By Peter A. McCullough, MD, MPH
As a cardiologist, I always inspect the mouth and make a comment in my notes about dental health status. According to the American Heart Association (AHA), Porphyromonas gingivalis is one of the principal bacterial pathogens associated with periodontal disease and is a biologically plausible contributor to atherosclerotic cardiovascular disease (ASCVD). The AHA notes that oral pathogens such as P. gingivalis can enter the bloodstream from inflamed periodontal tissues and disseminate systemically, where their virulence factors, including lipopolysaccharides (LPS) and proteolytic enzymes, may promote endothelial dysfunction, vascular inflammation, and immune activation. The AHA also highlights evidence suggesting that immune responses to P. gingivalis may contribute to vascular injury through molecular mimicry and chronic low-grade systemic inflammation. However, while substantial epidemiologic and mechanistic evidence supports an association between periodontal disease and cardiovascular disease, the AHA emphasizes that a direct causal relationship has not yet been conclusively established and that further longitudinal studies and randomized clinical trials are needed. [profession....heart.org], [ahajournals.org]
