An interesting article titled “Relationship Between Periodontitis and Atrial Fibrosis in Atrial Fibrillation: Histological Evaluation of Left Atrial Appendages” appears in the JACC: Clinical Electrophysiology written by Shunsuke Miyauchi and et. al. (Volume 9, Issue 1, January 2023, Pages 43-53). The article seeks to explore the relationship of periodontitis with atrial fibrillation (AF) and atrial fibrosis.
Periodontitis (periodontal disease) is an inflammatory disease where bacteria accumulates at the gum line. The likelyhood of periodontal disease occurring later in life in the wisdom tooth region is a reason dentists and oral surgeons give to support removing healthy wisdom teeth in the teenage and twenty years of age. Various associations to periodontitis has been showed over the years as covered before on this site see for example the posts Omega 3 Fatty Acids Inversely Proportional to Periodontitis, Blueberry extract could help treat periodontitis, Estrogen therapy can help reduce gum disease, and Additional link between cardiovascular and periodontal disease.
In the article mentioned earlier, the authors conducted a study on 76 patients with atrial fibrosis, 55 with nonparoxsymal atrial fibrosis, 25 with mitral valve regurgitation, and 18 with left atrial appendage thrombus, who were scheduled to undergo left atrial appendage excision. All patients in the study had an oral exam performed. This exam assessed the remaining number of teeth, bleeding on probing, periodontal probing depth, and periodontal inflamed surface area. The authors assessed the degree of fibrosis in each patient by studying resected left atrial appendages by Azan–Mallory staining.
The authors found that bleeding on probing, periodontal probing depth of 4mm or greater, and periodontal inflamed surface area were all positively correlated with atrial fibrosis. For patients that had more than 10 teeth, periodontal inflamed surface area was positively and strongly correlated with atrial fibrosis. After adjustments for age, atrial fibrillation duration, body mass index, mitral valve regurgitation, congestive heart failure, hypertension, age, diabetes, and previous stroke/transient ischemic attack score, the authors determined periodontal inflamed surface area was significantly associated with atrial fibrosis. Thus the authors determined an association of periodontitis with atrial fibrosis. The authors feel that periodontitis is likely a risk factor for atrial fibrillation and fibrosis scarring that can lead to an irregular heartbeat. In the future the authors hope to conduct additional studies on this topic.