The Management of Patients with Periodontal and Cardiovascular Diseases
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 cytokines^95,96
• Concentrations of CRP in patients with and without coronary heart disease^95-99
• Levels of fibrinogen and white blood cells⁹⁸
• Levels of total cholesterol^95,100
• Levels of low-density (“bad”) cholesterol^100,101
• 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 optimise CVD care.¹⁰⁵