Zambon, M., Mandò, C., Lissoni, A., Anelli, G.M., Novielli, C., Cardellicchio, M., Leone, R., Monari, M.N., Massari, M., Cetin, I. & Abati, S. (2018) Inflammatory and Oxidative Responses in Pregnancies With Obesity and Periodontal Disease. Reproductive Sciences 25, 10.
This study investigates how maternal obesity and gestational diabetes mellitus (GDM) exacerbate both local oral and systemic oxidative stress and inflammation during pregnancy. Salivary and plasma biomarkers, including total antioxidant capacity (s-TAC) and C-reactive protein (CRP), were significantly elevated in obese women, particularly those with GDM. The findings highlight the synergistic effect of obesity and periodontal disease in amplifying inflammatory status, underscoring the importance of oral health management during high-risk pregnancies.
Kripal, K., Kumari, S.J. & Prasanna. (2011) Periodontal status in elderly patients with type 2 diabetes mellitus. Biomedicine 31, 2.
A cross-sectional study of elderly Indian adults showed that diabetes significantly worsens periodontal outcomes. Diabetic individuals exhibited higher plaque and calculus scores, deeper periodontal pockets, and greater attachment loss compared to non-diabetic controls. The study emphasizes the need for heightened periodontal care among aging populations with diabetes to prevent progressive oral tissue destruction.
Islam, S.A., Jafri, F., Mughal, R.A., Mashood, S., Hanif, S., Ali, I., Tejani, S., Amjad, J. & Maher, N. (2021) Knowledge and Awareness About Periodontal Risk and Oral Health Practices in Diabetic Patients. Pakistan Oral & Dental Journal 41, 2.
Surveying 400 diabetic participants, this study found that awareness of systemic complications exceeded that of oral complications, with only 40% recognizing risks such as tooth mobility and bleeding gums. Despite this, adherence to dental visits and oral hygiene practices was low, highlighting a critical gap in patient education and the need for targeted interventions linking diabetes management with oral health maintenance.
Kaur, J., Pruthi, G.K., Kapoor, H.S., Narang, V., Kaur, A. & Gupta, A. (2023) Knowledge, Attitude and Awareness among Diabetic vs. Non-Diabetic Patients about the Association between Diabetes and Oral Health. Indian Journal of Dental Research 34, 3.
Among 502 participants, diabetic patients showed high prevalence of xerostomia (96.7%) and periodontal complications (53.3%) but limited awareness of oral–systemic links. Non-diabetic individuals were more aware of sugar intake as a diabetes risk factor. The study calls for enhanced interdisciplinary collaboration between dentists and physicians to improve public knowledge and preventive oral care.
Marruganti, C., Suvan, J.E. & D'Aiuto, F. (2023) Periodontitis and metabolic diseases (diabetes and obesity): Tackling multimorbidity. Periodontology 2000.
This narrative review describes the interplay among periodontitis, diabetes, and obesity, emphasizing shared biological pathways such as systemic inflammation and insulin resistance. Highlighting multimorbidity as a growing global health challenge, the authors advocate for integrated, lifestyle-oriented, multidisciplinary care approaches to manage coexisting chronic inflammatory conditions effectively.
Dean, D. & Gandara, B. (2017) Oral manifestations of diabetes. In Principles of Diabetes Mellitus: Third Edition.
Diabetes mellitus predisposes individuals to periodontal disease, salivary dysfunction, dental caries, and mucosal abnormalities. The bidirectional relationship between diabetes and periodontitis can worsen glycemic control but also offers potential for improvement via periodontal therapy. The authors emphasize collaborative dental–medical care to improve outcomes and reduce healthcare costs.
Buczko, P., Zalewska, A. & Szarmach, I. (2015) Saliva and oxidative stress in oral cavity and in some systemic disorders. Journal of Physiology and Pharmacology 66, 1.
Saliva, as a non-invasive biomarker, reflects local and systemic oxidative stress. This review highlights its diagnostic potential in periodontitis, diabetes, oral cancer, rheumatoid arthritis, chronic renal failure, and other systemic conditions, emphasizing salivary biomarkers as tools for disease monitoring and early intervention.
Delnay, N., McNinch, N. & Toth, M. (2017) Pathogens in the inflammatory process of periodontal disease and juvenile idiopathic arthritis. Arthritis and Rheumatology 69.
