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Periodontal Disease and Systemic Health

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Periodontology

Part of the book series: BDJ Clinician’s Guides ((BDJCG))

Abstract

The possibility of periodontal disease influencing other systemic disease has been debated for many years, and there is still some contention around this possibility. It has been difficult to always separate association and shared risk factors from true causative pathways. This chapter discusses this, possible links and how these are not confirmed for all possible disease associations, but closes with how improving oral health has been shown to impact some aspects of significant systemic diseases and how this may impact health policy.

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Further Reading

Systematic and Other Reviews

  • Beck JD, Papapanou PN, Philips KH, Offenbacher S. Periodontal medicine: 100 years of progress. J Dent Res. 2019;98:1053–62.

    Article  PubMed  Google Scholar 

  • Paraskevas S, Huizinga JD, Loos BG. A systematic review and meta-analyses on C-reactive protein in relation to periodontitis. J Clin Periodontol. 2008;35:277–90.

    Article  PubMed  Google Scholar 

  • Sanz M, Marco del Castillo A, Jepsen S, et al. Periodontitis and cardiovascular diseases: consensus report. J Clin Periodontol. 2019:1–21.

    Google Scholar 

  • Teeuw WJ, Gerdes VE, Loos BG. Effect of periodontal treatment on glycemic control of diabetic patients: a systematic review and meta-analysis. Diabetes Care. 2010;33:421–7.

    Article  PubMed  PubMed Central  Google Scholar 

Background/Historical Literature

  • Boucher NE Jr, Hanrahan JJ, Kihara FY. Occurrence of C-reactive protein in oral disease. J Dent Res. 1967;46:624.

    Article  PubMed  Google Scholar 

  • Cairo F, Castellani S, Gori AM, Nieri M, Baldelli G, Abbate R, Pini-Prato GP. Severe periodontitis in young adults is associated with sub-clinical atherosclerosis. J Clin Periodontol. 2008;35:465–72.

    Article  PubMed  Google Scholar 

  • Cairo F, Nieri M, Gori AM, Rotundo R, Castellani S, Abbate R, Pini-Prato GP. Periodontal variables may predict sub-clinical atherosclerosis and systemic inflammation in young adults. A cross-sectional study. Eur J Oral Implantol. 2009;2:125–33.

    PubMed  Google Scholar 

  • Castillo DM, Sánchez-Beltrán MC, Castellanos JE, Sanz I, Mayorga-Fayad I, Sanz M, Lafaurie GIS. Detection of specific periodontal microorganisms from bacteraemia samples after periodontal therapy using molecular-based diagnostics. J Clin Periodontol. 2011;38:418–27.

    Article  PubMed  Google Scholar 

  • Chen CK, Wu YT, Chang YC. Association between chronic periodontitis and the risk of Alzheimer’s disease: a retrospective, population-based, matched-cohort study. Alzheimers Res Ther. 2017;9:56–62.

    Article  PubMed  PubMed Central  Google Scholar 

  • Choi S, Kim K, Chang J, Kim SM, Kim SJ, Cho H‐J, Park SM. Association of chronic periodontitis on Alzheimer’s disease or vascular dementia. J Am Geriatr Soc. 2019;67:1234–9.

    PubMed  Google Scholar 

  • Choi SE, Sima C, Pandya A. Impact of treating oral disease on preventing vascular diseases: a model-based cost-effectiveness analysis of periodontal treatment among patients with type 2 diabetes. Diabetes Care. 2020;43:563–71.

    Article  PubMed  Google Scholar 

  • Collins JG, Windley HW III, Arnold RR, Offenbacher S. Effects of a Porphyromonas gingivalis infection on inflammatory mediator response and pregnancy outcome in hamsters. Infect Immun. 1994;62:4356–61.

    Article  PubMed  PubMed Central  Google Scholar 

  • D'Aiuto F, Nibali L, Mohamed-Ali V, Vallance P, Tonetti MS. Periodontal therapy: a novel non-drug-induced experimental model to study human inflammation. J Periodontal Res. 2004;39:294–9.

    Article  PubMed  Google Scholar 

  • D'Aiuto F, Parkar M, Nibali L, Suvan J, Lessem J, Tonetti MS. Periodontal infections cause changes in traditional and novel cardiovascular risk factors: results from a randomized controlled clinical trial. Am Heart J. 2006;151:977–84.

    Article  PubMed  Google Scholar 

  • D'Aiuto F, Sabbah W, Netuveli G, Donos N, Hingorani AD, Deanfield J, Tsakos G. Association of the metabolic syndrome with severe periodontitis in a large U.S. population-based survey. J Clin Endocrinol Metab. 2008;93:3989–94.

