Oral Bacteria and Vascular Inflammation

Oral bacteria have been shown to enter the blood stream on a routine basis with eating, brushing and flossing, for a total time of approximately 5370 minutes per month.   In the presence of periodontal disease and inflammation, the periodontal tissue barrier becomes more permeable, allowing even more pathogens to enter the blood stream. Some bacterial species like A. actinomycetemcomitans  can cross intact oral tissue, while others are able to aggressively  destroy gingival collagen and bone, penetrate the walls of coronary vessels and stimulate the formation of atherosclerotic plaques (Spahr 2006). 

Furthermore, periodontal bacteria and their products activate the immune system, significantly increasing the production of various cytokines that have been shown to accelerate plaque formation. 

A large controlled study (Spahr et al. 2006) found a very significant association (OR 1.92) between the total number of  periodontal bacteria present in a patient's tissues and the presence of coronary heart disease. An even higher association (OR 2.70) was found between the quantity of a certain species (A. actinomycetemcomitans) and cardiovascular disease, while another independent correlation was identified with the number of P. intermedia pathogens.  Patients with heart disease had approximately twice as many periodontal bacteria. 

Systematic reviews and meta-analyses have found that periodontitis was significantly associated with coronary heart disease and stroke, and that it favored the deposition of atherosclerotic plaques (Spahr 2006). 


Spahr, Axel, et al. "Periodontal infections and coronary heart disease: role of periodontal bacteria and importance of total pathogen burden in the Coronary Event and Periodontal Disease (CORODONT) study." Archives of internal medicine 166.5 (2006): 554-559.