1. Nepal Medical College and Teaching Hospital (NMC), Nepal: diackmarie3@gmail.com
2. Nepal Medical College and Teaching Hospital (NMC), Nepal: steward001@gmail.com

*             Correspondence: steward001@gmail.com

Keywords: periodontitis, risk factors, cardiovascular diseases, prevalence

1. INTRODUCTION

 Oral health can be used to indicate general health. Periodontitis, one of the most common diseases, is caused by an infection of inflammatory hosts by bacteria, which results in the breakdown of connective tissue and loss of dental bone [1]. Periodontal problems can range in severity from gingivitis, a minor periodontal infection, to severe periodontitis [2]. It affects over 75% of the population in Nepal [3]. This illness is diagnosed by looking for redness, swelling, inflammation, and frequent bleeding in the gums. In the United States, 10% of persons have advanced periodontitis, while 30% of people have mild periodontitis [4]. Increased systemic inflammation can result from a destructive immune response triggered by periodontal disease-related systemic inflammation. The association between periodontal infections and systemic infections, especially cardiovascular illnesses (CVDs), is significant in periodontal research. A hypothesis associating periodontitis, systemic inflammatory disorders, and cardiovascular diseases (CVDs) dates back to the early 1980s [5]. The goal of the current study was to delve deeper into this connection.

2. MATERIALS AND METHODS

In 2021, a Nepal Medical College and Teaching Hospital housed the CVD patients and healthy controls for the case-control study. The sample size was calculated with an odds ratio (OR) of 1.92 and a prevalence rate of 0.453 using the epitools software [6]. Patients from the cardiology department were identified as the cases, and patients from other departments served as the controls. A simple random sampling method was used to select the samples. Groups matched by age were created. Patients with heart attacks, cardiomyopathy, malfunctioning heart valves, and coronary artery disease (CAD) were among those with cardiac diseases. In addition to other diagnostic techniques, symptoms were employed to select cases. Edentulous patients were not accepted. Data were collected by in-person interviews and a questionnaire with four sections: one for demographic information, another for CVD, a section for periodontitis data, and a section for additional possible risk factors. Prior to data collection, patients were informed about the questionnaire and the objectives of the study. Using SPSS 23, the data was analyzed. Clinical diagnosis was utilized to support a number of the case-related criteria that were looked at, and periodontitis parameters included things like bleeding gums, periodontal pockets, and gum swelling. It was considered significant at p<0.05.

3. RESULTS

Of the 146 participants, 73 (or 50%) were controls and cases. Periodontitis prevalence was 48 (65.75%) in the cases and 25 (34.25%) in the controls (p0.01), with 16 (21.91%) having the condition and 57 (78.08%) not (Table 1). Significant relationships were seen between periodontitis and heart attacks, CAD, CMP, and HVD (Table 2).

Table 1: Periodontitis relationship with cardiovascular disease (CVD)

Table 2: Peritonitis with individual cardiovascular disease (CVD)

4. DISCUSSION

The study found a strong link between heart disease and periodontitis, with periodontitis present in 48 (65.7%) of the cases. Our results are congruent with those of a previous study [7, 8]. According to recent research, persistent inflammations and dental infections, especially periodontal disease, play a role in the development of CAD [9]. Concerning evidence indicates that periodontal diseases may play a significant role in the initiation and progression of CVDs [10]. It has been discovered that the prevalence of HVD increases dramatically with age, raising serious concerns about public health [11]. Research has shown that Porphyromonas gingivalis is one of the most common opportunistic periodontal infections, and the current study showed a strong association between HVD and periodontitis [12]. Inflammation or swelling, which results in atherosclerosis, or the hardening of the arteries, is the common factor between heart attacks and periodontitis. The current study found a strong association between the two disorders, and an earlier study [13] corroborates this conclusion. A few fundamental concepts that connect periodontitis with myocardial infarction (MI) include the effects of lipopolysaccharides, the endotoxins produced by the bacteria, the effects of activated polysaccharides, and the indirect effects of host mediators. A study claims that porphyromonas (P.) gingivalis possesses vesicles on its outer membrane that are produced by lipid cells and have the ability to break down atherosclerotic plaques and oxidize low density lipopolysaccharides [14]. Certain oral bacteria have distinct surface proteins that match the activating collagen proteins on platelets. These bacteria include P. gingivalis and streptococcus species. When platelets aggregate due to these proteins and form thrombi, it can lead to cerebral or heart ischaemia [15]. Several investigations have also found a connection between MI and periodontitis [16].

5. CONCLUSION

Periodontitis is a risk factor for CVDs, as evidenced by the substantial relationship between the two conditions. The discovery brings together dental and medical cardiac care.

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