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LETTER TO EDITOR
Year : 2013  |  Volume : 2  |  Issue : 2  |  Page : 193-194

Periodontitis: Is it a risk factor for coronary heart disease?


1 Department of Prosthodontics, Shree Bankey Bihari Dental College, Ghaziabad, Uttar Pradesh, India
2 Department of Prosthodontics, ITS Dental College, Ghaziabad, Uttar Pradesh, India
3 Private Practitioner, Pitampura, New Delhi, India
4 Department of Conservative Dentistry and Endodontics, IDST Dental College, Ghaziabad, Uttar Pradesh, India

Date of Web Publication21-May-2013

Correspondence Address:
Prince Kumar
Department of Prosthodontics, Shree Bankey Bihari Dental College and Research Centre, Masuri, N.H. 24, Ghaziabad, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2278-9626.112329

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How to cite this article:
Kumar P, Kumar A, Khattar A, Goel R. Periodontitis: Is it a risk factor for coronary heart disease?. Eur J Gen Dent 2013;2:193-4

How to cite this URL:
Kumar P, Kumar A, Khattar A, Goel R. Periodontitis: Is it a risk factor for coronary heart disease?. Eur J Gen Dent [serial online] 2013 [cited 2019 Nov 15];2:193-4. Available from: http://www.ejgd.org/text.asp?2013/2/2/193/112329

Sir,

Periodontitis is a chronic infection caused by micro-organism, that severely compromises the supporting apparatus of teeth. The imperative relationship of periodontitis with coronary heart disease (CHD) have been shown in various cross-sectional and longitudinal studies. [1],[2] A remarkable increase in publications on this topic have been tracked in more than 180 peer reviewed English language journals in last two decades. [3] Most of these studies have shown a well established relationship between oral conditions, atherosclerosis and coronary heart disease. [4] Periodontitis and atherosclerosis have complex etiologies, genetic and gender predispositions and may share pathogenic mechanisms as well as common risk factors.

Atherosclerosis starts early in life since, disease progression is usually slow, clinical symptoms with or without hospitalization is rare before 45 years of age. The oral infections and chronic inflammatory conditions such as periodontitis can accelerate the atherosclerotic process. The evident association between periodontitis and coronary heart disease is usually difficult to explore as they share common multi factorial cascade. These include smoking, low social economic status and unfavorable health care practices of the individual. [5] Literature search with this perspective reveals number of publications addressing the relation between periodontitis and coronary heart disease. [3],[6],[7],[8] Some of the significant risk factors that could independently provoke periodontitis and cardiovascular disease are smoking, genetics, stress and increasing age. This may possibly lead to the misleading notion of the association of two diseases.

The Matrix metalloproteinase's (MMPs) also play a crucial role in periodontal tissue destruction and cardiovascular disease including the deleterious changes in extracellular matrix in the myocardium. Studies have also revealed that the inhibition of MMPs slowdowns periodontal attachment loss and the development of cardiac failure. [9] In addition, the oral cavity facilitates food mastication, digestion and acts as a doorway between the external environment and oral cavity. Poor oral hygiene and subsequent tooth loss can potentially affect gastrointestinal flora and nutritional status and they have implications for the development of chronic diseases. [7] It is therefore, essential to have definitive long term clinical studies that could demonstrate or further elucidate the associations between periodontitis and cardiovascular disease. However, by studying the apparent interaction between these two diseases, it is likely that we will learn even more about both.

 
  References Top

1.Beck J, Garcia R, Heiss G. Periodontal disease and cardiovascular disease. J Periodontol 1996;67:1123-37.  Back to cited text no. 1
    
2.Beck JD, Eke P, Heiss G, Madianos P, Couper D, Lin D, et al. Periodontal disease and coronary heart disease: A reappraisal of the exposure. Circulation 2005;112:19-24.  Back to cited text no. 2
    
3.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;125:1-25.  Back to cited text no. 3
    
4.DeStefano F, Anda RF, Kahn HS, Williamson DF, Russell CM. Dental disease and risk of coronary heart disease and mortality. BMJ 1993;306:688-91.  Back to cited text no. 4
    
5.Marshall JR, Graham S, Haughey BP, Shedd D, O'Shea R, Brasure J, et al. Smoking, alcohol, dentition and diet in the epidemiology of oral cancer. Eur J Cancer B Oral Oncol 1992;28B: 9-15.  Back to cited text no. 5
    
6.Buhlin K, Gustafsson A, Pockley AG, Frostegard J, Klinge B. Risk factors for cardiovascular disease in patients with periodontitis. Eur Heart J 2003;24:2099-107.  Back to cited text no. 6
    
7.Rutger Persson G, Ohlsson O, Pettersson T, Renvert S. Chronic periodontitis, a significant relationship with acute myocardial infarction. Eur Heart J 2003;24:2108-15.  Back to cited text no. 7
    
8.Papapanou PN, Trevisan M. Periodontitis and atherosclerotic vascular disease: What we know and why it is important. J Am Dent Assoc 2012;143:826-8.  Back to cited text no. 8
    
9.Matsumura S, Iwanaga S, Mochizuki S, Okamoto H, Ogawa S, Okada Y. Targeted deletion or pharmacological inhibition of MMP-2 prevents cardiac rupture after myocardial infarction in mice. J Clin Invest 2005:115:599-609.  Back to cited text no. 9
    




 

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