The Systemic Link Between Oral Health and Cardiovascular Disease: Contemporary Evidence, Mechanisms, and Risk Factor Implications.

BACKGROUND

Oral health plays a critical role in systemic wellbeing, with growing evidence supporting strong associations between oral conditions and cardiovascular disease (CVD). These connections extend beyond periodontal disease and involve oral microbiota imbalance, systemic inflammation, and oral side effects of cardiovascular pharmacotherapy.

OBJECTIVE

To explore these links, a narrative literature review was performed using PubMed, Scopus, and ScienceDirect, covering studies published between 2000 and 2025.

METHODS

A comprehensive literature search was conducted in PubMed, Scopus, and ScienceDirect for studies published between January 2000 and May 2025. Both MeSH and free-text terms related to oral health, periodontal disease, systemic inflammation, endothelial dysfunction, and atherosclerosis were used. Eligible studies included observational and interventional research, systematic reviews, and meta-analyses.

KEY FINDINGS: The evidence consistently supports an association between chronic periodontal inflammation and cardiovascular risk, mediated by systemic dissemination of proinflammatory cytokines (IL-6, TNF-α, CRP) and microbial products that promote endothelial activation and atherogenesis. Interventional data indicate that periodontal therapy may reduce systemic inflammatory burden and improve vascular parameters, though heterogeneity across studies limits causal inference.

CONCLUSIONS

Current findings highlight a significant oral-systemic connection through inflammatory and endothelial mechanisms. Strengthening interdisciplinary collaboration between dental and cardiovascular care providers is essential to translate this evidence into preventive and therapeutic practice. Further longitudinal and mechanistic studies are required to confirm causality and guide clinical integration.