The editors state that although causality of periodontal disease generating CVD cannot be confirmed with a high level of confidence, they do note that those patients with moderate-to-severe periodontitis should be informed that they might be at an increased risk of atherosclerotic CVD. Cardiologists and family physicians should be sensitive to this and refer CVD patients to their dental care providers for a complete periodontal assessment.

Similarly, general dentists, periodontists, and dental hygienists need to conduct careful assessments to identify risk factors for both periodontal disease and CVD, and refer patients with periodontal disease for a complete physical examination, measurement of blood pressure, blood lipid profile, blood glucose measurement, and a plasma hsCRP evaluation if they have not had such a work-up within the past 12 months. In general, patients with periodontitis who have two or more known major atherosclerotic CVD risk factors should be referred for medical evaluation.

Both dental and medical practitioners should discuss lifestyle changes, including weight management and stress reduction, to reduce the risk of CVD as part of their preventive education. For those patients who report a smoking habit, a smoking cessation program should be offered. This program could be supported by the dentist or dental hygiene provider, or managed by the patient’s physician. For those patients diagnosed with hypertension, dentists and physicians should coordinate the selection of antihypertensive medication to avoid the worsening of periodontal conditions with the development of gingival hyperplasia, such as can occur with the use of calcium channel blockers.

Periodontitis patients can also assess their own risk for future CVD events by calculating their Reynolds Risk Score or by using the National Cholesterol Education Program Risk Calculator.