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Int J Cardiol Cardiovasc Risk Prev
Int J Cardiol Cardiovasc Risk Prev
International Journal of Cardiology. Cardiovascular Risk and Prevention
2772-4875
Elsevier

S2772-4875(24)00085-0
10.1016/j.ijcrp.2024.200320
200320
Article
Toothache of cardiovascular origin
Siddiqui Shanezehra shanezehrasiddiqui@gmail.com
⁎
Dow University of Health Sciences, Karachi, Pakistan
Adil Yamaan yamaanadilqureshi@gmail.com

Dow University of Health Sciences, Karachi, Pakistan
⁎ Corresponding author. Dow University of Health Sciences, New Labour Colony Nanakwara, Mission Rd, Karachi, Karachi City, Sindh, Pakistan. shanezehrasiddiqui@gmail.com
13 8 2024
9 2024
13 8 2024
22 20032031 7 2024
9 8 2024
© 2024 The Authors. Published by Elsevier B.V.
2024

https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Handling editor: D Levy
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pmcLetter

The primary cause of global mortality is cardiovascular diseases. Hypertension, dyslipidemia, diabetes mellitus, and smoking are all risk factors. The relationship between cardiovascular diseases and non-odontogenic pain is the subject of ongoing debate. For those who have a pre-existing CAD, toothache can be a significant indicator of coronary artery disease (CAD). CAD can also be indicated by discomfort in the viscerocranium, which includes the left mandible, right mandible, left temporomandibular joint, and left ear, in addition to toothache. This is one of the most common symptoms. The following are the cardinal warning indications of a non-odontogenic toothache:A. Multiple toothaches that occur spontaneously.

B. An inadequate local dental issue causes the discomfort.

C. Toothaches that are non-pulsatile, searing, and stimulating.

D. Non-variable, perpetual toothaches.

E. Recurrent, persistent toothaches.

F. The pain is not alleviated by local anaesthetic blockade of the offending tooth.

G. The toothache fails to respond to reasonable dental therapy [1]. Additionally, chest discomfort is typically absent in these circumstances.

Penn State has not provided a specific explanation for this association; however, individuals who have an infection in their pharynx may induce an inflammatory response in their body. The immune system may become excessively aggressive in response to it, which results in the hardening of the arteries as a consequence of the irritation caused by the reaction [2]. This condition is known as ischemic heart disease. In addition, Harvard has proposed a variety of theories, such as the following: 1. The bacteria that infect the gums and cause gingivitis and periodontitis also travel to blood vessels in other parts of the body, where they cause inflammation and damage. This can result in the formation of small blood clots, heart attacks, and strokes. The discovery of oral bacteria remnants in atherosclerotic blood vessels located far from the mouth lends credence to this hypothesis. 2. Although there is no direct correlation between periodontal disease and cardiovascular disease, they may co-occur due to a third risk factor (such as smoking) that is associated with both conditions [3].

Periodontal disease is characterized by chronic infection and inflammation, resulting in tooth loss and bone degeneration. Additionally, it progresses slowly. Only the number of lost teeth was substantially associated with obstructive CAD among the seven dental health indices. Patients with obstructive CAD had significantly more lost teeth than those without [4].

Numerous studies have demonstrated that the long-standing inflammatory stimuli of dental infection are implicated in the pathogenesis of atherosclerosis and subsequent CAD, but others have been unable to identify a clear association between dental infection and CAD. Consequently, there is ongoing discussion regarding the correlation between dental disease and CAD [4]. It is imperative to prioritize oral hygiene, regardless of its relevance, as it not only contributes to preserving healthy teeth but also offers additional potential benefits that are still being investigated.

Declaration

None.

Funding

None.

CRediT authorship contribution statement

Shanezehra Siddiqui: Conceptualization, Writing – original draft, Writing – review & editing. Yamaan Adil: Writing – review & editing.

Declaration of competing interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Acknowledgment

None.
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References

1 Okeson J.P. Non-odontogenic toothache NW. Dent. 79 5 2000 Sep-Oct 37 44 PMID: 11413614
2 Medical Minute, Penn State Health - https://pennstatehealthnews.org/category/medical-minute/.
3 Harvard Health Publishing, Harvard Medical School - https://www.health.harvard.edu/.
4 Lee H. Kim H.L. Jin K.N. Oh S. Han Y.S. Jung D.U. Sim H.Y. Kim H.S. Lim W.H. Seo J.B. Kim S.H. Zo J.H. Kim M.A. Association between dental health and obstructive coronary artery disease: an observational study BMC Cardiovasc. Disord. 19 1 2019 Apr 27 98 10.1186/s12872-019-1080-9 PMID: 31029089; PMCID: PMC6487007 31029089
