Periodontal disease is a risk marker for coronary heart disease?
METHODS
Relevant studies were identified using Medline and bibliographies of reviews, editorials, book chapters and letters discussing the relationship between periodontal disease and coronary heart disease (CHD).


METHODS
Studies were assessed for inclusion by two reviewers. Prospective studies with cohort or nested case-control design with CHD or cardiovascular disease (CVD) as an outcome were included. Study quality was rated.


METHODS
Data were abstracted by one reviewer and reviewed for accuracy by another author: any discrepancies were adjudicated by a third author. Meta-analysis was conducted to evaluate heterogeneity and publication bias.


RESULTS
Seven studies were included, some of which found that periodontal disease was independently associated with increased risk of CHD. Summary relative risk estimates for different categories of periodontal disease (including periodontitis, tooth loss, gingivitis and bone loss) ranged from 1.24 [95% confidence interval (CI), 1.01-1.51] to 1.34 (95% CI, 1.10-1.63). Risk estimates were similar in subgroup analyses by gender, outcome, study quality and method of periodontal disease assessment.


CONCLUSIONS
Periodontal disease is a risk factor or marker for CHD that is independent of traditional CHD risk factors, including socioeconomic status. Further research is warranted in this important area of public health.
Cronin
Aaron
A
Maxillofacial Unit, Sherwood Forest Hospitals NHS Trust, King's Mill Hospital, Sutton in Ashfield, Nottinghamshire, UK.