    Article  PubMed  Google Scholar 

  • D'Aiuto F, Nibali L, Parkar M, Patel K, Suvan J, Donos N. Oxidative stress, systemic inflammation, and severe periodontitis. J Dent Res. 2010;89:1241–6.

    Article  PubMed  PubMed Central  Google Scholar 

  • D’Aiuto F, Gkranias N, Bhowruth D, et al. TASTE group. Systemic effects of periodontitis treatment in patients with type 2 diabetes: a 12 month, single-Centre, investigator-masked, randomised trial. Lancet Diabetes Endocrinol. 2018;6:954–65.

    Article  PubMed  Google Scholar 

  • Demmer RT, Norby FL, Lakshminarayan K, et al. Periodontal disease and incident dementia The Atherosclerosis Risk in Communities Study (ARIC). Neurology. 2020;95:e1660–71.

    Article  PubMed  PubMed Central  Google Scholar 

  • Dominy SS, Lynch C, Ermini E, et al. Porphyromonas gingivalis in Alzheimer’s disease brains: evidence for disease causation and treatment with small-molecule inhibitors. Sci Adv. 2019;5:eaau3333.

    Article  PubMed  PubMed Central  Google Scholar 

  • Duzagac E, Cifcibasi E, Erdem MG, Karabey V, Kasali K, Badur S, Cintan S. Is obesity associated with healing after non-surgical periodontal therapy? A local vs. systemic evaluation. J Periodontal Res. 2016;51:604–12.

    Article  PubMed  Google Scholar 

  • Fischer LA, Demerath E, Bittner-Eddy P, Costalonga M. Placental colonization with periodontal pathogens: the potential missing link. Am J Obstet Gynecol. 2019;221:383–92.e3

    Article  PubMed  PubMed Central  Google Scholar 

  • Geerts SO, Nys M, De MP, Charpentier J, Albert A, Legrand V, Rompen EH. Systemic release of endotoxins induced by gentle mastication: association with periodontitis severity. J Periodontol. 2002;73:73–8.

    Article  PubMed  Google Scholar 

  • Goadby KW. Pyorrhoea alveolaris. Lancet. 1907:633–43.

    Google Scholar 

  • Graziani F, Cei S, Tonetti M, Paolantonio M, Serio R, Sammartino G, Gabriele M, D'Aiuto F. Systemic inflammation following non-surgical and surgical periodontal therapy. J Clin Periodontol. 2010;37:848–54.

    Article  PubMed  Google Scholar 

  • Han YW, Redline RW, Li M, Yin L, Hill GB, McCormick TS. Fusobacterium nucleatum induces premature and term stillbirths in pregnant mice: implication of oral bacteria in preterm birth. Infect Immun. 2004;72:2272–9.

    Article  PubMed  PubMed Central  Google Scholar 

  • Higashi Y, Goto C, Jitsuiki D, Umemura T, Nishioka K, Hidaka T, Takemoto H, Nakamura S, Soga J, Chayama K, Yoshizumi M, Taguchi A. Periodontal infection is associated with endothelial dysfunction in healthy subjects and hypertensive patients. Hypertension. 2008;51:446–53.

    Article  PubMed  Google Scholar 

  • Hill GB. Preterm birth: associations with genital and possibly oral microflora. Ann Periodontol. 1998;3:222–32.

    Article  PubMed  Google Scholar 

  • Hillier SL, Witkin SS, Krohn MA, Watts DH, Kiviat NB, Eschenbach DA. The relationship of amniotic fluid cytokines and preterm delivery, amniotic fluid infection, histologic chorioamnionitis, and chorioamnion infection. Obstet Gynecol. 1993;81:941–8.

    PubMed  Google Scholar 

  • Hunter W. Oral sepsis as a cause of disease. Br Med J. 1900;2:215.

    Article  PubMed  PubMed Central  Google Scholar 

  • Iacopino AM. Periodontitis and diabetes interrelationships: role of inflammation. Ann Periodontol. 2001;6:125–37.

    Article  PubMed  Google Scholar 

  • Ide M, Jagdev D, Coward PY, Crook M, Barclay GR, Wilson RF. The short-term effects of treatment of chronic periodontitis on circulating levels of endotoxin, C-reactive protein, tumor necrosis factor-alpha, and interleukin-6. J Periodontol. 2004;75:420–8.

    Article  PubMed  Google Scholar 

  • Ide M, Papapanou PN. Epidemiology of association between maternal periodontal disease and adverse pregnancy outcomes—systematic review. J Clin Periodontol. 2013;(Suppl. 14):S181–94.

    Google Scholar 

  • Ide M, Harris M, Stevens A, et al. Periodontitis and cognitive decline in Alzheimer’s disease. PLoS One. 2016;11:e0151081.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kang J, Wu B, Bunce D, Ide M, Pavitt S, Wu J. Cognitive function and oral health among ageing adults. Community Dent Oral Epidemiol. 2019;47:259–66.

