Periodontal Disease and Atherosclerotic Vascular Disease: Does the Evidence Support an Independent Association?

American Heart Association Scientific Statement

April 18, 2012 Categories: Scientific Statements/Guidelines
UPDATED: MAY 15, 2012
Statement Highlights:
  • There is no definitive evidence at the present time that proves gum disease causes heart disease or stroke, or treating gum disease reduces the risk of those diseases.
  • Gum and heart disease share common risk factors, including smoking, age and diabetes. Although studies have found an association between the two diseases that cannot be explained by the common risk factors, more evidence is needed to address whether periodontal disease can cause atherosclerotic heart disease.
DALLAS, April 18, 2012 — UPDATED: MAY 15, 2012  -- Despite popular belief, gum disease hasn’t been proven to cause atherosclerotic heart disease or stroke, and treating gum disease hasn’t been proven to prevent heart disease or stroke, according to a new scientific statement published in Circulation, an American Heart Association journal
Keeping teeth and gums healthy is important for your overall health, but current data don’t conclusively indicate whether regular brushing and flossing or treatment of gum disease can cut the incidence of atherosclerosis, the narrowing of the arteries that can cause heart attacks and strokes.
That conclusion represents what we know right now – it doesn’t mean a link won’t be identified in the future, because many observational studies have noted associations between gum disease and cardiovascular disease. Observational studies are not designed to determine cause and effect -- instead, they look at subjects to see if they have a relationship or association.
Gum disease and cardiovascular disease both produce markers of inflammation such as C-reactive protein, and share other common risk factors as well, including cigarette smoking, age and diabetes mellitus. These common factors may help explain why diseases of the blood vessels and mouth occur in tandem, but the association between gum disease and cardiovascular disease appears to exist independent of these risk factors in many studies.
For more than a century, doctors have proposed that infected gums lead to systemic problems like atherosclerotic heart disease, and that mouth bacteria frequently enter the blood stream during dental procedures and during naturally occurring events such as tooth brushing.
Statements that imply a cause-and-effect relationship between periodontal disease and cardiovascular disease, or claim that dental treatment may prevent heart attack or stroke are “unwarranted,” at this time, the statement authors said.
The American Dental Association Council on Scientific Affairs agrees with the conclusions of this report and the World Heart Federation endorsed the statement.
The statement’s writing group was co-chaired by Ann F. Bolger, M.D. Other co-authors are Panos N. Papapanou, D.D.S., Ph.D.; Olusegun Osinbowale, M.D.; Maurizo Trevisan, M.D.; Matthew E. Levison, M.D.; Kathryn A. Taubert, Ph.D.; Jane W. Newburger, M.D., M.P.H; Heather L. Gornik, M.D., M.H.S.; Michael H. Gewitz, M.D.; Walter R. Wilson, M.D.; Sidney C. Smith Jr., M.D.; and Larry M. Baddour, M.D. Author disclosures are on the manuscript.
Learn more about how a healthy lifestyle and healthy eating are important steps toward good health. Take these free risk assessment quizzes and find your personal risk of heart attack, high blood pressure and diabetes. Visit the American Stroke Association site for comprehensive info on stroke.
The American Heart Association/American Stroke Association receives funding mostly from individuals. Foundations and corporations donate as well, and fund specific programs and events. Strict policies are enforced to prevent these relationships from influencing the association’s science content. Financial information for the American Heart Association, including a list of contributions from pharmaceutical companies and device manufacturers, is available at
NR12-1061 (Circ Statement/Lockhart)
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