Periodontitis and coronary artery disease are linked

Untreated periodontitis considerably increases the risk of coronary artery disease and stroke. It is therefore all the more important to treat periodontitis in good time in order to avoid serious comorbidities.

Electrocardiogram and a stethoscope

The link between coronary artery disease (CAD) and periodontitis has been demonstrated in numerous scientific studies. For example, full-blown periodontal disease increases the risk of CAD by a factor of 1.15 and of stroke by a factor of 4.3. Periodontopathogenic marker bacteria appear to play a key role in this: Considerably higher prevalences of A. actinomycetemcomitans and red complex bacteria were found in patients with acute myocardial infarction than in healthy control subjects. Periodontitis-associated bacterial DNA was also identified in significantly higher quantities in atherosclerotic plaque from CAD patients.

Processes in the arterial walls

In atherosclerosis, small patch-like changes occur in the blood vessels that are referred to as plaques. They develop as a result of chronic inflammation of the vessel walls, the cause of which is not yet fully understood. What is certain is that, in the course of plaque formation, macrophages are transformed into foam cells in the epithelium. This process leads to the formation of “fatty streaks”. The thickness of the plaques increases as a result of fibrous tissue accumulation. This leads to a narrowing of the vessels and thus restriction of the blood flow.

If this happens in the coronary arteries, the oxygen supply to the myocardium is reduced, and this results in ischemia. Thrombi may also form if the plaque is swept into the bloodstream after rupture of the inner vessel wall. This can lead to life-threatening complications such as myocardial infarction or stroke.

Periodontitis exacerbates these processes

In periodontitis patients, the bacteria disseminated into the bloodstream and the toxins they produce stimulate the immune response. This in turn enhances the release of inflammatory mediators and thus drives the accumulation of plaque in the arterial walls. These interrelationships suggest that successful treatment of periodontitis will also have a positive impact on atherosclerosis progression. The dentist therefore has a responsibility for general as well as oral health.