Periodontal Disease and Systemic Inflammation in Cardiovascular Patients

Objectives: To determine the possible contribution of periodontal disease to the total burden of inflammation in patients with documented cardiovascular disease. Methods: The study population consisted of 400 patients with cardiovascular disease (evidence of myocardial infarction, unstable angina or abnormal cardiogram requiring hospitalisation within the last 3 years) and a minimum of 12 teeth. Periodontal probing depths and bleeding on probing were recorded at 6 sites/tooth. Serum C-reactive Protein (CRP) and ESR (erythrocyte sedimentation rate) were used as measures of the total burden of inflammation. Periodontal disease was considered in terms of the presence of either 6 or more sites with probing depths ≥ 3.5mm or 6 or more sites ≥ 5.5mm. Results: The mean age (± st.dev.) of the patients was 61.5 (± 8.4) years with 78% being male. CRP values ≥ 2mg/L were recorded in 35% of patients and ESR values ≥ 14mm/Hr in 30%, with 41% of the latter being female. 25% of those with CRP ≥ 2 had 6 or more sites with probing depths ≥ 3.5mm compared with 21% for those with CRP ≤ 2 and 7% versus 2% for probing depths ≥ 5.5mm. For ESR ≥ 14, 20% and 4% had probing depths ≥ 3.5mm and ≥ 5.5mm respectively, compared with 23% and 3% for those with ESR values ≤ 14 mm/Hr. Conclusion: These preliminary data suggest that within this population there was no relationship between periodontal disease and the total burden of inflammation as reflected in CRP and ESR levels. In individual patients, however, such a relationship may exist and intervention studies are required to determine the extent of such a relationship. This study was supported by Colgate Palmolive Ltd.