    Article  PubMed  Google Scholar 

  • Kang J, Wu B, Bunce D, Ide M, Aggarwal VR, Pavitt S, Wu J. Bidirectional relations between cognitive function and oral health in ageing persons: a longitudinal cohort study. Age Ageing. 2020;49:793–9.

    Article  PubMed  Google Scholar 

  • Lin D, Smith MA, Champagne C, Elter J, Beck J, Offenbacher S. Porphyromonas gingivalis infection during pregnancy increases maternal tumor necrosis factor alpha, suppresses maternal interleukin-10, and enhances fetal growth restriction and resorption in mice. Infect Immun. 2003;71:5156–62.

    Article  PubMed  PubMed Central  Google Scholar 

  • Loos BG, Craandijk J, Hoek FJ, Wertheim-van Dillen PM, van der Velden U. Elevation of systemic markers related to cardiovascular diseases in the peripheral blood of periodontitis patients. J Periodontol. 2000;71:1528–34.

    Article  PubMed  Google Scholar 

  • Macones GA, Parry S, Nelson DB, Strauss JF, Ludmir J, Cohen AW, Stamilio DM, Appleby D, Clothier B, Sammel MD, Jeffcoat M. Treatment of localized periodontal disease in pregnancy does not reduce the occurrence of preterm birth: results from the periodontal infections and prematurity study (PIPS). Am J Obstet Gynecol. 2010;202:147.

    PubMed  Google Scholar 

  • Merchant AT, Georgantopoulos P, Howe CJ, Virani SS, Morales DA, Haddock KS. Effect of long-term periodontal care on hemoglobin A1c in type 2 diabetes. J Dent Res. 2016;95:408–15.

    Article  PubMed  Google Scholar 

  • Michalowicz BS, Hodges JS, DiAngelis AJ, Lupo VR, Novak MJ, Ferguson JE, Buchanan W, Bofill J, Papapanou PN, Mitchell DA, Matseoane S, Tschida PA. Treatment of periodontal disease and the risk of preterm birth. N Engl J Med. 2006;355:1885–94.

    Article  PubMed  Google Scholar 

  • Michalowicz BS, Novak MJ, Hodges JS, DiAngelis A, Buchanan W, Papapanou PN, Mitchell DA, Ferguson JE, Lupo V, Bofill J, Matseoane S, Steffen M, Ebersole JL. Serum inflammatory mediators in pregnancy: changes after periodontal treatment and association with pregnancy outcomes. J Periodontol. 2009;80:1731–41.

    Article  PubMed  PubMed Central  Google Scholar 

  • Moore S, Ide M, Coward PY, Randhawa M, Borkowska E, Baylis R, Wilson RF. A prospective study to investigate the relationship between periodontal disease and adverse pregnancy outcome. Br Dent J. 2004;197:251–8.

    Article  PubMed  Google Scholar 

  • Nilsson H, Berglund JS, Renvert S. Periodontitis, tooth loss and cognitive functions among older adults. Clin Oral Investig. 2018;22:2103–9.

    Article  PubMed  Google Scholar 

  • Noack B, Klingenberg J, Weigelt J, Hoffmann T. Periodontal status and preterm low birth weight: a case control study. J Periodontal Res. 2005;40:339–45.

    Article  PubMed  Google Scholar 

  • Offenbacher S, Katz V, Fertik G, Collins J, Boyd D, Maynor G, McKaig R, Beck J. Periodontal infection as a possible risk factor for preterm low birth weight. J Periodontol. 1996;67:1103–13.

    Article  PubMed  Google Scholar 

  • Offenbacher S, Beck JD, Jared HL, Mauriello SM, Mendoza LC, Couper DJ, Stewart DD, Murtha AP, Cochran DL, Dudley DJ, Reddy MS, Geurs NC, Hauth JC, for the Maternal Oral Therapy to Reduce Obstetric Risk (MOTOR) Investigators. Effects of periodontal therapy on rate of preterm delivery: a randomized controlled trial. Obstet Gynecol. 2009;114:551.

    Article  PubMed  PubMed Central  Google Scholar 

  • Office of the Chief Dental Officer, NHS England. Commissioning Standard: Dental Care for People with Diabetes Version number: 1.0 2019 https://www.england.nhs.uk/wp-content/uploads/2019/08/commissioning-standard-dental-care-for-people.pdf

  • Padilla C, Lobos O, Hubert E, Gonzalez C, Matus S, Pereira M, Hasbun S, Descouvieres C. Periodontal pathogens in atheromatous plaques isolated from patients with chronic periodontitis. J Periodontal Res. 2006;41:350–3.

