Periodontal Therapy in Patients with CVD

A recent systematic review of interventional trials evaluating the effects of periodontal therapy on CVD outcomes concluded that there are no studies currently that evaluate periodontal therapy as a primary prevention of CVD in patients with periodontitis.93 Authors conclude that periodontal treatment does reduce several risk factors for CVD, but that more studies are needed to determine the value of periodontal therapy for CVD patients.93,94

There is current evidence that periodontal therapy improves the following CVD risk factors:

  • Levels of pro-inflammatory cytokines95,96
  • Concentrations of CRP in patients with and without coronary heart disease95-99
  • Levels of fibrinogen and white blood cells98
  • Levels of total cholesterol95,100
  • Levels of low-density (“bad”) cholesterol100,101
  • Levels of high-density (“good”) cholesterol101
  • Triglyceride levels95
  • Endothelial function,102 especially in people with diabetes and CVD95
  • Systolic and diastolic blood pressure103
  • Left ventricular mass103
  • Pulse-wave velocity as a measure of arterial function103
  • Carotid intima-media thickness104

As a result of the above evidence, a joint statement from the editors from the Journal of Cardiology and the Journal of Periodontology was developed. This statement recommended that patients who are diagnosed with CVD should be managed by both physicians and periodontists to treat periodontal disease, maintain periodontal health, and optimize CVD care.105