Figure 1

Schematic representation of how oral bacteria can increase the risk of cardiovascular diseases (CVDs): (1) The oral cavity contains millions of microorganisms, which comprise bacteria, viruses, fungi, and protozoa which interact with the gingival and periodontal tissues and lead to periodontal inflammation. (2) This host microbial interaction triggers an inflammatory response with massive release of proinflammatory mediators such as tumour necrosis factors (TNF), interleukins (IL-1, IL6, IL8), free radicals or reactive oxygen species (ROS). These proinflammatory mediators along with microbial by-products reach the systemic circulation either directly via swallowing or the blood vessels surrounding the teeth. (3) The microbes along with inflammatory mediators increase systemic inflammation and activates the release of various Acute Phase Proteins such as C-reactive protein (CRP), pentraxin, and fibrinogen from the liver. (4) These Acute Phase proteins, particularly fibrinogen and CRP increase the viscosity of the blood, injure the endothelium of the blood vessels and induce platelet aggregation, and alter lipid metabolism. This increases the risk of atherosclerosis and thrombus formation in the blood vessels. (5) Thrombus formation constricts the blood vessel and reduces the blood supply to the heart and organs [Created with BioRender.com].