It's long been held that gum health is directly linked with heart health, but a new study is injecting some skepticism into the association.
A statement in the journal Circulation, written by a committee of the American Heart Association, points out that there is no evidence to show that heart disease is actually caused by gum disease.
"There's a lot of confusion out there," Peter Lockhart, D.D.S., co-chair of the group that wrote the statement and professor and chair of oral medicine at the Carolinas Medical Center in Charlotte, N.C., said in a statement. "The message sent out by some in healthcare professions that heart attack and stroke are directly linked to gum disease, can distort the facts, alarm patients and perhaps shift the focus on prevention away from well known risk factors for these diseases."
The new piece published in the journal takes a look at 500 studies that have been published on the subject. Even though the studies did suggest an association between gum health and heart health, none of them were able to show proof of causation.
The researchers noted that when a person has gum disease or heart disease, markers of inflammation -- like C-reactive protein -- may be produced, which may explain some of the association. And lifestyle factors, such as cigarette use, age and having diabetes, are all risks for both gum disease and heart disease.
"We already know that some people are less proactive about their cardiovascular health than others," Lockhart said in the statement. "Individuals who do not pay attention to the very powerful and well proven risk factors, like smoking, diabetes or high blood pressure, may not pay close attention to their oral health either."
The American Academy of Periodontology also released their own release, supporting the AHA statement.
While current research does not yet provide evidence of a causal relationship between the two diseases, scientists have identified biologic factors, such as chronic inflammation, that independently link periodontal disease to the development or progression of cardiovascular disease in some patients.
However, the AAP cautioned that just because there is no evidence of causation, it doesn't mean that there isn't some sort of more complicated relationship between oral health and heart health.
"Periodontal disease and cardiovascular disease are both complex, multi-factorial diseases that develop over time. It may be overly simplistic to expect a direct causal link. The relationship between the diseases is more likely to be mediated by numerous other factors, mechanisms, and circumstances that we have yet to uncover," AAP president Pamela McClain, DDS, said in a statement.
"However, as the AHA statement points out, the association is real and independent of shared risk factors," McClain added. "Patients and healthcare providers should not ignore the increased risk of heart disease associated with gum disease just because we do not have all the answers yet."