In children with CCP- or RF-positive juvenile idiopathic arthritis (JIA), oral pathogen profiles, including Porphyromonas gingivalis, were similar to those in children with periodontal disease, highlighting potential risk for early periodontal inflammation. The study underscores the importance of integrating oral health evaluations in managing pediatric rheumatologic patients.
Nishimura, F. & Murayama, Y. (2001) Biological: Periodontal Inflammation and Insulin Resistance—Lessons from Obesity. Journal of Dental Research 80, 8.
This review links chronic periodontal inflammation with systemic insulin resistance, a key factor in type 2 diabetes. The authors suggest that effective periodontal therapy may improve metabolic control by reducing inflammatory cytokines, such as TNF-α, produced by adipose tissue.
Chung, S.-K. (2019) Oral and Human Microbiome Research. Journal of Dental Hygiene Science 19, 2. This review highlights the emerging role of the oral microbiome in systemic health and disease, including diabetes, obesity, inflammatory bowel disease, and neurological disorders. Oral microbial dysbiosis can influence systemic inflammation, while computational analyses of oral microbiome composition offer diagnostic and preventive potential.
PhD, L.C.M., DDS, M.A., PhD, L.S.G., PhD, C.H. & PhD, A.C. (2022) Comparative Evaluation of Homeopathic Therapy in the Treatment of Chronic Periodontitis. Alternative Therapies in Health and Medicine 28, 1.
A randomized study in patients with periodontitis and type 2 diabetes showed that adjunct homeopathic therapy improved local periodontal and systemic clinical parameters, including CRP and glycemic markers, compared to conventional treatment alone, suggesting potential complementary benefits in chronic inflammatory disease management.
Gowdar, I.M. & Almuhaiza, M. (2016) Diabetes and Oral Health Problems. Annals of International Medical and Dental Research 2, 2. The review describes how uncontrolled diabetes compromises oral defenses, increasing risk for periodontitis, caries, xerostomia, and fungal infections. The authors highlight the importance of oral care as a preventive measure in diabetic populations.
Khatri, M., Mangalekar, S.B., Dhole, R.I., Sahare, P., Tejaswi, K.L.S., Satisha, T.S. & Paiwal, K. (2022) Oral health status among adults with type 2 diabetes compared to that of those without diabetes. European Journal of Molecular and Clinical Medicine 9, 7.
This cross-sectional study of 500 adults in India found significantly higher rates of decayed, missing, and filled teeth, deeper periodontal pockets, and greater attachment loss among diabetics compared to non-diabetics, reinforcing the strong link between diabetes and poor periodontal health.
Monsarrat, P., Fernandez de Grado, G., Constantin, A., Willmann, C., Nabet, C., Sixou, M., Cantagrel, A., Barnetche, T., Mehsen-Cetre, N., Schaeverbeke, T., Arrivé, E. & Vergnes, J.-N. (2019) The effect of periodontal treatment on patients with rheumatoid arthritis: The ESPERA randomised controlled trial. Joint Bone Spine 86, 5.
Periodontal therapy in RA patients improved local oral inflammation but had no significant effect on systemic disease activity, highlighting safety and potential oral health benefits of integrating periodontal care in RA management.
Vergnes, J.N., Canceill, T., Vinel, A., Laurencin-Dalicieux, S., Maupas-Schwalm, F., Blasco-Baquè, V., Hanaire, H., Arrivé, E. et al. (2018)
he effects of periodontal treatment on diabetic patients: The DIAPERIO randomized controlled trial. Journal of Clinical Periodontology 45, 10. Periodontal therapy in metabolically unbalanced diabetic patients improved oral health-related quality of life, although glycemic control remained unaffected, supporting periodontal treatment as a safe and beneficial intervention for diabetic oral health management.
Tomita, N.E., Chinellato, L.E.M., Pernambuco, R.A., Lauris, J.R.P., Franco, L.J., Hirai, A., Hirai, A.T., Hariama, H., Matsumura, L., Iunes, M., Cardoso, M.A., Kikuchi, M., Barros, N. et al. (2002) Periodontal conditions and diabetes mellitus in the Japanese-Brazilian population. Revista de Saude Publica 36, 5.
In a large epidemiologic study, diabetic participants exhibited greater periodontal attachment loss and deeper pockets, although statistical significance was not reached, emphasizing the need for preventive dental care in at-risk populations.
