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Overview
In new research published in the New England Journal of Medicine  ,1 adult patients with severe periodontitis who received intensive periodontal treatment had improved vascular endothelial function two to six months after treatment. The study received media coverage from HealthDay News ,2 MedPageToday ,3 HeartWire ,4 and JournalWatch .5
The study, which was partially funded by industry, included 120 patients with severe periodontitis, defined as probing pocket depths of >6 mm and marginal alveolar bone loss of over 30%, with over half of all teeth affected. The control group received supragingival scaling and polishing, and the test group underwent intensive periodontal treatment, including: scaling and root planing; extraction of teeth that could not be saved; and subgingival administration of minocycline microspheres. Patients were evaluated at 1 day, 1 week, and 1, 2, and 6 months. Patients in the test group had a transient acute systemic inflammatory response and a transient impairment of endothelial function. However, at 6 months after the intensive periodontal treatment, the test group had reduced indexes of periodontal disease severity and improved endothelial function.
The endothelium is a thin layer of cells that form the inner lining of blood vessels, and endothelial dysfunction is considered an important factor in the development of coronary atherosclerosis. Previous research, including a 2006 study in the American Heart
Journal , 6 has suggested that treating patients with severe periodontal disease may potentially improve their endothelial function.
A definitive causal link between periodontal treatment and cardiovascular health has not been established, and the clinical significance of the study findings remains unclear and needs to be independently confirmed. Further research is encouraged to determine if there is a causal relationship between periodontal disease and cardiovascular disease, and to evaluate the overall influence of periodontal treatment on long-term cardiovascular health.
Footnotes
1Tonetti MW et al. Treatment of periodontitis and endothelial function. N Engl J Med 2007;356: 911-20.
2Edelson E. Infected gums can harm the heart. HealthDay News, February 28, 2007. Available at: “http://www.healthday.com/Article.asp?AID=602319 ”.
Accessed March 2, 2007.
3Phend C. Treating dental disease improves vascular function. MedPageToday, February 28, 2007. Available at: "http://www.medpagetoday.com/Cardiology/CoronaryArteryDisease/tb/
5161
“.
Accessed March 5, 2007.
4O’Riordan M. Make sure to floss! Intensive treatment of periodontal disease improves endothelial function. Available at: "http://www.theheart.org/article/773409.do ".
Accessed
March 6, 2007.
5Krumholz HM. Improving endothelial function via . . . the gums? Journal Watch Cardiology February 28, 2007. Available at: "http://cardiology.jwatch.org/cgi/content/full/2007/228/3
".
Accessed March 6, 2007.
6Elter JR, Hinderliter AL, Offenbacher S, Beck JD, Caughey M, Brodala N, Madianos PN. The effects of periodontal therapy on vascular endothelial function: a pilot trial. Am Heart J. 2006 Jan;151(1):47. Available at: "http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=Search&
DB=pubmed ".
Accessed March 6, 2007.
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Science in the News is a service by the American Dental Association (ADA) to present current information about science topics in the news. The ADA is a professional association of dentists committed to the public's oral health, ethics, science and professional advancement; leading a unified profession through initiatives in advocacy, education, research and the development of standards. As a science-based organization, the ADA's evaluation of the scientific evidence may change as more information becomes available. Your thoughts would be greatly appreciated.
Page Posted March 2007
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