Scientists at University College London (UCL) have discovered that an intensive treatment for periodontitis directly improves the health of blood vessels, according to a study published in the March 1 issue of The New England Journal of Medicine.
The researchers randomly assigned middle-aged subjects with severe periodontitis, but no evidence of cardiovascular disease, to dental treatments of two intensity levels. After six months, those who received the more intensive periodontitis treatment experienced a marked improvement in their periodontal disease and demonstrated a significant restoration of blood vessel function.
"The intensive treatment involved removal of plaque through scaling and root planing techniques, as well as extraction of teeth that could not be saved," explained Francesco D’Aiuto, DMD, PhD, project leader and a therapist, UCL Eastman Dental Institute.
"This initially resulted in some inflammation and dysfunction of the blood vessels and arteries," he said. "However, that was short-lived, and six months later the treatment led to an improvement in both oral health and arterial function."
"Previous studies have shown an association between periodontitis and blood vessel dysfunction, heart attack and stroke," said John Deanfield, MB, BChir, senior author, UCL Institute of Child Health. "However, a clinical trial was required to test whether these links could be causal.
"This finding therefore has potential implications for public health, but further studies are now required to determine whether the treatment of severe periodontitis could directly contribute to the prevention of disease of the arteries (atherosclerosis), stroke and heart attacks," said Dr. Deanfield.
The mechanism by which periodontitis affects endothelial function in the body still is uncertain. One possibility is that the bacteria disturb endothelial function directly, because some bacteria can enter the bloodstream. Alternatively, the periodontitis might trigger a low-grade inflammatory response throughout the body that has a detrimental effect on the vascular wall.
This study was supported by grants from the British Heart Foundation, the European Research Group on Periodontology, the Coronary Artery Disease Research Foundation and Johnson & Johnson.
