Narrative review demonstrates mechanistic links between periodontal dysbiosis and premature atherosclerosis in adults, indicating that clinical trials are needed to prove causality.
Key Points
To evaluate the oral–gut–vascular axis as a mechanistic framework linking periodontal dysbiosis to premature coronary artery disease and premature atherosclerosis.
Structured narrative search of PubMed/MEDLINE, Scopus, Embase, and Web of Science for English-language publications published between January 2015 and June 2026.
Synthesized evidence from human observational and interventional studies, mechanistic analyses, systematic reviews, meta-analyses, and scientific statements.
Identified plausible biological pathways linking oral pathobiont translocation, gut dysbiosis, increased epithelial permeability, TLR2/TLR4 signaling, and TMAO production to vascular endothelial dysfunction.
Observed that periodontal treatment and microbiome-targeted interventions reduce systemic inflammatory biomarkers like hsCRP and IL-6, though protective effects against major cardiovascular events remain unproven.