Is C-Reactive Protein an Indicator of Periodontal Risk?


C-reactive protein
Cardiovascular disease




Periodontitis is a chronic, multifactorial, inflammatory disease caused by microorganisms and characterized by the progressive destruction of tooth-supporting tissue. In recent years, studies have shown a correlation and association between periodontitis and atherosclerotic cardiovascular disease, because both the disease has some similar risk factors and they produce an increase in plasma C-reactive protein (CRP) level. This protein has been attributed favorable characteristics as an inflammatory marker. This study was aimed to identify if there is any relationship between periodontitis and CRP values before starting periodontal treatment in a group of patients from the Faculty of Dentistry of the University of Costa Rica. Periodontal examinations were performed on 30 patients, and a blood sample was obtained from each patient to determine the P-CR concentration. The average P-CR was found to be 3.72mg/L (95%CI: 2.06–5.38), which is a moderate to severe risk marker. Fifty-four percent of the total patients had chronic generalized periodontal disease, with no significant difference between the different periodontal disease with gender (p=0.416) or age (p=0.477). Meanwhile, forty-three and three percent of the total patients had localized chronic periodontal disease, and gingivitis respectively. It was observed that the female gender showed a relatively higher cardiovascular risk compared to the opposite gender (p=0.640). In contrast, no statistically significant difference was found in the P-CR value by gender, age or the presence of other diseases, although it was higher in those with metabolic diseases (5.5mg/L) compared to those without (2.7mg/L).


Gasner NS, Schure RS, 2020, Periodontal Disease, In NCBI Bookshelf, Treasure Island: StatPearls Publishing, 1-12.

Kinane D, Stathopoulou P, Papapanou Y, 2017, P. Periodontal Diseases. Nat Rev dis Primers, 2017(3): 17038.

Genco RJ, Borgnakke WS, 2013, Risk Factor for Periodontal Disease. Periodontol 2000, 2013(62): 59-94.

Haffajee AD, Socransky SS, 2009, Relation of Body Mass Index, Periodontitis and Tannerella Forsythia. J Clin Periodontol, 2009(36): 89-99.

Shoelson S, Lee J, Goldfina A, 2006, Inflammation and Insulin Resistance. J Clin Invest, 2006(116): 1793–801.

Premoli G, Villareal J, Gonzalez A, 2008, Proteina C Reactiva Y Su Relacion Con La Enfermedad Periodontal Y La Aterosclerosis (C-Reactive Protein and its Relation to Periodontal Disease and Atherosclerosis). Acta Odontologica Venezolana, 2008(46): 92-93.

Opolski, 2002, Novel Biochemical Predictors of Unfavorable Prognosis for Stable Coronary Disease. Medicine, 97.

Tonetti MS, Van Dyke TE, 2013, Periodontitis and Atherosclerotic Cardiovascular Disease: Consensus Report of the Joint EFP/AAP Workshop on Periodontitis and Systemic Diseases. J Periodont, 84.

Genco R, Offenbacker S, Beck J, 2002, Periodontal Disease and Cardiovascular Disease: Epidemiology and Possible Mechanisms. J Am Dent Assoc, 133.

Amezcua L, Springall R, Bojalil R, 2007, Proteina C Reactiva: Aspectos Cardiovasculares De Una Proteina De Fase Aguda (C-reactive Protein: Cardiovascular Aspects of an Acute-phase Protein). Arch Cardiol Mex, 2007(77): 58-66.

Offenbacker S, Beck JD, 2005, A Perspective on the Potential Cardioprotective Benefits of Periodontal Therapy. Am Heart J.

Slots J, 2019, Focal Infection of Periodontal Origin. Periodontol 2000, 2019(79): 233-235.

Lao W, Araya H, 2018, Periodontal Disease in Costa Rica Year 2017. Odontologia Vital, 2017(29): 59-68.

Tajer D, Charask A, 2013, Genero Y Enfermedad Cardiovascular (Gender and Cardiovascular Disease). Rev Argentina de Cardiologia, 2013(81): 295.

De Freitas C, Luz de Aquino A, Costa de Lima K, et al., 2009, Proteina C Reactiva Ultrasensible En Pacientes Con Y Sin Periodontitis Cronica Severa Generalizada (Ultra-Sensitive C-Reactive Protein in Patients with and Without Chronic Severe Generalised Periodontitis). Av Periodon Implantol, 2009(21): 145-155.

Freitas C, Otros Y, 2010, Influence of Periodontal Therapy on C-reactive Protein Level: A Systematic Review and Meta-analysis. J Appl Oral Sci.

Ebersole JL, 1997, Sistemic Acute-phase Reactants, C Reactive Protein and Haptoglobin in Adult Periodontitis. Clin Exp Inmunol, 1997(107): 347-352.

Slade GD, 2000, Acute-Phase Inflamatory Response to Periodontal Disease in the US Population. J Dent Res, 2000(79): 49-57.