teeth is related to atherosclerotic plaque in the carotid arteries in an elderly population. J Periodontol. 2012;83(3):287-91. doi: 10.1902/jop.2011.110100. [PubMed: 21861640].
  • 37. Syrjala AM, Ylostalo P, Hartikainen S, Sulkava R, Knuuttila ML. Number of teeth and myocardial infarction and stroke among elderly never smokers. J Negat Results Biomed. 2009;8:6. doi: 10.1186/1477-5751-8-6. [PubMed: 19386093].
  • 38. Frisk F, Hakeberg M, Ahlqwist M, Bengtsson C. Endodontic variables and coronary heart disease. Acta Odontol Scand. 2003;61(5):257-62. [PubMed: 14763775].
  • 39. Kozarov EV, Dorn BR, Shelburne CE, Dunn WJ, Progulske-Fox A. Human atherosclerotic plaque contains viable invasive Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis. Arterioscler Thromb Vasc Biol. 2005;25(3):e17-8. doi: 10.1161/01.ATV.0000155018.67835.1a. [PubMed: 15662025].
  • 40. Li L, Michel R, Cohen J, Decarlo A, Kozarov E. Intracellular survival and vascular cell-to-cell transmission of Porphyromonas gingivalis. BMC Microbiol. 2008;8:26. doi: 10.1186/1471-2180-8-26. [PubMed: 18254977].
  • 41. Reichert S, Schlitt A, Beschow V, Lutze A, Lischewski S, Seifert T, et al. Use of floss/interdental brushes is associated with lower risk for new cardiovascular events among patients with coronary heart disease. J Periodontal Res. 2015;50(2):180-8. doi: 10.1111/jre.12191. [PubMed: 24824149].
  • 42. Saffi MA, Furtado MV, Montenegro MM, Ribeiro IW, Kampits C, Rabelo-Silva ER, et al. The effect of periodontal therapy on C-reactive protein, endothelial function, lipids and proinflammatory biomarkers in patients with stable coronary artery disease: study protocol for a randomized controlled trial. Trials. 2013;14:283. doi: 10.1186/1745-6215-14-283. [PubMed: 24010954].
  • 43. Dietrich T, Sharma P, Walter C, Weston P, Beck J. The epidemiological evidence behind the association between periodontitis and incident atherosclerotic cardiovascular disease. J Clin Periodontol. 2013;40 Suppl 14:S70-84. doi: 10.1111/jcpe.12062. [PubMed: 23627335].
  • 44. Dorn JM, Genco RJ, Grossi SG, Falkner KL, Hovey KM, Iacoviello L, et al. Periodontal disease and recurrent cardiovascular events in survivors of myocardial infarction (MI): the Western New York Acute MI Study. J Periodontol. 2010;81(4):502-11. doi: 10.1902/jop.2009.090499. [PubMed: 20367093].
  • 45. Mucci LA, Hsieh CC, Williams PL, Arora M, Adami HO, de Faire U, et al. Do genetic factors explain the association between poor oral health and cardiovascular disease? A prospective study among Swedish twins. Am J Epidemiol. 2009;170(5):615-21. doi: 10.1093/aje/kwp177. [PubMed: 19648170].
  • 46. Ernst FD, Uhr K, Teumer A, Fanghanel J, Schulz S, Noack B, et al. Replication of the association of chromosomal region 9p21.3 with generalized aggressive periodontitis (gAgP) using an independent case-control cohort. BMC Med Genet. 2010;11:119. doi: 10.1186/1471-2350-11-119. [PubMed: 20696043].
  • 47. Yu YH, Chasman DI, Buring JE, Rose L, Ridker PM. Cardiovascular risks associated with incident and prevalent periodontal disease. J Clin Periodontol. 2015;42(1):21-8. doi: 10.1111/jcpe.12335. [PubMed: 25385537].
  • 48. Kuramitsu HK, Qi M, Kang IC, Chen W. Role for periodontal bacteria in cardiovascular diseases. Ann Periodontol. 2001;6(1):41-7. doi: 10.1902/annals.2001.6.1.41. [PubMed: 11887470].
  • 49. Bokhari SA, Khan AA, Leung WK, Wajid G. Association of periodontal and cardiovascular diseases: South-Asian studies 2001-2012. J Indian Soc Periodontol. 2015;19(5):495-500. doi: 10.4103/0972-124X.157876. [PubMed: 26644713].
  • 50. Taylor GW, Manz MC, Borgnakke WS. Diabetes, periodontal diseases, dental caries, and tooth loss: a review of the literature. Compendium Continu Educ Dent. 2004;25(3):179-84.
Creative Commons License Except where otherwise noted, this work is licensed under Creative Commons Attribution Non Commercial 4.0 International License .

Search Relations:



Create Citiation Alert
via Google Reader

Readers' Comments