As gum health improves, progression of atherosclerosis slows to a clinically significant degree, researchers from the Columbia University Mailman School of Public Health in New York have found.
Atherosclerosis, the narrowing of arteries through the buildup of plaque, is a major risk factor for heart disease, stroke, and death.
As part of the Oral Infections and Vascular Disease Epidemiology Study, the researchers followed 420 adults, a randomly sampled cohort of New York residents. Participants were examined for periodontal infection with more than 5,000 plaque samples taken from several teeth and beneath the gums. The samples were then analyzed for 11 bacterial strains linked to periodontal disease and seven control bacteria. Fluid around the gums was sampled to assess levels of interleukin-1β, a marker of inflammation. Atherosclerosis in both carotid arteries was measured using high-resolution ultrasound.
Over a median follow-up period of three years, the researchers found that improvement in periodontal health and a reduction in the proportion of specific bacteria linked to periodontal disease correlated to a slower intima-medial thickness (IMT) progression, and worsening periodontal infections paralleled the progression of IMT.
The researchers found a 0.1-mm difference in IMT change over three years among study participants whose periodontal health was deteriorating compared with those whose periodontal health was improving. Previous research showed that a 0.033-mm/year increase in carotid IMT (equivalent to approximately 0.1 mm over three years) is associated with a 2.3-fold increased risk for coronary events.
Even subtle changes to periodontal status had a dose-response relationship to carotid IMT.
Bacteria in the mouth may contribute to the onset of atherosclerosis in a number of ways, the researchers said. Animal studies indicate that they may trigger immune response and high levels of inflammatory markers, which may initiate or exacerbate the inflammatory aspect of atherosclerosis.
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