Loesche, WJ. Anaerobic Periodontal Infections as Risk Factors for Medical Diseases. Current Infectious Disease Reports 1999; 1:33-38.
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. Epidemiological studies have indicated, that untreated periodontal disease could be a risk factor for pre-term delivery of low birth-weight infants, coronary heart disease and cerebral vascular accidents. This is because the gram negative anaerobic species implicated in periodontal disease; Bacteroides forsythus, Porphyromonas gingivalis, Treponema denticola, could introduce lipopolysaccharides, heat shock proteins, and pro-inflammatory 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.