Stanisic, D., Obradovic, R., Vujovic, S., Jovanovic, M. & Zivkovic, V. (2019) The Connection of Periodontal Disease and Diabetes Mellitus: The Role of Matrix Metalloproteinases and Oxidative Stress. Serbian Journal of Experimental and Clinical Research.
This review details the molecular interplay between periodontal disease and diabetes, highlighting the role of neutrophils, matrix metalloproteinases, and oxidative stress in periodontal tissue destruction and systemic metabolic dysregulation. The authors suggest monitoring these markers may aid in diagnosis and therapeutic planning.
Patschan, S., Bothmann, L., Patschan, D., Henze, E., Schmalz, G., Ritter, O., & Ziebolz, D. (2020). Association of cytokine patterns and clinical/laboratory parameters, medication and periodontal burden in patients with rheumatoid arthritis (RA). Odontology, 108(3). https://doi.org/10.1007/s10266-020-00517-9
This study evaluated serum levels of IL-6, IL-10, IL-17, and IL-23 in 157 rheumatoid arthritis patients with periodontal disease. Elevated cytokine levels correlated with disease activity, medication, and periodontal burden. For example, IL-10 increased with longer morning stiffness and higher rheumatoid factor, while IL-23 was linked to periodontal probing depth and clinical attachment loss. The findings highlight the complex interplay between systemic inflammation, medication, and oral health in RA patients.
Seymour, G.J., Ford, P.J., Cullinan, M.P., Leishman, S., & Yamazaki, K. (2007). Relationship between periodontal infections and systemic disease. Clinical Microbiology and Infection, 13(SUPPL. 4).
This review emphasizes the epidemiological association between periodontal disease and systemic conditions such as cardiovascular disease, stroke, adverse pregnancy outcomes, diabetes, and respiratory diseases. Mechanistic hypotheses include systemic inflammation, direct bacterial infection, and molecular mimicry. Notably, Porphyromonas gingivalis has been implicated in atherosclerosis, illustrating oral infections as potential systemic risk factors.
Wagner, A., Preoteasa, C.T., & Preoteasa, E. (2018). Oral health and dental implants in type 2 diabetes mellitus patients: A literature review. Romanian Journal of Oral Rehabilitation, 10(4).
This review examined oral health and implant outcomes in type 2 diabetic patients. Diabetes is associated with periodontal disease, xerostomia, delayed healing, and tooth loss. Dental implants are generally safe in controlled diabetes, with osseointegration rates of 85–96.4%, while uncontrolled diabetics may require alternative prosthetic solutions.
Krejci, C.B., & Bissada, N.F. (2000). Periodontitis – the risks for its development. General Dentistry, 48(4).
The article discusses systemic, environmental, and behavioral factors influencing periodontitis progression. It highlights the role of diabetes, HIV, genetic susceptibility, smoking, stress, and osteoporosis in exacerbating periodontal disease, emphasizing that comprehensive management requires awareness of systemic influences.
Johnston, S., Al-Osman, A., Kalman, L., Johnson, M., Tabbara, N., & Galil, K. (2015). Development of an online tool for periodontal disease education. The FASEB Journal, 29(S1).
This study developed a computer-based educational tool with modules on periodontal disease types, causes, prevention, and risk assessment. The tool aims to improve patient knowledge and promote oral hygiene, potentially reducing periodontal disease prevalence.
Gokmenoglu, C., Bavbek, N., Gurel, M., & Dincer, M. (2017). Periodontal health status of children with type 1 diabetes mellitus. Journal of Turgut Ozal Medical Center.
The study evaluated 40 type 1 diabetic children versus 60 healthy controls. Findings indicated that diabetes, especially when uncontrolled, adversely affects periodontal health, with higher plaque and calculus accumulation contributing to greater periodontal disease severity.
Polla, D., Astafurov, K., Elhawy, E., & Hyman, L. (2015). Dental health in glaucoma. Investigative Ophthalmology and Visual Science, 56(7).
This study observed that primary open-angle glaucoma patients had fewer teeth and higher edentulism, suggesting a potential link between oral health and glaucoma-related chronic inflammation. The results support the idea that poor dental health may contribute to systemic inflammatory burden.
Chatzopoulos, G.S., Cisneros, A., Sanchez, M., & Wolff, L.F. (2018). Systemic medical conditions and periodontal status in older individuals. Special Care in Dentistry, 38(6).
