The Perio & Cardio Workshop, a joint event of the EFP and the World Heart Federation (WHF), has ended with a rallying call for greater awareness among health professionals and the public of the links between gum disease and heart disease.
After reviewing the latest evidence on the associations between periodontitis and cardiovascular diseases, the 20 experts from the two organisations noted how good oral health can improve cardiovascular outcomes and how both cardiologists and periodontists should integrate these findings into their daily practice.
“More awareness is needed of the link between oral health and cardiovascular disease,” said Pablo Perel, WHF senior science adviser at the conclusion of the workshop.
“The Perio & Cardio Workshop has provided evidence-based recommendations in relation to cardiovascular health and periodontology. Since cardiovascular disease is the first cause of death in the world, reducing risk factors that contribute to heart disease is of utmost importance.”
The evidence reviewed by the workshop suggests that patients with severe gum disease are at greater risk of heart attack and stroke, particularly if they have had a previous cardiovascular event. Bacteria in the mouth can move into the circulatory system and promote inflammation and hardening of the arteries (atherosclerosis).
In addition, periodontitis and heart disease share common risk factors including smoking, alcohol consumption, diabetes, and age. Cardiovascular diseases (CVD) are the number-one cause of death globally, while severe periodontitis is the sixth most common chronic condition.
“Both periodontitis and cardiovascular disease affect many people worldwide,” said Mariano Sanz, EFP co-chair of the Perio & Cardio Workshop, which was sponsored by EFP partner Dentaid. “Determining the importance of periodontal-disease prevention and therapy as a means to reduce cardiovascular risk can have significant public-health and economic implications.”
Improving cardiovascular outcomes
The workshop, held at the Hotel Quinta de los Cedros in Madrid on February 18 and 19, updated the work of the EFP’s IX European Workshop on Periodontology, held in 2012, which explored the links between periodontitis and systemic conditions including cardiovascular diseases.
Its two working groups explored the epidemiological evidence linking periodontitis and CVD and the biological mechanisms for the increased risk of atherosclerosis in patients with periodontitis (working group 1), and the effect of periodontal treatment on the risk of atherosclerosis and the potential cardiovascular risks of oral interventions (working group 2).
“Cardiologists should be aware of the connection between gum disease and heart disease and encourage their patients to be screened for periodontitis and pursue good oral hygiene because it will improve cardiovascular outcomes,” said Alvaro Marco Del Castillo, WHF co-chair of working group 1.
Regarding the effect of periodontal treatment on the risk of atherosclerosis, José Ramón González Juanatey, WHF co-chair of working group 2, said that more research was needed but that “current evidence suggests that the progression of CVD may be influenced by good oral hygiene and successful periodontal treatment.”
Søren Jepsen, EFP co-chair of working group 2, added: “Patients with periodontitis should be advised that they have a higher risk of heart disease and should manage their CVD risk factors. Regarding potential cardiovascular risks of periodontal treatment, available research indicates that periodontal treatment is safe for cardiac patients.”
The workshop also pinpointed areas for future research, including clinical trials using hard cardiovascular outcomes and further studies to understand the mechanisms by which oral bacteria may cause damage to cardiovascular tissues.
The EFP and WHF recommendations will be written up and published as an open-access supplement in the EFP’s Journal of Clinical Periodontology.
An outreach project will later be developed by the EFP’s communications team to create awareness about the essential role of oral health in reducing the risk of heart disease.
This project – which, like the workshop, will be sponsored by Dentaid – will disseminate the key information from this workshop to oral-healthcare professionals, physicians, pharmacists, researchers, media, patients, and the public.