Sir, I enjoyed reading the article Link found between gum disease and heart attack printed in your News section (BDJ 2009; 206: 566).

Now I expect I'm missing something but I understand that some poor folk are genetically susceptible to periodontal disease, and I presume that even if their disease is treated and stabilised, they remain genetically predisposed to periodontal disease. I understand from the article that there is a genetic link between CHD and periodontal disease, but I would presume that this predisposition to CHD would also remain whether the periodontal disease is stabilised or left untreated.

It may be that the presence of some organisms in periodontal pockets might explain the relationship between these two diseases, but the genetic link seems a far more likely explanation.

I wonder if rather than making sure we treat those 10% or so of periodontally predisposed patients to help prevent CHD we should be routinely referring all those in this susceptible group not just to the periodontist but to the heart specialist as well.