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Nakib SA, Pankow JS et al. J Periodontol 2004; 75: 505–510

Some research has suggested that periodontal inflammation contributes to cardiovascular disease, but the apparent association has also been attributed to tobacco smoking which is a causal factor common to both conditions. Some investigators have strongly recommended studies in life-long non-smokers. In participants from the ARIC study, a sub-sample of 269 subjects was selected; these had received dental examinations and a cardiac CT scan for coronary artery calcification (CAC).

Subjects with attachment loss of 3 mm+ at 10% or more of periodontal sites were older and had smoked significantly more than those with <10% of sites affected. Subjects with a CAC score of 100+ were older, and more likely to be male, smokers, and on antihypertensive medication, and had a higher waist-to-hip ratio. Multiple logistic regression with these and other cardiac risk factors as covariates gave a non-significant odds ratio of 1.51 (95% CIs: 0.54, 4.23) for the association between periodontitis and CAC. Even if an association could be identified, the path of causality would also need to be demonstrated.