Periodontal Disease, C-Reactive Protein and Overall Health

Article from the American Academy of Periodontology

Researchers have known for quite some time that elevated C-reactive protein (CRP) levels increase the risk for cardiovascular disease. A recent study published in The New England Journal of Medicine identified elevated CRP levels as a stronger predictor of heart attacks than elevated cholesterol levels, and recommended CRP and cholesterol screening for accurate risk assessment of cardiovascular disease.

However, many clinicians were unclear of the cause of elevated CRP levels. A study published earlier this year in the Journal of Periodontology reported that inflammatory effects from periodontal disease, a chronic bacterial infection of the gums, cause oral bacterial byproducts to enter the bloodstream and trigger the liver to make proteins such as CRP that inflame arteries and promote blood clot formation.

"Periodontal disease needs to be considered as a major contributor to increased levels of CRP by the medical community," said Dr. Steven Offenbacher, member of the American Academy of Periodontology.

Previous studies reported that inflammatory effects from periodontal disease could cause oral bacterial byproducts to enter the bloodstream and trigger the liver to make proteins such as CRP that inflame arteries. In addition, these effects may cause blood clots that contribute to clogged arteries leading to heart attacks or strokes.

"What makes the recent findings noteworthy is that oral examinations were conducted on more than 5,000 adults in four U.S. communities already participating in a study to determine the risk of atherosclerosis," said Offenbacher. "This is most likely the largest study confirming that periodontal disease and body mass index are jointly associated with increased levels of CRP in healthy adults."

He added, "To reduce levels of CRP, and presumably the risk of cardiovascular disease, not only would it be important to lose weight if you are overweight, but it would also be important to get your gums treated."

CRP testing is now available in many hospitals and health centers. The American Heart Association and the Centers for Disease Control and Prevention are developing a summary on whether CRP levels should be routinely tested to diagnose heart disease or to monitor progress of treatments.

"Based on this information and the potential to prevent heart attacks and strokes, I foresee patients receiving routine CRP testing in their dentist or periodontist office in the near future," said Dr. Gordon Douglass, president of the American Academy of Periodontology. "This could help early diagnosis of potential heart disease sooner rather than later, as most people see their dentist or periodontist at minimum two times a year."