Periodontitis and cardiovascular disease in Africa: a scoping review of local and systemic links, causal plausibility, and research gaps

Background: Cardiovascular disease is the leading cause of mortality globally, with its impact escalating swiftly throughout Africa. Periodontitis, a widespread chronic inflammatory condition, is a recognized correlate of cardiovascular disease in high-income countries; however, evidence from Africa remains unsynthesised. This scoping review systematically examined the existing evidence concerning the local and systemic associations between periodontitis and cardiovascular disease in African populations, evaluated their implications for causal plausibility, and identified key research gaps requiring attention. Methods: The review followed the Joanna Briggs Institute methodology and was reported in accordance with the PRISMA Extension for Scoping Reviews. Eligible sources were primary studies conducted in African populations that reported a measure of periodontal status together with a cardiovascular or cardiometabolic outcome, risk indicator, or related care construct. MEDLINE (PubMed), Scopus, Web of Science, and African Journals Online were searched from inception to June 2026. Records were independently screened by two reviewers, with disagreements resolved by a third reviewer; findings were charted and synthesised using descriptive methods. Results: Only seven primary studies, concentrated in Cameroon, Nigeria, and Rwanda, met the eligibility criteria. The studies were predominantly cross-sectional and hospital-based. Reported associations aligned with the global literature, particularly for hypertension and cardiometabolic risk; however, periodontal exposure was defined inconsistently and few studies adjusted fully for shared risk factors. No interventional study with a cardiovascular endpoint and no prospective cohort was identified. Discussion: African research on the periodontitis and cardiovascular disease association is limited, predominantly cross-sectional, and concentrated in a few countries. Causal plausibility therefore cannot be adequately assessed from the current evidence, which is dominated by seven cross-sectional studies. Given that the region carries one of the highest periodontitis burdens globally alongside a rising cardiovascular burden, longitudinal and interventional research and integrated oral and cardiovascular care should be prioritised.