Several longitudinal studies have demonstrated a relationship between periodontal disease and an increased risk of cardiovascular events. The chronic inflammatory burden of periodontal disease and the host response to this inflammation may result in dysfunction of the vascular endothelium and the development of atherosclerosis. Objective: To examine whether periodontal therapy in chronic periodontitis will improve endothelial function as measured by flow mediated vasodilatation (FMD). Methods: 22 subjects with untreated advanced chronic periodontitis were included in this study. All were otherwise in good health, with no history of heart disease, stroke, diabetes, or hypertension. FMD, C-Reactive protein (hsCRP), and interleukin-6 (IL-6) were measured on three occasions: twice one month apart prior to treatment, and again 1 month after treatment. Therapy consisted of complete mouth disinfection via scaling and root planing, periodontal surgery (flap curettage or osseous surgery) and extraction of hopeless teeth by a qualified periodontist. Results: Of the 22 subjects (age range 31 to 55 years, mean: 42.4 years) 54.5% were female and 22.7% were smokers. FMD averaged 8.56 + 4.65 % at baseline (pooled baseline) and improved to 10.15 + 3.89 % after periodontal therapy (p = 0.03). Decreases in median hsCRP (2.38 to 1.40 mg/L, p = 0.12) and median IL-6 (1.67 to 1.07 pg/mL, p = 0.03) were also observed. Conclusions: These findings suggest that the association of coronary events with periodontal disease may be mediated by the effects of chronic inflammation on the vascular endothelium, and that aggressive therapy of periodontal disease may improve cardiovascular health.

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