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Br Dent J. 2017 Mar 10;222(5):381-385. doi: 10.1038/sj.bdj.2017.224.

Evidence summary: the relationship between oral and cardiovascular disease.

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Professor and Head of Oral Surgery, The School of Dentistry, University of Birmingham, 5 Mill Pool Way, Edgbaston, Birmingham, B5 7EG.
Consultant Cardiologist King's College London, King's College Hospital, Denmark Hill, Bessemer Road, London SE5 9RS.
Speciality Trainee/ACF in Special Care Dentistry, Birmingham Teaching Hospital, Mindelsohn Way Edgbaston Birmingham, B15 2TH.
STR Oral Surgery, York Hospital, Wigginton Rd, York YO31 8HE.
Gastrointestinal Bacteria Reference Unit National Infection Service, Public Health England, Denmark Hill Campus, Bessemer Road, SE5 9RS.
Dental Public Health Teacher/ Research Associate, Population and Patient Health Division, Denmark Hill Campus, Bessemer Road, SE5 9RS.
Director of Dental Public Health, Population Health &Care Division, Health and Wellbeing Directorate, Public Health England, Skipton House, 80 London Road, London SE1 6LH.
Head of Population and Patient Health, Newland Pedley Professor of Oral Health Strategy, Honorary Consultant in Dental Public Health King's College London Dental Institute, Denmark Hill Campus, Bessemer Road, SE5 9RS.


Aim This paper reports on one review of four rapid reviews undertaken to explore the relationships between oral health and general medical conditions, in order to support teams within Public Health England, health practitioners and policy makers. This review aimed to explore the most contemporary evidence on whether poor oral health and cardiovascular disease occurs in the same individuals or populations, to outline the nature of the relationship between these two health outcomes and to discuss the implication of any findings for health services and future research.Methods The review was undertaken by a group comprising consultant clinicians from medicine and dentistry, trainees, public health and academics. The methodology involved a streamlined rapid review process and synthesis of the data.Results The results identified a number of systematic reviews of low to high quality, which suggests that there is: (1) fairly robust evidence of an increased risk of atherosclerotic vascular disease (ASVD) amongst individuals with chronic periodontitis, independent of other established cardiovascular risk factors; (2) there is some evidence that the incidence of caries and tooth loss is higher in patients with cardiovascular disease; and (3) that orofacial pain can presents as the sole symptom of stroke in some patients. The findings are discussed in relation to implications for service and future research.Conclusion There is high quality evidence to support an association between cardiovascular disease and oral health. This evidence is mainly related to the association between chronic periodontitis and atherosclerotic heart disease, and is independent of confounding factors as drawn from epidemiological observational studies.

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