Periodontal infection, a widespread problem in the general population, is a possible trigger of chronic inflammation. Spahr and colleagues examined the association between periodontal infection and coronary heart disease (CHD), focusing on microbiological aspects in 263 patients with CHD and 526 population-based, age- and sex-matched controls. A statistically significant association between periodontitis and the presence of CHD was seen. More importantly, however, the authors found a strong, statistically significant association between the periodontal pathogen burden and the presence of CHD, and these microbiological parameters were stronger predictors for the presence of CHD compared with the clinical assessment of periodontal disease. These findings suggest an association between periodontal infection and presence of CHD and furthermore point to the fact that periodontal pathogen burden may play a prominent role.