Hidden danger: Study links periapical periodontitis to coronary artery disease

Periapical periodontitis is very common and often has no obvious symptoms. New findings from the University of Helsinki indicate that the condition could be a risk factor for acute coronary syndrome. (Photograph: Stas Walenga/Shutterstock)

Dental Tribune International

三. 3 八月 2016

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HELSINKI, Finland: A new study at the University of Helsinki has found that hidden periapical periodontitis increased the risk of coronary artery disease (a cardiovascular disease). According to the researchers, infections of the root tip of a tooth are very common—about one in four Finns suffered from at least one in the study group—and are often unnoticed by patients, as they can be present without obvious symptoms.

Although there is a great deal of research on the connection between oral infections and many common chronic diseases, such as heart disease and diabetes, periapical periodontitis has been investigated relatively little in this context. In the recent study, 58 per cent of the patients, who presented with symptoms requiring examination via coronary angiogram, had one or more such inflammatory lesions.

“Acute coronary syndrome is 2.7 times more common among patients with untreated teeth in need of root canal treatment than among patients without this issue,” said lead author Dr John Liljestrand. Moreover, the study found that periapical periodontitis was connected with a high level of serum antibodies related to common bacteria causing such infections.

The study was carried out at the Department of Oral and Maxillofacial Diseases of the university, in cooperation with the Heart and Lung Centre at Helsinki University Hospital. It examined the coronary arteries of 508 patients with a mean age of 62, of whom 36 per cent had stable coronary artery disease, 33 per cent suffered from acute coronary syndrome, and 31 per cent had acute coronary syndrome-like results, but no significant coronary artery disease.

Periapical periodontitis is an immune response to microbial infection in the dental pulp, most commonly caused by caries. The often symptomless infections are usually detected by chance in radiographs, the researchers said. In light of the findings, root canal treatment of an infected tooth may reduce the risk of heart disease; however, additional research is needed to confirm the relationship between the two conditions, they said.

According to figures from the World Health Organization, cardiovascular disease is the primary cause of death globally. In 2012, an estimated 17.5 million people died from cardiovascular disease, representing 31 per cent of all global deaths. Of these, 7.4 million were due to coronary artery disease and 6.7 million were due to stroke.

The study, titled “Association of endodontic lesions with coronary artery disease”, was published online ahead of print on 27 July in the Journal of Dental Research.