Cardiovascular diseases (CVD) primarily are a result of atherosclerosis and are the number one cause of mortality worldwide. Increasing evidence over the past decade suggests that severe periodontal disease is associated with increased cardiovascular disease risk.
Several possible mechanisms may operate independently or in concert to explain this association. The mechanisms resulting in pathology from both periodontitis and CVD are similar i.e., both diseases have complex causation that includes genetic and gender predispositions, age, diabetes, smoking, social status, and stress. Periodontal infections may directly contribute to the pathogenesis of atherosclerosis and thromboembolicevents by providing repeated systemic challenges with LPS and inflammatory cytokines. The oral cavity of individuals with periodontitis represents a potentially large reservoir of Gram-negative pathogenic organisms that can penetrate gingival tissues, enter the circulation and contribute to atherosclerosis progression.
The possible relationship between infectious diseases and the genesis of atherosclerosis remains hypothetical. It is important to distinguish between the potential role of infectious diseases in atherogenesis and the possibility that infection may enhance a smoldering inflammatory process that is already present in atheromatous plaques.