Due to the complex pathophysiology of periodontitis and its impact on the risk for CVD, the bacteria, risk factors, and inflammation all need to be addressed when developing a treatment plan. The focus should be on reducing the impact of biofilm and resolving gingival inflammation. Treatment of moderate to severe periodontitis, sufficient to reduce the clinical signs of the disease, also decreases the level of systemic inflammatory markers, such as CRP.

Use of systemic antibiotics, locally delivered antibiotics, host-modulation therapy, and surgery are treatment considerations that have been shown to facilitate bacterial control and heal bone and soft tissue attachments. Regular biofilm removal and instruction in maintaining excellent oral hygiene at home is critical to preventing periodontitis. Product recommendations should include the use of interdental devices and mouthrinses. For those patients who are already challenged by both oral and systemic disease, the toothpaste recommended should offer both antibacterial and anti-inflammatory properties. Colgate Total, for example, contains triclosan, known for its ability to both kill the bacteria and reduce the inflammation associated with gingivitis, which, if left untreated, can lead to more serious forms of periodontal disease.

It is surmised that if greater emphasis on research efforts to better understand the underlying mechanisms regulating the progression of periodontitis and CVD can be identified, the development of treatment protocols to reduce the inflammatory burden might be enhanced. This landmark article offers excellent treatment recommendations based on the best evidence available to date. It is anticipated that support of future large-scale human clinical trials may lead to improved means to better manage both diseases.

Finally, a close collaboration between dentists and physicians is warranted to minimize differences in outcome measures. Oral healthcare providers are well positioned to help identify people at risk for atherosclerotic cardiovascular disease, and appropriate referrals and treatment can enhance the overall health and well-being of their patients.