Objective:

To review the evidence linking periodontal disease with atherosclerotic cardiovascular disease (ASCVD) and update findings from a 2012 AHA report, highlighting the importance of these updates in the context of recent research advancements.

Key Findings:

• ASCVD is the leading cause of death globally, with periodontal disease affecting 42% of U.S. adults aged 30 and older, including 7.8% with severe disease.
• Shared risk factors include older age, smoking, diabetes, hypertension, obesity, and lower socioeconomic status, with specific statistics provided.
• Direct mechanisms include bacteremia and vascular infection; indirect mechanisms involve systemic inflammation, with examples of inflammatory markers.
• Epidemiologic studies show associations between periodontal disease and various cardiovascular outcomes, including specific conditions.
• Interventional studies yield inconclusive results regarding the impact of periodontal treatment on ASCVD events, with examples of intermediate outcomes.

Interpretation:

While substantial evidence supports an association between periodontal disease and ASCVD, a definitive causal relationship has not been established, underscoring the urgent need for further research.

Limitations:

• Methodological differences and limited statistical power in studies, which may affect the reliability of findings.
• Inconclusive results from interventional studies on cardiovascular outcomes, highlighting the need for more robust research.

Conclusion:

Further research is needed to clarify causality and clinical implications, including longitudinal studies, randomized clinical trials, and specific mechanistic investigations.