scholarly journals The Infection Hypothesis Revisited: Oral Infection and Cardiovascular Disease

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Lise Lund Håheim
Keyword(s):  
Cardiovascular Disease ◽  
Periodontal Disease ◽  
Medical Research ◽  
Oral Bacteria ◽  
Aortic Aneurysms ◽  
World Health ◽  
Risk Level ◽  
Oral Infections ◽  
Periodontal Infection ◽  
Bacterial Products

Background. The pathophysiology of cardiovascular disease (CVD) includes inflammation in the development of atherosclerosis and thrombosis. Increasing evidence supports oral infections, and in particular the common periodontal disease, to be associated with CVD development. Periodontal infection is present in populations worldwide and in the moderate to mild form in about 35% of populations according to the World Health Organization. Objective. This review of the literature aims to present cross evidence from medical research disciplines that explore how oral infections can contribute to increase the risk for CVDs and how treatment of oral infections can reduce the risk for CVDs. Design. Review article. Results. Long-term exposure to active nontreated infections of the oral cavity presents an opportunity for bacteria, bacterial products, and viruses to enter the circulation. Toxic bacterial products enter the circulation, affecting atherosclerosis, causing platelet adhesiveness that results in clot formation, and establishing cardiac vegetation. Pathological observations have identified oral bacteria in heart valves, aortic aneurysms, and arterial walls. Clinical intervention studies on periodontal disease reduce the risk level of serological predictors for CVDs. Conclusions. This paper presents evidence across medical research disciplines for oral infections to be considered as one of the risk factors for CVDs.

scholarly journals The Bi-Directional Relationship between Periodontal Disease and Hyperlipidemia

2008 ◽  
Vol 02 (02) ◽  
pp. 142-149 ◽  
Author(s):  
Ozlem Fentoglu ◽  
F. Yesim Bozkurt
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Periodontal Disease ◽  
Serum Lipids ◽  
Plasma Lipids ◽  
Periodontal Infection ◽  
Increased Risk ◽  
Potential Link ◽  
Common Risk Factors ◽  
Accumulation Of Lipids

ABSTRACTIt has been proposed for several decades that infections may be responsible for the accelerated development of atherosclerosis. The initiation of the atherosclerotic plaque is ascribed to focal accumulation of lipids. This explains the importance of plasma lipids in the development of atherosclerosis. Recent reports point towards a possible association between periodontal disease and increased risk for cardiovascular disease. Thus, periodontitis and cardiovascular disease may share common risk factors, and association between periodontitis and coronary heart disease may be due to the elevated levels of plasma lipids. Epidemiological and clinical studies have also suggested that there is a relationship between periodontal disease and impaired lipid metabolism. In this review, we summarized the potential link mechanisms in the association between periodontal infection and serum lipids. (Eur J Dent 2008;2:142-149)

Periodontal Medicine: 100 Years of Progress

2019 ◽  
Vol 98 (10) ◽  
pp. 1053-1062 ◽  
Author(s):  
J.D. Beck ◽  
P.N. Papapanou ◽  
K.H. Philips ◽  
S. Offenbacher
Keyword(s):  
Cardiovascular Disease ◽  
Periodontal Disease ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcomes ◽  
Lessons Learned ◽  
Case Definitions ◽  
Medicine Research ◽  
Periodontal Infection ◽  
Adverse Pregnancy ◽  
Periodontal Medicine

Periodontal medicine is a term used to describe how periodontal infection/inflammation may impact extraoral health. Periodontitis has been linked to over 50 systemic diseases and conditions. As part of the Journal of Dental Research’s Centennial Celebration, this narrative review discusses periodontal medicine research done over the past 100 y, with particular focus on the effects of periodontal disease on 3 pathological conditions: cardiovascular disease, diabetes mellitus, and adverse pregnancy outcomes. We selected 29 total studies that were the “first” of their kind, as they provided novel observations or contributed to shifting paradigms as well as important studies that made strong contributions to progress in understanding relationships to the systemic conditions. These studies were organized in an overview timeline and broken down into timelines by topic: cardiovascular disease ( n = 10), diabetes ( n = 12), and adverse pregnancy outcomes ( n = 7). Overall, the majority of cross-sectional, case-control, and longitudinal studies have revealed positive associations between poor periodontal status and cardiovascular disease, diabetes metabolic control, and a number of adverse pregnancy outcomes, and these associations are upheld in systematic reviews. Findings from randomized controlled trials testing the effects of periodontal therapy on systemic health outcomes were conflicting and inconsistent. While there has been a great deal of progress, we highlight lessons learned and make comments and suggestions on a number of key aspects, including the heterogeneity of case definitions of periodontal disease across studies, accounting for features of the periodontal phenotype that are most relevant to the biological link between periodontitis and systemic outcomes, the role of other comorbid inflammatory conditions, selection of study participants, and timing and intensity of the periodontal intervention.

