The Relationship Between Periodontitis, Gingivitis, Smoking, Missing Teeth, Endodontic Infections, Aortic Aneurysm, and Coronary Artery Disease: The 10-Year Results of 25 Patients.

Background Emerging research suggests a correlation between poor oral health and cardiovascular diseases (CVDs), with inflammation being a central mechanism. Periodontitis and gingivitis are chronic inflammatory diseases that can lead to systemic health issues if untreated. It has been indicated previously that endodontic infections and missing teeth may contribute to elevated cardiovascular risk, and smoking exacerbates both periodontal and cardiovascular conditions. This study expands upon existing research by examining both periodontal and endodontic health factors together and investigating smoking as a potentially amplifying factor. Poor periodontal health may contribute to systemic inflammation, which is a recognized risk factor for atherosclerosis and cardiovascular events. This study aims to evaluate these relationships over a decade, providing insights into the potential preventive impact of periodontal care on cardiovascular health. Materials and methods This 10-year retrospective study examines the complex relationships among periodontal health factors (including periodontitis, gingivitis, and missing teeth), endodontic infections, smoking, and cardiovascular conditions, specifically coronary artery disease (CAD) and aortic aneurysm. By analyzing data from 25 patients aged 45-75, the study aims to assess whether these oral health indicators correlate with increased cardiovascular risks. The study's methodology included comprehensive dental and cardiovascular evaluations for each patient, with baseline data collected at the study's inception and follow-ups over the next decade. Oral health assessments documented the severity of periodontal diseases and recorded the presence of endodontic infections. Cardiovascular evaluations were conducted to establish the incidence and progression of CAD and aortic aneurysm, while lifestyle factors, particularly smoking, were noted as significant contributors. This approach allowed for an in-depth exploration of the possible causal pathways linking oral health to cardiovascular outcomes.  Results Results demonstrated that severe periodontitis, high numbers of missing teeth, and the presence of endodontic infections were significantly associated with higher incidences of CAD and aortic aneurysm. Smoking, as expected, acted as a compounding factor, intensifying the risk of cardiovascular outcomes in patients with poor oral health. Interaction terms further highlighted how smoking combined with advanced periodontitis notably increased CAD risk. The findings align with the hypothesis that severe periodontal disease and endodontic infections contribute to cardiovascular risk, especially among smokers. These results indicate that periodontal disease may serve as a marker for systemic inflammation, which has far-reaching effects beyond oral health alone. Conclusion The 10-year study showed a strong association between periodontal disease, smoking, hypertension, periodontitis and CVDs. This study underscores the importance of maintaining good oral health and cessation of smoking to mitigate cardiovascular risk. The results advocate for a multidisciplinary approach to patient care, integrating dental health with broader cardiovascular risk management. Future research is recommended to confirm these findings in larger, more diverse cohorts and to explore further the underlying mechanisms connecting oral infections and systemic inflammation with cardiovascular health.