Relationship between periodontal disease and cirrhosis of the liver in humans

Abstract

The periodontal condition of a well-described group of cirrhotic patients was compared with that of a control group, matched for age, sex ratio and socio-economic background, expressed as years of education. The test group comprised 30 cirrhotic patients, 35-64 years of age. The diagnosis cirrhosis of the liver was confirmed histologically, and no other systemic diseases were present. The material was grouped according to age, 35-44, 45-54 and 55-64 years of age. The examination included determination of tooth loss, a plaque index, a gingival index, retentive calculus, retentive decay and fillings, and loss of attachment. The amount of plaque was equal in test and control groups, whereas the cirrhotics had a higher degree of severity of gingival inflammation as well as a greater amount of subgingival calculus than the controls. Test and control groups exhibited no significant difference as regards loss of attachment and tooth loss, and similar correlations between loss of attachment and age were demonstrated in the two groups. Patients suffering from cirrhosis for more than 3 years showed significantly greater loss of attachment, as well as more plaque and calculus compared with those with a disease duration of less than 3 years. It is suggested that this aggravation of the periodontal condition is related to increasing neglect of the teeth, as the cirrhotic condition aggravates.

Periodontitis in individuals with liver cirrhosis: A case–control study

“…Further, observational studies have confirmed these findings (Aberg et al, ; Alazawi et al, ; Di Profio et al, ; Jaiswa et al, ; Lins et al, ; Oettinger‐Barak et al, ; Raghava et al, ). However, other studies failed to report this association (Guggenheime et al, ; Movin, ; Novacek et al, ). Frequent potential biases can be observed in several studies such as the use of retrospective data obtained from medical records, indexes or radiograph exams for characterizing periodontitis, small samples, self‐reported information on periodontal and cirrhosis conditions.…”

“…Some studies have addressed the relationship between periodontal disease and liver cirrhosis (Grønkjaer, 2015). While studies reported a higher rate of periodontitis among cirrhotic individuals when compared to controls (Åberg, Helenius-Hietala, Meurman, & Isoniemi, 2014;Alazawi et al, 2017;Di Profio et al, 2018;Grønkjaer,et al, 2018;Jaiswal, Deo, Bhongade, & Jaiswal, 2011;Lins et al, 2011;Oettinger-Barak et al, 2001;Raghava, Shivananda, Mundinamane, Boloor, & Thomas, 2013), others failed to indorse this finding (Guggenheimer, Eghtesad, Close, Shay, & Fung, 2007;Movin, 1981;Novacek et al, 1995). Additionally, other cirrhotic outcomes have been linked to periodontitis and include the progression of liver disease, accelerated Model for End-Stage Liver Disease (MELD) scores (Åberg et al, 2014) and the presence of systemic infections (Lins et al, 2011).…”

Alcohol Consumption Increases Periodontitis Risk

“…The numbers of cases among those reporting recent alcohol intake of 0.1-4.9 g/day were 550; 5.0-14.9 g/day, 562; 15-29.9 g/day, 276; for > 30 g/day, 288; and for non-drinkers, 449. intake and periodontitis. Early studies observed increased prevalence and severity of periodontal disease among patients with cirrhosis (Sandler and Stahl, 1960;Movin, 1981), and attributed this to poor oral hygiene (Movin, 1981). Other studies reported worse periodontal conditions in alcoholic patients with and without cirrhosis than in healthy subjects (Dunkley and Carson, 1968;Novacek et al, 1995) and in nonalcoholic patients with cirrhosis (Novacek et al, 1995).…”

Amount and type of alcohol and periodontitis in the Copenhagen City Heart Study

“…Studies of the past decade have suggested a positive association between high alcohol consumption and periodontitis (Sakki et al 1995, Tezal et al 2001, 2004, Pitiphat et al 2003, Shimazaki et al 2005, Okamoto et al 2006, Jansson 2008. Also, studies have related alcohol abuse (Harris et al 1997) and alcohol-induced hepatic cirrhosis (Movin 1981, Novacek et al 1995 to periodontal status. However, the studies differed according to the definition of periodontitis and results were diverse.…”