The mouth is teeming with bacteria and serious infections, such as endocarditis, are commonly from an odontogenic source. The purported pathophysiology behind periodontal disease and coronary artery disease includes indirect mechanisms such as inflammation and mimicry and direct mechanisms such as bacterial invasion of atherosclerotic plaques.
The data to date support an association between periodontal disease and heart disease independent of known confounders, they do not, however, support a causative relationship.Last, there is no convincing data to suggest that treatment of periodontal disease will impact, in the long term, cardiovascular disease.
Heart disease has also been associated with Chlaymydia pneumoniae and Helicobacter infections. Association does not mean causation and to date coronary artery disease is not treated with antibacterials.