Periodontitis, Bacteremia and Infective Endocarditis: A Review Study

Context: Earlier evidences show that periodontitis with inflamed and ulcerated crevicular or pocket epithelium surrounding the teeth may be a portal of entry for bacteria into the bloodstream. A newly proposed causal model predicts that an early bacteremia may affect the endothelial surface of the heart over many years and promote valve thickening rendering the heart valve susceptible to vegetation by a later bacteremia that would culminate over a few weeks into fulminant infection. Evidence Acquisition: In this review, various published sources of information pertaining to periodontitis, bacteremia and infective endocarditis were reviewed. This review is focused on the role of the viridans group streptococci (VGS) in periodontitis, bacteremia and infective endocarditis. Results: The viridans group streptococci present in the oral cavity were the most important causes of bacteremia following dental procedures and infective endocarditis. In most of the studies, significantly higher rates of bacteremia occurring in patients with periodontitis than patients without periodontitis indicated that periodontitis opens up the route for oral streptococci to gain entry into the bloodstream. In addition, the significantly higher rates of isolation of the VGS from the patients of infective endocarditis with periodontitis showed that there was a positive association between periodontitis, infective endocarditis and the VGS. Conclusions: The literature survey presented in this review suggests that there is a definite relation between periodontitis, bacteremia and infective endocarditis and would provide valuable data for the future dentists as well as the physicians, because a large proportion of the world’s population lives a lifetime with periodontitis. Moreover, infective endocarditis still remains a cause of concern as this disease is a cause of considerable morbidity and mortality regardless of modern antimicrobial and surgical treatment.