1. Identifying and managing the periodontal
pathogens that affect cardiovascular disease for
health care professionals.

2. Aim:
This research is aimed at oral health care providers to
identify the periodontal pathogens that are associated
with cardiovascular disease (CVD) and periodontal
disease. So that periodontal pathogens can be identified
and managed to prevent succession of systemic
conditions.

3. Identifying the association between periodontal
disease and CVD is significant to public health (Hujoel,
Drangsholt & Spiekerman, 2000) as CVD accounts for
29% of deaths worldwide (Kim & Amar, 2006) and still
represents the major cause of death in industrialised
countries (Spahr et al, 2005).
The source of chronic inflammation is associated with
an increase in CVD; in retro-spec periodontal disease is
a possible trigger of this chronic inflammation (Spahr
et al, 2005).

4. Research Question
“Do periodontal pathogens affect cardiovascular
disease?”
My research plan will be a survey and in-vitro testing using quantitative methods. This
approach is appropriate because it deals with the numerical measurements required to
ascertain the affects of periodontal pathogens on CVD.
This is the preferred methodology because it aims to test the existing hypotheses, and
to identify the numerical difference’s that effect’s each group.

5. The sample group will consist of 300 participants who have
been previously affected by cardiovascular disease from
within the north island.
The instruments chosen for this research plan are a self-report
questionnaire sent via mail and in-vitro testing:
1. The questionnaire will be multi-choice questions, sent via mail,
and will be prefaced with a cover letter outlining the purpose
and nature of the study.
1. For the in-vitro testing a sample of calculus or plaque will be
taken via scaling of the tooth surface adjacent to the gingival
margin and submitted for laboratory analysis (Polit & Beck,
2004). The analysis will measure the microbiologic levels of the
individual participants.

6. The data collection from the in-vitro testing will
require trained professionals or trained assistants to
accurately take samples from the individual
participants (Brinkerhoff et al, n.d.).
The data from the questionnaire will be quantified
from the original qualitative data to quantitative data
for statistical analysis (Polit & Beck, 2008).
The answers from the qualitative data will be
transformed, through the process of coding, into
quantitative values.

7. The theory of probability statistical analysis will be used to
interpret the quantitative data and discover the underlying
causes, patterns, relationships and trends.
The coded variables will be assigned locations within a data
file - a codebook is used for documentation of the assigned
locations and lists the codes and attributes accordingly.
SPSS or micro-case will be used for transferring of the data
for statistical analysis
Univariate analysis will be used to describe the single
variable of periodontal pathogen levels, specifically the
attributes it composes. Representation of the univariate
data will be reported for all individual cases according to
their attribute in terms of the periodontal pathogen levels
(Babbie, 2008).

8. The expected outcome of this research is for the
identification of the periodontal pathogens causing an
effect on cardiovascular disease. Thus, highlighting for
dental professionals the need for oral hygiene
prevention in this area. In addition, increasing
awareness and attention to the link between
periodontal disease and cardiovascular disease.

9. References
Auckland University of Technology ethics committee (AUTEC). (2009, May 14). Research Ethics: ethics and research involving human
participants. Retrieved from http://www.aut.ac.nz/research/research-ethics.
Babbie, E. (2008). The basics of social research. (4th ed.). Belmont, United States: Thomson Wadsworth.
Brinkerhoff, R.O., Brethower, D.M., Hluchyi. T. & Nowakowski, J.R. (n.d.). Program evaluation: a practitioner’s guide for trainers and
educators. Retrieved from http://ohioline.osu.edu/b868/pdf/b868.pdf
Cohen, I.R. (2007). Review of biomarkers, self-antigens and the immunological homunculus. Journal of Autoimmunity 29(2007) 246-
249. Retrieved from https://www.weizmann.ac.il/immunology/iruncohen/reprints/2007/479.pdf
Creswell, J.W. (2009). Research design: qualitative, quantitative, and mixed methods approaches (3rd ed.). University of Nebraska-
Lincoln.
Demmer, R.T., & Desvarieux, M. (2006). Periodontal infections and cardiovascular disease: The heart of the matter. The Journal of
the American Dental Association, 137, 14S-20S. Retrieved from http://www.adajournal.com/cgi/reprint/137/suppl_2/14S
Desvarieux, M., Demmer, R.T., Rundek, T., Boden-Albala, B., Jacobs Jnr, D.R., Sacco, R.L, & Papapanou, P.N. (2005). Periodontal
Micro biota and Carotid Intima-Media Thickness: The Oral Infections and Vascular Disease Epidemiology Study (INVEST). Journal of
the American heart association, 111(5), 576-581. Retrieved from http://circ.ahajournals.org/cgi/reprint/111/5/576
Hedges, C., & Bliss-Holtz, J. (2006). Not too big, not too small, but just right: the dilemma of sample size estimation. Advanced
Critical Care Nursing, 17(3), 341-344.
Hujoel, P. P., Drangsholt, M., & Spiekerman, C. (2000). Periodontal disease and coronary heart disease risk. The Journal of American
Medical Association, 284(11), 1406-1410. Retrieved from http://jama.amaassn.org/cgi/content/abstract/284/11/1406

10. Hujoel, P. P., Drangsholt, M., Spiekerman, C & DeRouen, T.A. (2002). Pre-existing cardiovascular disease and periodontitis: A Follow-
up Study. Journal of Dental Research, 81(3), 186-191. Retrieved from http://jdr.sagepub.com/content/81/3/186.full.pdf+html
Joshipura, K.J., Wand, H.C., Merchant, A.T., & Rimm, E.B. (2004). Periodontal Disease and Biomarkers Related to Cardiovascular
Disease. Journal of dental research, 83(2), 151-155. Retrieved from http://jdr.sagepub.com/content/83/2/151.full.pdf+html
Kim, J. & Amar, S. (2006). Periodontal disease and systemic conditions: a bidirectional relationship. Odontology, 94(1), 10–21.
Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2443711/pdf/nihms-13055.pdf
Koc, M., Karaarslan, O., Abali, G., & Batur, M.K. (2010). Variation in high-sensitivity C-reactive protein levels over 24 hours: in patients
with stable coronary artery disease. Texas Heart Institute Journal, 37(1), 42-48. Retrieved from
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2829811/pdf/20100200s00009p42.pdf
Polit, D.F., & Beck, C.T. (2008). Nursing research: creating and assessing evidence for nursing practice (8th ed.). Philadelphia: PA,
Lippincott Williams & Wilkins.
Polit, D.F., & Beck, C.T. (2004). Nursing research: creating and assessing evidence for nursing practice(7th ed.). Philadelphia: PA,
Lippincott Williams & Wilkins.
Research Ethics Office. (2008). Why do you need ethics approval. Retrieved from
http://www.mykcl.info/content/1/c6/04/02/82/whydoineedethicsapproval/2008.pdf.
Spahr, A., Klein, E., Khusevinova, N., Boeckh, C., Muche, R., & Kunze, M. (2005). Periodontal Infections and Coronary Heart Disease:
Role of Periodontal Bacteria and Importance of Total Pathogen Burden in the Coronary Event and Periodontal Disease (CORODONT)
Study. Internal medicine journal, 166, 554-559. Retrieved from http://archinte.ama-assn.org/cgi/reprint/166/5/554