Gum disease increases the risk of developing heart disease in men under the age of 60, according to a new study published in Circulation: The Journal of the American Heart Association. While the research focused on HIV-negative men, it has implications for HIV-positive individuals as well, many of whom face an increased risk of cardiovascular disease due to other factors.

Periodontitis is a serious dental infection that can destroy gum tissue and bone. It begins as the more benign and common tooth and gum disease known as gingivitis. Rates of gingivitis and periodontitis in people living with HIV range from 5 to 50 percent in various studies. Though researchers have suspected that periodontal disease may be associated with an increased risk for heart disease for some time, until now there have been no conclusive studies linking the two.

Thomas Dietrich, DMD, MD, MPH, of the Boston University Goldman School of Dental Medicine, and his colleagues studied the medical records of 1,231 men enrolled in the U.S. Department of Veteran Affairs’ Dental Longitudinal Study (DLS), which began enrolling in 1966.

A trained periodontist conducted thorough oral exams on the men once every three years and assigned a score based on the degree of bone loss on each tooth. The scores ranged from 0, where the men had no bone loss, to 5, where then men had lost 80 percent of the bone. The men also were screened regularly for all traditional heart disease risk factors, such as cholesterol, weight, and whether or not they smoked.

Dietrich’s team found that for each 20 percent increase in bone loss, the men’s heart disease risk increased by 39 percent. This was independent of all other risk factors, except for age. The association between periodontitis and heart disease was strongest for the youngest men and weakest for the oldest men, and the association diminished to below the level of statistical significance in men older than 60, meaning that any association could have occurred by chance.

Given that inflammation has been linked to heart disease, and that periodontitis causes considerable and chronic inflammation, it may be wise for younger men with other risk factors for heart disease to be checked regularly by a dental professional, and this is equally true for men living with HIV.