Anaerobic Periodontal Infections as Risk Factors for Medical Diseases.

Advanced forms of periodontal disease are associated with the overgrowth of a limited number of gram-negative anaerobic species in plaques found in periodontal pockets. Double-blind clinical trials of metronidazole and doxycycline, combined with debriding of the tooth surfaces, have significantly reduced the need for periodontal surgery. Epidemiologic studies have indicated that untreated periodontal disease could be a risk factor for preterm delivery of low birth weight infants, coronary heart disease, and cerebral vascular accidents. This is because gram-negative anaerobic species implicated in periodontal disease, eg, Bacteroides forsythus, Porphyromonas gingivalis, and Treponema denticola, could introduce lipopolysaccharides, heat-shock proteins, and proinflammatory cytokines into the blood stream. If periodontal disease is a risk factor for cardiovascular disease, then it is a modifiable risk factor, as periodontal disease is treatable.