If oral infection causes CVD, there is a moral imperative to avoid CVD by
reducing oral infections. But what if it is not clear whether oral infection causes CVD? Then
we are faced with conceptual, methodological and moral challenges. The literature, as the rest
of this book, is focusing on methodological challenges, trying to show that and how oral
infections cause CVD. However, there has been little or no attention on the conceptual and
moral challenges, which are the topics for this chapter. A closer analysis of the scientific
basis for claiming that oral infection causes CVD reveals a series of moral issues. These stem
from a) how to choose between the many conceptions of causality, and from b) the moral
challenge of preventing harm when there is an unclear or weak causal relationship between
oral infection and CVD or c) when various kinds of uncertainty prevail. The challenge of
how to act under uncertain circumstances comes out as questions of resource allocation and
prioritization, but it also poses issues of medicalization and not causing unnecessary health
anxiety. Hence, although the literature is void of discussing moral challenges with the
relationship between oral infection and CVD, the challenges are ample.
