July 13, 2005
Over the last few years, researchers have gathered a growing but somewhat circumstantial body of evidence suggesting that people who have chronic and/or severe gum, or periodontal, disease may be at greater risk for coronary heart disease. The evidence remains circumstantial for two reasons: One, most studies have employed clinically defined measures of periodontal disease to make the link, which assumes conditions in the mouth directly influence those in the heart; and, two, most studies have not properly accounted for the effects of smoking, which is strongly associated with both conditions. With these concerns in mind, a team of NIDCR grantees and colleagues recently looked again at the possible periodontal-cardiovascular disease link in almost 7,000 adult participants of the Atherosclerosis Risk in Communities (ARIC) Study. This time, the scientists examined the relationship between coronary heart disease and two measures of periodontitis: (1) clinically defined periodontal disease and (2) serum antibody levels to 17 oral microbes. As a key component of their analysis, the scientists carefully stratified participants based on their smoking habits and histories.
As published in the July 5, 2005 issue of the journal Circulation, the scientists found that serum antibody levels were indeed associated with coronary heart disease, suggesting the quantity and quality of the immune response against oral bacteria may provide a more relevant measure of the association. Interestingly, the group found that clinical signs of periodontal disease were not associated with coronary heart disease. The authors concluded, “. . . We believe that these findings are relevant for future research in that they indicate that clinical measures of periodontitis may not adequately represent the systemic burden of periodontal disease. Instead, future researchers may want to use measures that better capture the interplay of the infection, the host immune and inflammatory responses, and resulting clinical signs of this complex exposure that may affect general health.”