Analysis of 2,163 adults ≥60 years showed associations between moderate/severe periodontitis and diabetes or tobacco use, highlighting the need for integrated dental-medical care for older populations.
Soroye, M.O., & Ayanbadejo, P.O. (2016). Oral conditions, periodontal status, and periodontal treatment need of chronic kidney disease patients. Journal of Oral Research and Review, 8(2).
In a cohort of 65 CKD patients, the majority had poor periodontal health (CPI code 2), requiring scaling, polishing, and root planing. The study emphasizes nonsurgical periodontal treatment to mitigate systemic complications in CKD.
Keller, D.C. (2023). Perio Protect™ treatment of chronic periodontitis reduces biofilm and inflammation. Oral Health and Dental Science, 7(1).
This article describes the Perio Protect Method™, which uses subgingival hydrogen peroxide delivery to manage plaque and inflammation, reverse dysbiosis, and improve systemic inflammatory markers. Effective periodontal management may reduce the risk of systemic conditions such as diabetes, obesity, stroke, and rheumatoid arthritis.
ACTRN12619000560190. (2019). Benefits of systemically administered adjunctive azithromycin with non-surgical periodontal therapy in treating advanced gum disease. WHO Trial Registry.
A clinical trial protocol examining adjunctive azithromycin in stage III/IV, grade C periodontitis. Outcomes include PISA scores, clinical attachment level, pocket depth, bone biomarkers, cytokines, microbiological changes, and antibiotic resistance, assessing the efficacy of systemic antibiotics in enhancing periodontal therapy.
R, Keerthana; Nasim, Iffat; Chaudhary, Manjari (2020). Association between failed root canal treatment and systemic diseases. Journal of Complementary Medicine Research 11(4). doi:10.5455/jcmr.2020.11.04.06.
This study explored the link between failed root canal treatments and systemic diseases, particularly diabetes. Apical periodontitis, caused by microorganisms in necrotic root canals, initiates as localized inflammation but can extend to periapical tissue destruction if untreated. Retrospective data from a private dental college revealed that diabetes was the most common systemic disease in patients requiring retreatment. While no significant association with gender was found, the study highlights that systemic health can influence periapical healing and the outcome of endodontic treatment, emphasizing the interplay between tooth-related and systemic factors.
Noauthor (2012). Prevalence Of Periodontal Diseases In Diabetic And Non-Diabetic Patients- A Clinical Study. The Internet Journal of Epidemiology 10(1). doi:10.5580/13f6.
A clinical study assessed periodontal disease prevalence among 2,000 Mauritian adults, including diabetic and non-diabetic patients. The results demonstrated that diabetes significantly increases susceptibility to periodontitis, confirming the bidirectional relationship between periodontal and systemic health. Patients with diabetes not only have higher infection risk but also face challenges in metabolic control due to oral infections. The study underlines the need for integrated management of diabetes and periodontal disease.
Kudiyirickal, Marina G.; Pappachan, Joseph M. (2024). Periodontitis: An often-neglected complication of diabetes. World Journal of Diabetes 15(3), 318. doi:10.4239/wjd.v15.i3.318.
This review emphasizes the bidirectional relationship between type 2 diabetes mellitus (T2DM) and periodontitis. Diabetes enhances the virulence of oral pathogens like Porphyromonas gingivalis, aggravating local inflammation, while periodontal inflammation exacerbates systemic insulin resistance. The prevalence of periodontitis in Chinese T2DM patients was 75.7%, with predictive factors including high HbA1c, triglycerides, total cholesterol, low tooth brushing frequency, and age. Understanding these predictors can guide early interventions to improve periodontal health and long-term glycemic control.
Nguyen, Long H.; Cao, Yin; Zhang, Xuehong; Michaud, Dominique S.; Fuchs, Charles; Giovannucci, Edward; Ogino, Shuji; Wu, Kana; Huttenhower, Curtis; Chan, Andrew T. (2017). Periodontal Disease, Tooth Loss, and Risk of Colorectal Adenoma: Results from the Nurses' Health Study. Gastroenterology 152(5). doi:10.1016/s0016-5085(17)33003-2.
Using data from the Nurses’ Health Study, this prospective cohort investigated whether tooth loss and periodontal disease with bone loss increase the risk of colorectal adenomas. Analysis of 4,963 cases showed no significant association, suggesting that while poor oral health may modestly influence colorectal cancer progression, it may not contribute directly to adenoma formation. The findings point toward the need for further research on oral-gut microbiota interactions in tumorigenesis.
