The presence of specific bacteria and combinations of bacteria in periodontal pockets might explain the relationship between periodontal disease and acute coronary syndrome (ACS), according to a study published in the July issue of Journal of Periodontology.
Researchers from Sweden, Switzerland and the United States evaluated 161 subjects diagnosed with ACS and a control group of 161 matched subjects who did not have ACS. They studied the subjects’ serum white blood cell counts, high- and low-density lipoprotein levels, high-sensitivity C-reactive protein levels, and clinical periodontal routine parameters. They also assayed the subjects’ subgingival pathogens using the checkerboard DNA-DNA hybridization method.
Researchers found that the amount of oral bacteria was two times higher in the ACS group for the combination of the bacteria streptococci species Porphyromonas gingivalis, Tannerella forsythensis and Treponema denticola. Specifically, the findings suggest that T. denticola, T. forsythia and streptococci species are bacteria in a shared infectious etiology for periodontitis and ACS.
"This might be one of several explanations as to why elevated bacteria and the combination of specific pathogens in periodontal pockets can be linked to a history of ACS," said lead author Dr. Stefan Renvert, Department of Health Sciences, Kristianstad University, Sweden. "We also found that the amount of periodontal bacteria results in an inflammatory response that elevates the white blood cell counts and high-sensitivity C-reactive protein levels, which has also been linked in past studies to heart disease."
Researchers also found that the extent of alveolar bone loss was significantly greater among subjects in the ACS group. Seventy-seven percent of the subjects in the ACS group and 42 percent of subjects in the control group had evidence of periodontitis. The extent of bone loss was more severe in the ACS group than it was in the control group.
