The role of periodontal disease remains a headline-generating topic. Periodontal disease, caused chiefly by bacteria, is characterized by inflammation, bacteremia, a strong immune response, and loss of connective tissue attachment and bone. It is speculated that a continuous long-term exposure to oral bacteremia and bacterial toxins induces immune responses that could contribute to coronary atherosclerosis and, in conjunction with other risk factors, lead to coronary heart disease and myocardial infarction. Periodontal disease might initiate pathological changes in blood vessel walls and act as a precursor of atherosclerosis in susceptible hosts. Many causal factors can play a role in heart diseases. Periodontal disease caused by pathogen bacteria as a low-grade inflammation could represent one of several possible causal factors of heart disease.