Almeida, R. Faria; Alba, A. López; Casanovas, H. J. Rodríguez; González, D. Herrera (2013). Effects of periodontal diseases on diabetes. Avances en Diabetologia 29(5). doi:10.1016/j.avdiab.2013.07.003.
This review consolidates evidence that periodontitis is both influenced by and contributes to poor glycemic control. Infections in periodontal tissues trigger systemic inflammation, which correlates with elevated HbA1c levels in both diabetic and non-diabetic individuals. Periodontal therapy has been shown to improve glycemic control in type 2 diabetes patients, potentially reducing diabetes-related complications, emphasizing the importance of oral health in systemic disease management.
Lira, Ronaldo; Åkerman, Sigvard; Klinge, Björn; Boström, Elisabeth A.; Gustafsson, Anders (2018). Salivary microbial profiles in relation to age, periodontal, and systemic diseases. PLoS ONE 13(3). doi:10.1371/journal.pone.0189374.
This study examined how age, periodontal disease, and systemic conditions influence salivary microbiota. In 441 participants, older adults showed higher bacterial loads, with Eubacterium nodatum, Porphyromonas gingivalis, and Tannerella forsythia significantly increased in generalized bone loss cases. Mental and musculoskeletal disorders also altered microbial profiles, highlighting saliva as a diagnostic tool for systemic and oral health monitoring.
Guilbeau, Janis R.; Hurst, Helen (2009). Brush Up: Periodontal Disease and Pregnancy. Nursing for Women's Health 13(6). doi:10.1111/j.1751-486x.2009.01484.x.
This article reviews how periodontal disease may increase risks for systemic complications in pregnant women, including preterm and low-birth-weight infants. Periodontal inflammation has been linked to diabetes, cardiovascular disease, and other systemic disorders. The study reinforces the need for oral health monitoring as part of prenatal care.
Townsend, Cheryl (2004). Team care for periodontal disease: A model for patient rights. Dentistry Today 23(12).
Townsend advocates a multidisciplinary, team-based approach to periodontal disease management, integrating diagnosis, treatment planning, and patient education. Such collaboration can enhance disease control, preserve dentition, and improve systemic health outcomes, particularly in patients with diabetes.
Percy, Melanie S. (2008). Oral health of adolescents – it's more than dental caries. MCN The American Journal of Maternal Child Nursing 33(1).
Highlighting oral health as an indicator of systemic conditions, this paper underscores that lesions in adolescents may reveal undiagnosed diabetes, infections, or other chronic conditions. School and camp nurses play a critical role in screening, education, and early intervention.
Kudiyirickal, Marina George; Pappachan, Joseph M. (2015). Diabetes mellitus and oral health. Endocrine 49(1). doi:10.1007/s12020-014-0496-3.
This review explores the bidirectional relationship between diabetes and oral health, emphasizing periodontitis as a common complication. The authors stress the importance of coordinated care between dentists and diabetologists for prevention and optimal management.
Ports, E.; Pena, A.; Allen, G.; Gue, S.; Couper, J. (2019). Periodontal disease relates to diabetes control in children and adolescents with type 1 diabetes. Hormone Research in Paediatrics 91(Suppl 1).
Among 73 children with T1D, 51% exhibited early periodontal disease. Poor glycemic control (HbA1c ≥ 8.2%) correlated with higher plaque and gingival indices. The study emphasizes early periodontal assessment and education as part of pediatric diabetes management.
Lifshitz, Fima; Casavalle, Patricia Lucia; Bordoni, Noemí; Rodriguez, Patricia Noemi; Friedman, Silvia Maria (2016). Oral Health in Children with Obesity or Diabetes Mellitus. Pediatric Endocrinology Reviews 14(2). doi:10.17458/PER.2016.LCB.Oralhealth.
This review links obesity and diabetes to periodontal disease and dental caries in children, highlighting that systemic inflammation and metabolic control affect oral health. Multidisciplinary interventions are recommended to prevent chronic oral and systemic complications.
Pergola, Giovanni De et al. (2014). The bad association: Obesity, periodontal disease, inflammation and insulin resistance. Review and personal findings. Nutritional Therapy and Metabolism 32(2). doi:10.5301/NTM.2014.12327.
The authors detail the relationship between obesity, periodontal disease, and systemic inflammation, demonstrating that both conditions contribute to insulin resistance and diabetes risk. Oral bacteria may influence metabolism and appetite, linking oral health to systemic metabolic regulation.
