1.Cardiovascular disease (CVD) is an abnormal function of the heart or blood vessels. It cancause an increase in risk for heart attack, heart failure, sudden death, stroke and cardiacrhythm problems, thus resulting in decreased quality of life and decreased life expectancy.The causes of cardiovascular disease rangefrom structural defects, to infection, inflammation, environment and genetics. In order to help prevent cardiovascular disease one must adopt a healthy lifestyle and avoid smoking, fattening foods and stress.

2. CVD risk factors that can be preventedor treated include: high blood pressure,high cholesterol, excess weight, physicalinactivity, smoking, diabetes, excessivealcohol consumption, illegal drug useand stress. Unpreventable risks include:previous heart attack, family memberwith heart disease, increasing age,gender and race. 3. One in three American adults has some form ofCardiovascular Disease (CVD). Heart disease andstroke are the most common cardiovasculardiseases. They are the first and third leadingcauses of death for both men and women in theUnited States. Cardiovascular Disease includeshigh blood pressure, coronary heart disease, heartfailure and stroke. It is the leading cause of deathin America and the World 4. Several theories exist to explain the linkbetween periodontal disease and heart disease.One theory is that oral bacteria can affect theheart when they enter the blood stream,attaching to fatty plaques in the coronaryarteries (heart blood vessels) and contributingto clot formation. Coronary artery disease ischaracterized by a thickening of the walls of thecoronary arteries due to the buildup of fattyproteins. Blood clots can obstruct normal bloodflow, restricting the amount of nutrients andoxygen required for the heart to functionproperly. This may lead to heart attacks. 5. Another possibility is that the inflammationcaused by periodontal disease increases plaquebuild up, which may contribute to swelling ofthe arteries.Researchers have found that people withperiodontal disease are almost twice as likely tosuffer from coronary artery disease as thosewithout periodontal disease. 6. Periodontal disease can also exacerbate existingheart conditions. Patients at risk for infectiveendocarditis may require antibiotics prior to dentalprocedures. Your periodontist and cardiologist willbe able to determine if your heart conditionrequires use of antibiotics prior to dentalprocedures. 7. Additional studies have pointed to a relationshipbetween periodontal disease and stroke. In one studythat looked at the causal relationship of oral infection asa risk factor for stroke, people diagnosed with acutecerebrovascular ischemia were found more likely to havean oral infection when compared to those in the controlgroup. 8. Recognition of the research advances andimportance of inflammatory mechanisms inessentially all of the chronic diseases of aging,including periodontal diseases, led the AmericanAcademy of Periodontology to convene a conferenceon January 29 and 30, 2008 in Boston titled,Inflammation and Periodontal Diseases: AReappraisal. This conference brought togetheropinion leaders in several major diseases and in theinflammatory mechanisms that seem to underlieand unify all of these diseases. 9. Inflammation is now known to play a critical role indiseases that are not usually classified as inflammatorydiseases, such as cardiovascular disease andAlzheimers disease. Although this conclusion is theresult of many years of research, much of theknowledge has crystallized into coherent conceptsonly very recently. The Boston conference broughttogether many of the people who have lead the newthinking relative to inflammation. 10. Healthy Gums and a Healthy Heart: The Perio-CardioConnection Clinical recommendations encourage cardiologists toexamine the mouth and periodontists to ask questionsabout heart health. CHICAGOJune 1, 2009Cardiovascular disease, theleading killer of men and women in the United States, is amajor public health issue contributing to 2,400 deaths eachday. Periodontal disease, a chronic inflammatory diseasethat destroys bone and gum tissues that support the teethaffects nearly 75 percent of Americans and is the majorcause of adult tooth loss. And while the prevalence rates ofthese disease states seems grim, research suggests thatmanaging one disease may reduce the risk for the other. 11. A consensus paper on the relationship between heart diseaseand gum disease was published concurrently in the onlineversions of two leading publications, the American Journal ofCardiology (AJC), a publication circulated to 30,000cardiologists, and the Journal of Periodontology (JOP), theofficial publication of the American Academy ofPeriodontology (AAP). Developed in concert by cardiologists,the physicians specialized in treating diseases of the heart, andperiodontists, the dentists with advanced training in thetreatment and prevention of periodontal disease, the papercontains clinical recommendations for both medical and dentalprofessionals to use in managing patients living with, or whoare at risk for, either disease. As a result of the paper,cardiologists may now examine a patients mouth, andperiodontists may begin asking questions about heart healthand family history of heart disease. 12. The clinical recommendations were developedat a meeting held earlier this year of topopinion-leaders in both cardiology andperiodontology. In addition to the clinicalrecommendations, the consensus papersummarizes the scientific evidence that linksperiodontal disease and cardiovascular diseaseand explains the underlying biologic andinflammatory mechanisms that may be thebasis for the connection. 13. According to Kenneth Korman, DDS,PhD, Editor of theJournal of Periodontology and a co-author of theconsensus report, the cooperation between thecardiology and periodontal communities is animportant first step in helping patients reduce theirrisk of these associated diseases. Inflammation is amajor risk factor for heart disease, and periodontaldisease may increase the inflammation levelthroughout the body. Since several studies have shownthat patients with periodontal disease have anincreased risk for cardiovascular disease, we felt it wasimportant to develop clinical recommendations for ourrespective specialties. Therefore, you will now seecardiologists and periodontists joining forces to helpour patients. 14. For patients, this may mean receiving someunconventional advice from their periodontist orcardiologist. The clinical recommendationsoutlined in the consensus paper advise thatperiodontists not only inform their patients of theincreased risk of cardiovascular disease associatedwith periodontal disease, but also assess their riskfor future cardiovascular disease and guide themto be evaluated for the major risk factors. Thepaper also recommends that physicians managingpatients with cardiovascular disease evaluate themouth for the basic signs of periodontal diseasesuch as significant tooth loss, visual signs of oralinflammation, and receding gums. 15. While additional research will help identify theprecise relationship between periodontaldisease and cardiovascular disease, recentemphasis has been placed on the role ofinflammation - the bodys reaction to fight offinfection, guard against injury or shield againstirritation. While inflammation initially intendsto have a protective effect, untreated chronicinflammation can lead to dysfunction of theaffected tissues, and therefore to more severehealth complications. 16. Both periodontal disease and cardiovasculardisease are inflammatory diseases, andinflammation is the common mechanism thatconnects them, says Dr. David Cochran, DDS,PhD, President of the AAP and Chair of theDepartment of Periodontics at the University ofTexas Health Science Center at San Antonio. Theclinical recommendations included in theconsensus paper will help periodontists andcardiologists control the inflammatory burden inthe body as a result of gum disease or heartdisease, thereby helping to reduce further diseaseprogression, and ultimately to improve ourpatients overall health. That is our common goal.