Periodontitis and Systemic Disease: Association or Causality?

Abstract

Purpose of ReviewThe aim was to assess recent evidence that diabetes, metabolic syndrome (MetS) and obesity impact the progression of periodontitis.Recent FindingsElectronic searches using Embase, Medline, and Web of Science were carried out for epidemiological studies on humans, published between 2014 and 2016. A small number of prospective studies and systematic reviews were identified that in general provide further support for the hypothesis that diabetes, metabolic syndrome and obesity can adversely affect the periodontal condition.SummaryConfounding remains the most challenging issue in the interpretation of the associations found between diabetes, MetS, obesity and periodontal disease. Recent research applying a Mendelian randomisation approach concluded that the association between obesity and periodontitis is confounded and questioned a role for obesity in causation. Further studies are warranted to assess the issue of causality.

Defining the gut microbiota in individuals with periodontal diseases: an exploratory study

“…Over the years, strong evidence has accumulated to indicate that the pathogenic microbiota and the chronic inflammation established in periodontitis contribute to the onset and/or progression of several systemic inflammatory diseases such as cardiovascular diseases [7,8], diabetes [9], obesity [10], metabolic syndrome [11], respiratory disease [12], cancer [13], chronic kidney disease (CKD) [14] and rheumatoid arthritis (RA) [15]. Most research on the periodontitis-systemic disease relationship, however, has not determined causality, and the link between these diseases are bi-directional associations [16]. …”

Introductory Chapter: Periodontitis - A Useful Reference

“…In recent developments, a study on the pathological link between periodontal health and systemic ailments [7] invited more interest and follow-up among researchers and public health organizations. There are significant findings supporting the association between periodontal disease and systemic conditions [8] namely cardiovascular disease [9], cerebrovascular diseases, peripheral arterial disease, respiratory diseases, mental disorders, type 2 diabetes mellitus [10], digestive diseases, endocrine disorders, obesity, adverse pregnancy outcomes [11], renal disorders, and rheumatoid arthritis (RA).…”

The Importance of Oral Health during Pregnancy: A review

“…4,5,6 The association of dental diseases with pulmonary infections had been described as early as the sixties. 23 Periodontitis has been found to show significant association with cardiovascular diseases, diabetes mellitus, respiratory conditions and osteoporosis.…”

“…These systemic diseases have been primarily attributed to the various pathogens seen in periodontitis. 5 A relative risk of cardiovascular disease in individuals with periodontitis was described in a meta-analysis. 24 Tooth mobility has been observed during pregnancy.…”