scholarly journals Fusobacterium nucleatum Induces Premature and Term Stillbirths in Pregnant Mice: Implication of Oral Bacteria in Preterm Birth

2004 ◽  
Vol 72 (4) ◽  
pp. 2272-2279 ◽  
Author(s):  
Yiping W. Han ◽  
Raymond W. Redline ◽  
Mei Li ◽  
Lihong Yin ◽  
Gale B. Hill ◽  
...  
Keyword(s):  
Endothelial Cells ◽  
Preterm Birth ◽  
Oral Cavity ◽  
Periodontal Disease ◽  
Amniotic Fluid ◽  
Blood Vessels ◽  
Fusobacterium Nucleatum ◽  
Oral Bacteria ◽  
Premature Delivery ◽  
Periodontal Infection

ABSTRACT Fusobacterium nucleatum is a gram-negative anaerobe ubiquitous to the oral cavity. It is associated with periodontal disease. It is also associated with preterm birth and has been isolated from the amniotic fluid, placenta, and chorioamnionic membranes of women delivering prematurely. Periodontal disease is a newly recognized risk factor for preterm birth. This study examined the possible mechanism underlying the link between these two diseases. F. nucleatum strains isolated from amniotic fluids and placentas along with those isolated from orally related sources invaded both epithelial and endothelial cells. The invasive ability may enable F. nucleatum to colonize and infect the pregnant uterus. Transient bacteremia caused by periodontal infection may facilitate bacterial transmission from the oral cavity to the uterus. To test this hypothesis, we intravenously injected F. nucleatum into pregnant CF-1 mice. The injection resulted in premature delivery, stillbirths, and nonsustained live births. The bacterial infection was restricted inside the uterus, without spreading systemically. F. nucleatum was first detected in the blood vessels in murine placentas. Invasion of the endothelial cells lining the blood vessels was observed. The bacteria then crossed the endothelium, proliferated in surrounding tissues, and finally spread to the amniotic fluid. The pattern of infection paralleled that in humans. This study represents the first evidence that F. nucleatum may be transmitted hematogenously to the placenta and cause adverse pregnancy outcomes. The results strengthen the link between periodontal disease and preterm birth. Our study also indicates that invasion may be an important virulence mechanism for F. nucleatum to infect the placenta.

scholarly journals Interrelationship between Diabetes and Periodontitis- A Review

2011 ◽  
Vol 51 (183) ◽  
Author(s):  
S Pradhan ◽  
K Goel
Keyword(s):  
Diabetes Mellitus ◽  
Periodontal Disease ◽  
Systemic Disease ◽  
The Other ◽  
Low Grade ◽  
Oral Infections ◽  
Periodontal Infection ◽  
The Individual ◽  
Length Of Life

Evidence for the link between periodontal disease and several systemic diseases is growing rapidly. Diabetes mellitus is a systemic disease with several major complications affecting both the quality and length of life causing morbidity and mortality. Periodontitis, one of these complications, is a chronic infection associated with substantial morbidity in the form of tooth loss and that affects the quality of life directly. The association between diabetes and inflammatory periodontal disease has been studied extensively. The relationship between these two conditions appears bidirectional. The presence of one condition tends to promote the other and the meticulous management of either may assist treatment of the other. It also provides a perfect example of a cyclical association, whereby a systemic disease predisposes the individual to oral infections, and once the oral infection is established, it exacerbates the systemic disease. This review focuses to explain the interrelationship between the two based on information in the literature and the potential common immunoregulatory connections involved, exploring the mechanisms through which periodontal infection can contribute to the low-grade general inflammation associated with diabetes. Keywords: Diabetes mellitus; inflammation; insulin resistance; periodontitis.

scholarly journals Periodontal Disease as a Risk Factor for Cardiovascular Disease - A Questionnaire Survey among Physicians

2021 ◽  
Vol 22 (1) ◽  
pp. 7-11
Author(s):  
Varun Arya ◽  
Ramya Shenoy Kudpi ◽  
Nikita Rungta
Keyword(s):  
Cardiovascular Disease ◽  
Risk Factor ◽  
Periodontal Disease ◽  
Questionnaire Survey ◽  
South India ◽  
Heart Diseases ◽  
School Curriculum ◽  
Periodontal Infection ◽  
Group I ◽  
Medical Colleges

