The relationship between poor oral health and cardiovascular disease is strongly associated, but causality is not definitively proven without clinical trials.

“there is a lot of research showing association uh we don't know what comes first so they show the relationship that's proven with periodontal disease and diabetes you know those diseases in low birth weight proton to disease and heart that is a hypothesis of course it's all based on the insult of the bacteria causing inflammation and systemic health we know that um and other things alzheimer's for example amyloid in the brain and a few studies that we did uh showed uh markers as well periodontal disease and markers of alzheimer's so it's they're all associations but the only way you can say casuality is if you do a clinical trial right you need to treat those patients and see changes on those markets and then you say see i changed their behavior they're brushing their teeth now look how better they became so we need to do those things”