Plausible mechanisms explaining the association of periodontitis with cardiovascular diseases

The association between periodontitis and cardiovascular diseases is now well established. Cardiovascular diseases include atherosclerosis, coronary heart (artery) disease, cerebrovascular disease, and peripheral artery disease. Atherosclerosis is the underlying pathology of cardiovascular diseases. In this chapter, we describe plausible mechanisms to explain the link between periodontitis, atherosclerosis, and the subsequent cardiovascular diseases. The explanations for the development and exacerbation of atherosclerotic plaques in periodontitis patients include: (1) bacteremia, (2) a pro-inflammatory state, (3) a prothrombotic state, (4) an overactive immunity, (5) dyslipidemia, and (6) common genetic risk factors. Most likely, these plausible mechanisms play all simultaneously a role. Obviously, much more fundamental and clinic research is needed to further study the associations between periodontitis and atherosclerotic diseases.