Introduction: Periodontal infections have been documented to influence coronary heart diseases such as angina, myocardial infarction, atherosclerosis and other systemic conditions like stroke, diabetes mellitus and preterm low birth weight babies. Over the last two decades, several studies have reported associations between periodontitis and cardiovascular disease (CVD). The association is now a part of the dental school curriculum and periodontology. However, in contrast, this important aspect is missing in the medical school curriculum and not many physicians are aware of the role periodontal disease plays in CVD. Aim: To assess the knowledge and practices of physicians of Mangalore City, South India, on periodontal disease as a risk factor in Cardiovascular Diseases (CVD). Methodology: A questionnaire survey was carried out to assess physicians’ knowledge and practices in the city of Mangalore, South India. The physicians were divided into four groups as follows: Group I - Physicians associated with medical colleges; Group II – Sole private practitioners; Group III - Physicians associated with medical colleges and having their private practice; Group IV - Post-graduate students. A Chi-square test was applied to test the difference between knowledge and practices among the groups. Results: Out of a total of 106 physicians, 56 (52.3%) participated in the survey. Periodontal disease was considered to be a risk factor in CVD by 87.5% (n=47) respondents and 96.4% (n=54) respondents stated that bleeding/enlargement of the gingivae was a sign of periodontal infection. Only 40% (n=23) of the respondents asked about oral problems during general check-up. Conclusions: The knowledge regarding the periodontal disease as a risk factor in CVD was high, however, the application of the knowledge in routine medical check-ups was observed to be less. J MEDICINE JAN 2021; 22 (1) : 7-11

Serum Retinol and β-carotene Levels and Risk Factors for Cardiovascular Disease in Morbid Obesity

2010 ◽  
Vol 80 (3) ◽  
pp. 159-167 ◽  
Author(s):  
Gabriela Villaça Chaves ◽  
Gisele Gonçalves de Souza ◽  
Andréa Cardoso de Matos ◽  
Dra. Wilza Abrantes Peres ◽  
Silvia Elaine Pereira ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Morbid Obesity ◽  
Serum Levels ◽  
World Health ◽  
Morbidly Obese ◽  
Serum Retinol ◽  
Significant Difference ◽  
Β Carotene

Objective: To evaluate retinol and β-carotene serum levels and their relationship with risk factors for cardiovascular disease in individuals with morbid obesity, resident in Rio de Janeiro. Methodology: Blood serum concentrations of retinol and β-carotene of 189 morbidly obese individuals were assessed. The metabolic syndrome was identified according to the criteria of the National Cholesterol Education Program (NCEP) and World Health Organization (WHO). Lipid profile, insulin resistance, basal insulin, glycemia, blood pressure, and anthropometry and their correlation with retinol and β-carotene serum levels were evaluated. Results: Metabolic syndrome diagnosis was observed in 49.0% of the sample. Within this percentage the levels of β-carotene were significantly lower when body mass index increased. Serum retinol didn't show this behavior. Serum retinol inadequacy in patients with metabolic syndrome (61.3%), according to WHO criterion, was higher (15.8%) than when the whole sample was considered (12.7%). When metabolic syndrome was diagnosed by NCEP criterion, β-carotene inadequacy was higher (42.8%) when compared to the total sample (37.5%). There was a significant difference between average β-carotene values of patients with and without metabolic syndrome (p=0.048) according to the classification of the NCEP. Lower values were found in patients with metabolic syndrome. Conclusion: Considering the vitamin A contribution in antioxidant protection, especially when risk factors for cardiovascular disease are present, it is suggested that great attention be given to morbidly obese. This could aid in prevention and treatment of cardiovascular disease, which affects a significant part of the population.

Diet quality and periodontal disease: Results from the oral infections, glucose intolerance and insulin resistance study (ORIGINS)

2021 ◽  
Vol 48 (5) ◽  
pp. 638-647
Author(s):  
Francesco DeMayo ◽  
Rebecca Molinsky ◽  
Muna J. Tahir ◽  
Sumith Roy ◽  
Jeanine M. Genkinger ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Periodontal Disease ◽  
Glucose Intolerance ◽  
Diet Quality ◽  
Oral Infections

scholarly journals Long-term body mass index changes in overweight and obese adults and the risk of heart failure, cardiovascular disease and mortality: a cohort study of over 260,000 adults in the UK

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Barbara Iyen ◽  
Stephen Weng ◽  
Yana Vinogradova ◽  
Ralph K. Akyea ◽  
Nadeem Qureshi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Body Mass Index ◽  
Cohort Study ◽  
Body Mass ◽  
World Health ◽  
Obese Adults ◽  
Bmi Trajectories ◽  
The Impact

