Metabolic syndrome and oral markers of cardiometabolic risk

Metabolic syndrome is associated with increased risk of cardiovascular disease and type 2 diabetes mellitus. However, clinical diagnosis of metabolic syndrome alone does not permit proper assessment of cardiometabolic risk. Instead, it should be viewed as a modifiable risk factor. The development and progression of metabolic syndrome may be the result of many elements, with visceral obesity as a central component. Both metabolic syndrome and visceral obesity are linked to chronic inflammation, which leads to atherosclerosis and, thus, increases cardiometabolic risk. Obesity has been related to caries, traumatic injury, hyposalivation, tooth loss and periodontal diseases, and the latter have been associated with almost every feature of atherosclerosis. Thus, severe or refractory periodontal disease or a significant loss of teeth could serve as markers of cardiometabolic risk. Finally, there is growing evidence that saliva can reflect virtually the entire spectrum of normal and disease states; thus, we are likely to see increased use of saliva as a diagnostic tool and consequently, dentists may have a greater involvement in the identification and monitoring of non-oral disorders.