Cardiovascular prevention starts from your mouth

Extract

This editorial refers to ‘Improved oral hygiene care attenuates the cardiovascular risk of oral health disease: a population-based study from Korea’^†, by S.-Y. Park et al., on page 1138.

Atherosclerosis remains the leading cause of cardiovascular disease worldwide and recent clinical evidence has confirmed that inflammation plays a significant role in its complications.^{1  ,  2} Diseases characterized by a chronic inflammatory exposure (including rheumatoid arthritis, psoriasis, oral inflammatory diseases, chronic bowel diseases, etc.) have been associated with raised risk of future cardiovascular events, and have been studied to explore the potential impact of anti-inflammatory drugs or procedures on mitigating the cardiovascular risk.³ The ability to modulate inflammation in these conditions has also enabled identification of inflammatory pathways potentially involved in the regulation of vascular homeostasis. The association between parameters of poor oral health and risk of cardiovascular diseases has been repeatedly reported by observational (cross-sectional, case controls, and prospective) studies in humans, leading to the inclusion of periodontitis (a common oral inflammatory disease) in the group of potential conditions increasing the risk of cardiovascular disease in the most recent European Guidelines for cardiovascular disease prevention.⁴ The interest around the potential link between oral health and cardiovascular disease is explained by its potential benefits in term of cardiovascular disease prevention. Indeed, oral diseases are highly prevalent in the general population, collectively affecting 3.9 billion people worldwide.⁵ This prevalence is significantly higher than other common cardiovascular risk factors (i.e. diabetes) and if a causal link with atherosclerosis could be demonstrated, the proportion of individuals in the general population who might obtain cardiovascular benefits from improved oral health could be substantial, with a significant reduction of the costs for the public health systems.