The link between cardiovascular and oral health

Background: Cardiovascular disease (CVD) is the leading cause of death globally, and there is emphasis on identifying new strategies to manage CVD risk and minimise its global burden. Targeting oral health has shown promise as an intervention to reduce the risk and severity of CVD. However, the evidence supporting a link between CVD and poor oral health is unclear. Aim/Objectives: This literature review aimed to identify the evidence for a link between CVD and oral health, and whether the links could be targeted clinically to reduce the risk and severity of CVD events. Methods: A literature search was performed on Ovid MEDLINE, Embase and CINAHL. Only papers available in English, published within the last 10 years, peer-reviewed, and describing primary research including systematic reviews of primary research were included. Relevant data (study population, design, methods, and results) of the selected papers were extracted and analysed by three researchers (AS, RS and PL). Findings: Twenty-three papers including cohort studies, a randomised controlled trial, and systematic reviews were selected for review. Research shows evidence of a relationship between oral health and CVD-risk biomarkers (e.g. C-reactive protein) or CVD events (e.g. myocardial infarction), and therapeutic benefits associated with clinical interventions. Systemic inflammation, suspected to result from circulation of periodontal bacteria Porphyromonas Gingivalis associated with inflammation of the gums, and its complications such as atherosclerosis, are predictors for CVD risk and severity. However, there is no definitive evidence for the mechanisms involved in the relationship. Research also demonstrated clinical interventions, including dental screening and scaling, reduced many biomarkers associated with CVD risk/events. Implications: This literature review provides a comprehensive summary of the available evidence linking CVD and oral health. Oral health interventions should be explored in primary care to improve prevention, early detection and management of CVD to minimise CVD burden.