    Article  PubMed  Google Scholar 

  • Page RC. The pathobiology of periodontal diseases may affect systemic diseases: inversion of a paradigm. Ann Periodontol. 1998;3:108–20.

    Article  PubMed  Google Scholar 

  • Poole S, Singhrao SK, Kesavalu L, Curtis MA, Crean S. Determining the presence of periodontopathic virulence factors in short-term postmortem Alzheimer’s disease brain tissue. J Alzheimers Dis. 2013;36:665–77.

    Article  PubMed  Google Scholar 

  • Ridker PM, Silvertown JD. Inflammation, C-reactive protein, and atherothrombosis. J Periodontol. 2008;79:1544–51.

    Article  PubMed  Google Scholar 

  • Romero R, Baumann P, Gomez R, Salafia C, Rittenhouse L, Barberio D, Behnke E, Cotton DB, Mitchell MD. The relationship between spontaneous rupture of membranes, labor, and microbial invasion of the amniotic cavity and amniotic fluid concentrations of prostaglandins and thromboxane B2 in term pregnancy. Am J Obstet Gynecol. 1993;168:1654–68.

    Article  PubMed  Google Scholar 

  • Romero R, Gomez R, Ghezzi F, Yoon BH, Mazor M, Edwin SS, Berry SM. A fetal systemic inflammatory response is followed by spontaneous onset of preterm parturition. Am J Obstet Gynecol. 1998;179:193.

    Article  Google Scholar 

  • Sato M, Iwasaki M, Minagawa K, et al. Associations between periodontal health/treatment and cognitive impairment: latest evidence from epidemiological studies. Curr Oral Health Rep. 2020;7:119–28.

    Article  Google Scholar 

  • Singhrao SK, Olsen I. Assessing the role of Porphyromonas gingivalis in periodontitis to determine a causative relationship with Alzheimer’s disease. J Oral Microbiol. 2019;11:1563405.

    Article  PubMed  PubMed Central  Google Scholar 

  • Solowiej-Wedderburn J, Ide M, Pennington M. Cost-effectiveness of non-surgical periodontal therapy for patients with type 2 diabetes in the UK. J Clin Periodontol. 2017:44700–7.

    Google Scholar 

  • Srinivas SK, Sammel MD, Stamilio DM, Clothier B, JEFFCOAT MK, Parry S, Macones GA, Elovitz MA, Metlay J. Periodontal disease and adverse pregnancy outcomes: is there an association? Am J Obstet Gynecol. 2009;200:497.

    Article  PubMed  Google Scholar 

  • Stewart R, Sabbah W, Tsakos G, et al. Oral health and cognitive function in the Third National Health and Nutrition Examination Survey (NHANES III). Psychosom Med. 2008;70:936–41.

    Article  PubMed  Google Scholar 

  • Stewart R, Weyant RJ, Garcia ME, Harris T, Launer LJ, Satterfield S, Simonsick EM, Yaffe K, Newman AB. Adverse oral health and cognitive decline: the health, aging and body composition study. J Am Geriatr Soc. 2013;61:177–84.

    Article  PubMed  PubMed Central  Google Scholar 

  • Suvan JE, Finer N, D’Autio F. Periodontal complications with obesity. Periodontol. 2018;78:98–128.

    Article  Google Scholar 

  • Taudorf S, Krabbe KS, Berg RM, Pedersen BK, Moller K. Human models of low-grade inflammation: bolus versus continuous infusion of endotoxin. Clin Vaccine Immunol. 2007;14:250–5.

    Article  PubMed  PubMed Central  Google Scholar 

  • Tonetti MS, D'Aiuto F, Nibali L, Donald A, Storry C, Parkar M, Suvan J, Hingorani AD, Vallance P, Deanfield J. Treatment of periodontitis and endothelial function. N Engl J Med. 2007;356:911–20.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Faculty of Dentistry, Oral and Craniofacial Sciences, King’s College London, London, UK

    Mark Ide

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  1. Mark Ide
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Correspondence to Mark Ide .

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Editors and Affiliations

  1. Faculty of Dentistry, Oral and Craniofacial Sciences, King’s College London, London, UK

    Richard Palmer

  2. Honorary Member of the British Society of Periodontology, Life Fellow Royal Society of Medicine, Founder and past Principal Periodontics, East Sussex, UK

    Peter Floyd

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Ide, M. (2021). Periodontal Disease and Systemic Health. In: Palmer, R., Floyd, P. (eds) Periodontology. BDJ Clinician’s Guides. Springer, Cham. https://doi.org/10.1007/978-3-030-76243-8_3

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  • DOI: https://doi.org/10.1007/978-3-030-76243-8_3

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