Periodontitis & cardiovascular diseases
PD Dr. Kristina Bertl, PhD MSc MBA
The ‘Perio–Cardio Workshop 2019’ took place in February 2019. This workshop was organized by the World Heart Federation in collaboration with the European Federation of Periodontology (http://www.efp.org/publications/projects/perio-cardio-workshop-2019/index.html).
Cardiovascular diseases, particularly coronary heart conditions and strokes, cause approximately 3.9 million deaths in Europe every year. A possible link between dental health and cardiovascular diseases has been discussed in literature for decades. For example, as early as 1989, a case-control study showed that the oral health of patients with acute myocardial infarction was significantly worse than that of patients in a control group (Mattila et al. 1989).
Based on the results of the Perio–Cardio Workshop, the following recommendations for oral health professionals were put together (Sanz et al. 2020):
- Periodontitis patients should be informed of their higher risk of cardiovascular diseases (e.g. myocardial infarction, stroke) and encouraged to reduce other risk factors (e.g. smoking, excess weight, high blood pressure, hyperlipidaemia, etc.) as much as possible.
- Periodontitis patients who have been diagnosed with a cardiovascular disease should be informed of their higher risk of cardiovascular complications and should be encouraged to attend regular check-ups and periodontal (maintenance) therapy.
- Oral health professionals should take a detailed history of the patient’s cardiovascular risk factors and, if necessary, recommend that the patient visit their general practitioner.
- Patients with cardiovascular diseases should be given a thorough examination with regard to their periodontal health status. If no periodontal disease is present, the patient should be offered preventative measures (e.g. oral hygiene instructions, oral hygiene sessions) and they should have a check-up at least once per year.
- Patients with cardiovascular diseases who are diagnosed with periodontal disease should – providing their health allows it – be started on non-surgical periodontal treatment as soon as possible, preferably in the form of several short sessions (30–45 minutes), in order to keep the systemic burden of treatment as low as possible. When planning any surgical treatment measures, other factors – for example high blood pressure and medications – should be taken into account.
- Mattila KJ, Nieminen MS, Valtonen VV, Rasi VP, Kesäniemi YA, Syrjälä SL, Jungell PS, Isoluoma M, Hietaniemi K, Jokinen MJ. Association between dental health and acute myocardial infarction. BMJ. 1989 Mar 25;298(6676):779-81.
Sanz M, Marco Del Castillo A, Jepsen S, Gonzalez-Juanatey JR, D'Aiuto F, Bouchard P, Chapple I, Dietrich T, Gotsman I, Graziani F, Herrera D, Loos B, Madianos P, Michel JB, Perel P, Pieske B, Shapira L, Shechter M, Tonetti M, Vlachopoulos C, Wimmer G. Periodontitis and cardiovascular diseases: Consensus report. J Clin Periodontol. 2020 Mar;47(3):268-288. doi: 10.1111/jcpe.13189.