Abstract Background Although obesity is a well-recognised risk factor for cardiovascular disease (CVD), the impact of long-term body mass index (BMI) changes in overweight or obese adults, on the risk of heart failure, CVD and mortality has not been quantified. Methods This population-based cohort study used routine UK primary care electronic health data linked to secondary care and death-registry records. We identified adults who were overweight or obese, free from CVD and who had repeated BMI measures. Using group-based trajectory modelling, we examined the BMI trajectories of these individuals and then determined incidence rates of CVD, heart failure and mortality associated with the different trajectories. Cox-proportional hazards regression determined hazards ratios for incident outcomes. Results 264,230 individuals (mean age 49.5 years (SD 12.7) and mean BMI 33.8 kg/m2 (SD 6.1)) were followed-up for a median duration of 10.9 years. Four BMI trajectories were identified, corresponding at baseline, with World Health Organisation BMI classifications for overweight, class-1, class-2 and class-3 obesity respectively. In all four groups, there was a small, stable upwards trajectory in BMI (mean BMI increase of 1.06 kg/m2 (± 3.8)). Compared with overweight individuals, class-3 obese individuals had hazards ratios (HR) of 3.26 (95% CI 2.98–3.57) for heart failure, HR of 2.72 (2.58–2.87) for all-cause mortality and HR of 3.31 (2.84–3.86) for CVD-related mortality, after adjusting for baseline demographic and cardiovascular risk factors. Conclusion The majority of adults who are overweight or obese retain their degree of overweight or obesity over the long term. Individuals with stable severe obesity experience the worst heart failure, CVD and mortality outcomes. These findings highlight the high cardiovascular toll exacted by continuing failure to tackle obesity.

scholarly journals Long term prognostic implication of newly detected abnormal glucose tolerance among patients with stable cardiovascular disease: a population-based cohort study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Maryam Kabootari ◽  
Samaneh Asgari ◽  
Seyedeh Maryam Ghavam ◽  
Hengameh Abdi ◽  
Fereidoun Azizi ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Glucose Tolerance ◽  
Plasma Glucose ◽  
Population Based ◽  
World Health ◽  
Incident Diabetes ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Diabetes Status ◽  
Adjusted Model

Abstract Background Fasting plasma glucose (FPG) and 2-h post challenge plasma glucose (2 h-PCPG), whether as continuous or categorical variables, are associated with incident cardiovascular disease (CVD) and diabetes; however, their role among patients with existing CVD is a matter of debate. We aimed to evaluate associations of different glucose intolerance states with recurrent CVD and incident diabetes among subjects with previous CVD. Methods From a prospective population-based cohort, 408 Iranians aged  ≥  30 years, with history of CVD and without known diabetes were included. Associations of impaired fasting glucose (IFG) according to the American Diabetes Association (ADA) and World Health Organization (WHO) criteria, impaired glucose tolerance (IGT), newly diagnosed diabetes (NDM) with outcomes of interest were determined by multivariable Cox proportional hazard models after adjustment for traditional risk factors. Furthermore, FPG and 2 h-PCPG were entered as continuous variables. Results Over a decade of follow-up, 220 CVD events including 89 hard events (death, myocardial infarction and stroke) occurred. Regarding prediabetes, only IFG-ADA was associated with increased risk of hard CVD [hazard ratio(HR), 95%CI: 1.62,1.03–2.57] in the age-sex adjusted model. In patients with NDM, those with FPG ≥ 7 mmol/L were at higher risk of incident CVD/coronary heart disease(CHD) and their related hard outcomes (HR ranged from 1.89 to 2.84, all P < 0.05). Moreover, those with 2 h-PCPG ≥ 11.1 mmol/L had significant higher risk of CVD (1.46,1.02–2.11), CHD (1.46,1.00–2.15) and hard CHD (1.95:0.99–3.85, P = 0.05). In the fully adjusted model, each 1 SD increase in FPG was associated with 20, 27, 15 and 25% higher risk of CVD, hard CVD, CHD and hard CHD, respectively; moreover each 1 SD higher 2 h-PCPG was associated with 21% and 16% higher risk of CVD, and CHD, respectively. Among individuals free of diabetes at baseline (n = 361), IFG-ADA, IFG-WHO and IGT were significantly associated with incident diabetes (all P < 0.05); significant associations were also found for FPG and 2 h-PCPG as continuous variables (all HRs for 1-SD increase > 2, P < 0.05). Conclusions Among subjects with stable CVD, NDM whether as high FPG or 2 h-PCPG, but not pre-diabetes status was significantly associated with CVD/CHD and related hard outcomes.

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