Äyräväinen, Leena; Heikkinen, Anna; Meurman, Jukka (2023). Impact of Oral Health on Rheumatoid Arthritis. Medical Research Archives 11(11). doi:10.18103/mra.v11i11.4644.
Oral infections, particularly by Porphyromonas gingivalis, contribute to systemic inflammation and autoantibody production in rheumatoid arthritis. Patients often face hyposalivation and limited manual dexterity, highlighting the importance of personalized oral care and regular dental monitoring.
Kalsi, D. S.; Chopra, Jyoti; Sood, Anchal (2015). Association of lipid profile test values, type-2 diabetes mellitus, and periodontitis. Indian Journal of Dentistry 6(2). doi:10.4103/0975-962x.157270.
The study found a correlation between worsening lipid profiles, glucose tolerance, and periodontal health. Chronic periodontitis may contribute to hyperlipidemia, demonstrating the systemic impact of oral inflammation.
A. T. Patil, S.; Rao, R. S.; Raj (2015). Periodontal Medicine: Past and Present. Journal of Dental & Oro-facial Research 11(1).
This review traces the evolution of “periodontal medicine,” emphasizing how oral pathogens and inflammatory processes influence systemic conditions such as atherosclerosis, diabetes, and respiratory disease, and how periodontal care can improve overall health outcomes.
Rapone, Biagio et al. (2021). Inflammatory status and glycemic control level of patients with type 2 diabetes and periodontitis: A randomized clinical trial. International Journal of Environmental Research and Public Health 18(6). doi:10.3390/ijerph18063018.
A 6-month trial of non-surgical periodontal therapy in T2DM patients demonstrated improvements in HbA1c and CRP levels, showing that periodontal treatment can contribute to better systemic inflammatory and glycemic control, even though the direct relationship to periodontal indices was weak.
Huang, Ren Yeong et al. (2012). Diacerein: A potential therapeutic drug for periodontal disease. Medical Hypotheses 79(2). doi:10.1016/j.mehy.2012.04.024.
This hypothesis paper suggests that diacerein, an anti-inflammatory agent, may have therapeutic potential in treating periodontitis by inhibiting IL-1 mediated inflammatory pathways, representing a promising adjunct to conventional periodontal therapy.
Marquez, Ignacio Christian (2023). Periodontal and Systemic Health - Shaping the Future of our Knowledge. SVOA Dentistry 4(4). doi:10.58624/svoade.2023.04.0140.
This review summarizes evidence linking periodontal disease to systemic conditions including obesity, metabolic endotoxemia, and type 2 diabetes. While mechanisms remain incompletely understood, periodontal infections are recognized as significant contributors to systemic health risks.
Aloyouny, Ashwag Y. et al. (2022). Impact of Rheumatic Diseases on Oral Health-Related Quality of Life. Cureus. doi:10.7759/cureus.32268.
Rheumatic diseases significantly impact oral health-related quality of life, with periodontal disease and dental caries being the most prevalent complaints. Conditions such as RA and SLE were associated with higher oral morbidity, highlighting the need for oral health monitoring in these populations.
Noauthor (2021). Association of Tooth Loss in Chronic Periodontitis Patients with And Without Mellitus. Journal of Contemporary Issues in Business and Government 27(2). doi:10.47750/cibg.2021.27.02.039.
This study found significant associations between chronic periodontitis, diabetes, and tooth loss. Interestingly, non-diabetic patients exhibited higher prevalence of missing teeth in some age groups, reinforcing the need for preventive oral health programs.
Hallmon, William W.; Mealey, Brian L. (1992). Implications of Diabetes Mellitus and Periodontal Disease. The Diabetes Educator 18(4). doi:10.1177/014572179201800409.
This seminal paper highlights the clinical interplay between diabetes and periodontal disease, emphasizing cooperative management among dental and medical professionals to preserve oral health and functional dentition in diabetic patients.
NCT04653714. The Effects of Non-surgical Periodontal Therapy in Patients Indicated for Bariatric Surgery. (2020)
This clinical trial explores how non-surgical periodontal therapy, administered one month prior to bariatric surgery, impacts local and systemic inflammation in obese patients with periodontitis or gingivitis. The study is motivated by evidence that obesity predisposes individuals to chronic diseases, including periodontal disease, and that bariatric surgery can improve metabolic parameters but may worsen periodontal inflammation. Patients are randomized into test and control groups, receiving targeted periodontal therapy combined with probiotic lozenges or minimal plaque removal as placebo. The trial aims to evaluate both periodontal outcomes and potential effects on obesity-related metabolic parameters.
