Treating gum disease to prevent heart disease: the evidence is unclear

Heart diseaseGum disease is a common chronic or persisting condition that can get worse over time. It involves inflammation of the gums, which surround and support the teeth, causing swollen and painful gums and in severe cases loss of the bone (alveolar) that supports the teeth. Clinical investigations have shown that there might be a link or association between chronic, ongoing gum disease and heart and blood vessel disease (cardiovascular disease). Some investigators believe that the treatment for gum disease, which gets rid of bacteria and infection and controls inflammation, might prevent the occurrence or recurrence.

What was the research?

A systematic review to examine whether or not treatment for moderate to severe gum disease also has an effect on the prevention or management of heart and blood vessel
(cardiovascular) disease.

Who conducted the research?

The research was conducted by a team led by Chunjie Li of  West China Hospital of Stomatology on behalf of Cochrane Oral Health. Zongkai Lv, Zongdao Shi, Ye Zhu, Yafei Wu, Longjiang Li and Zipporah Iheozor-Ejiofor were also on the team.

What evidence was included in the review?

Only one randomised controlled trial, which included 303 participants, was included. The trial compared scaling and root planing with community care in participants who had a greater than 50% blockage of a coronary artery, or who had had a heart attack or stroke in the previous three years.

What did the evidence say?

At present there is only one suitable study looking at this issue. The study had problems with its design. Based on this evidence it was not possible to determine whether or not treatment for gum (periodontal) disease has any effect on the occurrence or recurrence of heart disease in people with chronic gum disease.

How good was the evidence?

The quality of the evidence was very low as there was only one study with problems both in its design and how the study was conducted.

What are the implications for dentists and the general public?

We are unable to make any conclusions on the effect of treating gum disease to prevent heart disease based on the evidence.

What should researchers look at in the future?

There is a need for more randomized controlled trials on this topic, with long-term follow up of patients.


Li C, Lv Z, Shi Z, Zhu Y, Wu Y, Li L, Iheozor-Ejiofor Z. Periodontal therapy for the management of cardiovascular disease in patients with chronic periodontitis. Cochrane Database of Systematic Reviews 2017, Issue 11. Art. No.: CD009197. DOI: 10.1002/14651858.CD009197.pub3.

This post is an extended version of the review’s plain language summary, compiled by Anne Littlewood at the Cochrane Oral Health Editorial Base.