The Association of Periodontitis With Cardiovascular Disease Parameters: A Synthesis of Systematic Reviews
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Updated: Feb 26, 2026
Robust Ligature-Induced Model of Murine Periodontitis for the Evaluation of Oral Neutrophils
Published on: January 21, 2020
Max G P Schoenmakers1, Lotte P M Weijdijk1,2, Eveline J S Willems1
1Department of Periodontology Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam, Amsterdam, The Netherlands.
Insights
Periodontal disease (PerioD) shows a negligible to small association with cardiovascular diseases (CVD/CVE). Current evidence from systematic reviews does not confirm a causal link between PerioD and CVD/CVE.
Area of Science:
- Periodontology
- Cardiology
- Public Health
Background:
- Periodontal disease (PerioD) is a chronic inflammatory condition affecting the gums and supporting structures of the teeth.
- Cardiovascular diseases (CVD/CVE) represent a major global health burden, encompassing conditions affecting the heart and blood vessels.
- The potential link between PerioD and CVD/CVE has been investigated, necessitating a synthesis of existing evidence.
Purpose of the Study:
- To systematically review and analyze the association between periodontal disease and cardiovascular diseases as reported in existing systematic reviews (SRs).
- To evaluate the magnitude and potential causality of the relationship between PerioD and CVD/CVE based on synthesized data.
Main Methods:
- A comprehensive search of MEDLINE-PubMed and Cochrane-CENTRAL databases was conducted.
- Included systematic reviews primarily evaluated cardiovascular parameters in PerioD patients compared to controls.
- Data extraction, risk of bias assessment, descriptive analysis of meta-analyses, citation analysis, and grading of evidence were performed.
Main Results:
- Nineteen eligible systematic reviews were identified, comprising 13 on CVD and eight on CVE.
- The majority of meta-analyses (78%) indicated a negligible association between PerioD and CVD.
- For CVE, 46% of meta-analyses suggested a small magnitude of association, with variations based on demographic and clinical factors. Causality was not definitively confirmed.
Conclusions:
- The association between periodontal disease and cardiovascular diseases is generally of negligible to small magnitude.
- Existing systematic reviews do not provide sufficient evidence to confirm a causal relationship between PerioD and CVD/CVE.
- Further research may be needed to elucidate the complex interplay between oral health and cardiovascular outcomes.
Focused Question:
What is the association of periodontal disease (PerioD) and cardiovascular diseases (CVD/CVE) as reported in existing systematic reviews (SRs)?
Methods:
MEDLINE-PubMed and Cochrane-CENTRAL databases were searched. Papers that primarily evaluate cardiovascular parameters of CVD and CVE in PerioD patients compared to non-PerioD individuals were included. Data and conclusions as presented in the selected papers were extracted and the potential risk of bias was estimated. A descriptive analysis of the meta-analyses of the selected studies was conducted. A citation analysis was performed, the Bradford Hill criteria were assessed and the acquired evidence was graded.
Results:
Independent screening of 446 reviews resulted in 19 eligible SRs. These were categorised into 13 reviews evaluating CVD and eight evaluating CVE. In total 27 meta-analyses were obtained, the majority (78%) of reported risk ratios and odds ratios are estimated to show a negligible magnitude of the association of PerioD and CVD. For CVE, 46% of the values of the association are considered to be of small magnitude as emerging from 23 meta-analyses. For factors such as gender, age, PerioD severity, smoking status and geographic region, the statistical significance and magnitude of the association varied. Given the results, a definitive confirmation of causality according to the Bradford Hill criteria was not attainable. With moderate certainty, a predominantly negligible to small magnitude of the association of PerioD and CVD/CVE was identified.
Conclusion:
Based on data collected from existing SRs, the association between PerioD and CVD/CVE was generally observed to be of negligible to small magnitude. Additionally, the data does not confirm potential causality.
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