Nishimura, F., & Murayama, Y. Periodontal inflammation and insulin resistance – Lessons from obesity. Journal of Dental Research, 80(8), 2001.
This review highlights the link between chronic periodontal inflammation and systemic metabolic dysfunction, particularly insulin resistance in obesity and type 2 diabetes. The authors discuss how pro-inflammatory cytokines like TNF-α from adipose tissue exacerbate insulin resistance and hypothesize that effective periodontal therapy may improve insulin sensitivity by reducing systemic inflammation.
Escobar-Arregoces, F., et al. Inflammatory response in pregnant women with high risk of preterm delivery and its relationship with periodontal disease: a pilot study. Acta Odontologica Latinoamericana, 31(1), 2018.
This pilot case-control study assessed systemic inflammatory markers in pregnant women at high risk of preterm delivery and their association with periodontal disease. Women with chronic periodontitis exhibited higher levels of pro-inflammatory cytokines (IL-2, IL-4, IL-6, IL-10, TNF-α, TNF-γ), particularly in those at high risk for preterm birth, highlighting a potential link between maternal periodontal inflammation and adverse pregnancy outcomes.
Ahamed, S. T., Rajasekar, A., & Mathew, M. G. Assessment of tooth loss in chronic periodontitis patients with and without diabetes mellitus: A cross-sectional study. International Journal of Research in Pharmaceutical Sciences, 11(Special Issue 3), 2020.
In a cross-sectional study of 400 patients, diabetic individuals with chronic periodontitis showed significantly higher tooth loss (1002 missing teeth) than non-diabetic patients (638 missing teeth). Findings underscore the bidirectional relationship between diabetes and periodontal disease and the increased risk of tooth loss in patients with systemic metabolic disorders.
Dumitrescu, A. L. Occurrence of self-reported systemic medical conditions in patients with periodontal disease. Romanian Journal of Internal Medicine, 44(1), 2006.
This retrospective review of 1,044 patients revealed a high prevalence of systemic conditions in individuals with periodontal disease. While high blood pressure, coronary artery disease, and kidney disorders were common across gingivitis and periodontitis patients, rheumatoid arthritis was significantly more frequent in periodontitis, suggesting a strong interplay between systemic health and periodontal disease severity.
Okagbare, T. E., & Ayo-Yusuf, O. A. Systemic health status and self-reported periodontal health among South Africans. West African Journal of Medicine, 31(4), 2012.
Analysis of 6,319 dentate adults in South Africa found significant associations between chronic systemic conditions (stroke, arthritis) and self-reported poor periodontal health. Older age, problem drinking, and race were additional risk factors, highlighting the complex interconnection between systemic disease and periodontal outcomes in diverse populations.
Lopes, M. H., et al. Diabetes educators' knowledge, opinions and behaviors regarding periodontal disease and diabetes. Journal of Dental Hygiene, 86(2), 2012.
A survey of 298 certified diabetes educators (CDEs) revealed limited formal training in oral health but strong recognition of the link between periodontal disease and diabetes. Most CDEs agreed on the need for inter-professional collaboration with dental professionals and integrating oral health education into continuing education to improve patient care.
Silva, D. S., et al. Evidence-Based Research on Effectiveness of Periodontal Treatment in Rheumatoid Arthritis Patients: A Systematic Review and Meta-Analysis. Arthritis Care and Research, 74(10), 2022.
This systematic review and meta-analysis examined the impact of periodontal therapy on rheumatoid arthritis (RA) activity and systemic inflammation. Despite evidence suggesting modest improvements in RA outcomes following periodontal treatment, the low certainty of data highlights the need for rigorously designed prospective studies to validate these effects.
Abdo, J. A., et al. Influence of Dyslipidemia and Diabetes Mellitus on Chronic Periodontal Disease. Journal of Periodontology, 84(10), 2013.
This study analyzed how diabetes and dyslipidemia affect periodontal health. Diabetes, age, and smoking were significantly associated with increased clinical attachment loss, while dyslipidemia alone had no measurable effect. The findings reinforce diabetes as a key systemic modifier of periodontal disease severity.
