Cardiologists have a growing and logical tendency to base their decisions on available scientific evidence - evidence that is not always clear in the overall aspects of the systemic relationships that are established between cardiovascular and other systems in the body, such as the mouth. 

Hence the necessary relationship and joint training of cardiologists and dentists, with periodontal disease, and especially periodontitis, having been determined in recent years as a cardiovascular risk factor, particularly for coronary atherosclerotic disease. 

Recent studies, including a meta-analysis by Bouchard P et al., have shown a crucial epidemiological association, concluding that the presence of periodontal disease increases the risk of developing cardiovascular disease by 14%. According to Dr. Manuel Anguita, recently appointed as the Chairman of the Spanish Society of Cardiology (SEC), this association is logical even in terms of risk factors. And as he points out, “smoking, diabetes, obesity, stress, genetic polymorphisms, age or socioeconomic status are risk factors shared by periodontal and cardiovascular disease.” The challenge now, he acknowledges, “is to try to determine if there is a random or a causal relationship between diseases of the gums and those of the heart.” 

Close collaboration 

Whatever the case, the systemic nature of diseases such as periodontitis may well explain the increased risk of cardiovascular disease. “There is an increased risk in patients with periodontitis of suffering a systemic pathology, and vice versa - patients with a systemic pathology show a greater risk of developing a periodontal disease," recalls the cardiologist at the Reina Sofía Hospital in Córdoba, who points to the recent European Society of Cardiology guidelines, which indicate that periodontitis is associated with endothelial dysfunction, atherosclerosis and an increased risk of myocardial infarction and stroke. 

Faced with this fact, he suggests that “cardiologists and dentists must work together, to promote periodontal and cardiovascular prevention, and the creation of Cardio-Dental Units to address the most compromised cases.” 

Specifically, as the main tasks that the cardiologist must take on in this area, the Head of the SEC proposes three measures: 

1. Make patients aware of the importance of periodontitis as a risk factor for cardiovascular diseases, acting in the field of primary prevention (in association with Primary Care, to establish preventive measures for periodontal health in healthy patients to prevent the development of cardiovascular diseases), and of secondary prevention (in Cardiac Rehabilitation Units, to avoid the development of repeat cardiovascular events through the prevention or treatment of periodontal diseases). 

2. Perform periodontal health questionnaires for cardiovascular patients. 

3. Refer patients to the dentist when there are signs of periodontal disease. 

MimoCardio Cares for Your Gums 

This necessary cooperation between cardiologists and dentists already has a solid basis in the joint Working Group of the Spanish Society of Periodontology (SEPA) and the Spanish Society of Cardiology (SEC), with the support of DENTAID. 

This initiative is bearing significant results. Of these, “MimoCardio Cares for Your Gums” stands out as an innovative training and dissemination project. It aims to be the basis for greater collaboration and synergies between Cardiology and Periodontics in terms of primary and secondary prevention, as well as health promotion. In addition, it acknowledges the important strategic value of the dental clinic, as a promotion point for a healthy lifestyle and the prevention of cardiovascular disease. 

The many activities that are being developed within the SEPA-SEC joint activities programme include face-to-face training sessions, participation in congresses, specific communication activities or virtual training for cardiologists and dentists, among others. 

In this sense, it highlights the success achieved in the three editions of the “MimoCardio Cares for Your Gums” online course held so far, and which have trained about 150 professionals on the association between periodontal and cardiovascular health, as well as giving keys on the promotion of cardiovascular health at the dental clinic. 

SEPA and SEC have also cooperated in drafting an important consensus document on the perioperative and periprocedural management of antithrombotic treatment.