Chai, L., & Leung, W. K. Influences of systemic diseases on periodontal health. In Current Trends in Periodontics and Implant Dentistry, 2013.
This book chapter reviews the multifactorial etiology of periodontitis and its interactions with systemic diseases including diabetes, autoimmune disorders, cardiovascular disease, and mood disorders. It emphasizes how systemic conditions influence periodontal disease onset, progression, and response to treatment, offering guidance for integrated patient management.
Graves, D. T., Corrêa, J. D., & Silva, T. A. Oral Microbiome in Health. Critical Reviews in Oral Biology & Medicine, 98(2), 2019.
This article explores how systemic diseases like diabetes, RA, and SLE alter the oral microbiome, promoting pathogenic bacterial communities and periodontal inflammation. IL-17 emerges as a critical mediator linking systemic inflammation to oral microbial dysbiosis.
Rösing, C. K., et al. The impact of maintenance on peri-implant health. Brazilian Oral Research, 33, 2019.
The review highlights the importance of comprehensive risk assessment and preventive maintenance for peri-implant health. It underscores that prior periodontal disease significantly influences peri-implant complications, emphasizing tailored preventive strategies for long-term success.
Nishimura, F., et al. Negative effects of chronic inflammatory periodontal disease on diabetes mellitus. Journal of the International Academy of Periodontology, 2(2), 2000.
This article details the bidirectional influence between periodontal disease and diabetes, highlighting how chronic inflammation and TNF-α contribute to insulin resistance. It stresses the importance of non-surgical periodontal therapy and monitoring for systemic markers in diabetic patients.
Gupta, S., et al. Knowledge and Awareness about Systemic Effects of Periodontal Disease among Medical, Dental and Alternate Medical Practitioners. Mymensingh Medical Journal, 31(4), 2022.
A cross-sectional study of 560 practitioners revealed gaps in referral practices despite awareness of systemic links between periodontal disease and conditions like diabetes, cardiovascular disease, and adverse pregnancy outcomes. Findings highlight the need for interdisciplinary education and collaboration.
Botero, J. E., et al. Tooth and Periodontal Clinical Attachment Loss Are Associated With Hyperglycemia in Patients With Diabetes. Journal of Periodontology, 83(10), 2012.
This study found that hyperglycemia in diabetic patients exacerbates periodontal clinical attachment loss, particularly in smokers, reinforcing the bidirectional relationship between diabetes and periodontal health.
Schallhorn, R. A. Understanding the Inter-relationship Between Periodontitis and Diabetes: Current Evidence and Clinical Implications. Compendium of Continuing Education in Dentistry, 37(6), 2016.
This review summarizes current evidence on the complex interactions between periodontitis and type 2 diabetes, highlighting epidemiological links and clinical implications for integrated disease management.
Jain, S. K. A., et al. Oral disease as a risk factor for acute coronary syndrome – Single center experience. International Journal of Collaborative Research on Internal Medicine and Public Health, 4(6), 2012.
In a retrospective study of 130 acute coronary syndrome patients, 37% had periodontal disease, significantly exceeding expected prevalence. Findings suggest periodontal disease as a non-traditional risk factor for coronary heart disease and emphasize routine oral health assessment for cardiovascular prevention.
Kandaswamy, E., et al. Titanium as a Possible Modifier of Inflammation Around Dental Implants. The International Journal of Oral & Maxillofacial Implants, 37(2), 2022.
This study investigated titanium contamination in peri-implant crevicular fluid and its association with inflammatory mediators. Titanium was detectable even in healthy implants and correlated with elevated inflammatory cytokines, suggesting that titanium may influence peri-implant tissue inflammation and warrants further longitudinal study.
Guo, Zhengzhang (2023). What Is Dentists’ Role in Modulating Environmental and Epigenetic Determinant in Oral Health of Diabetic Patients? Journal of Biosciences and Medicines, 11(2).
This literature review explores the bidirectional relationship between diabetes and periodontitis, emphasizing the role of dentists in modulating environmental and epigenetic factors. It highlights that periodontitis exacerbates diabetes severity and that proper dental intervention can improve overall patient outcomes.
Trentin, Micheline Sandini, et al. (2018). Prevalence and severity of periodontal disease in type 2 diabetes mellitus patients: A cross-sectional study. Bioscience Journal, 34(4).
A cross-sectional study in Brazil showing that type 2 diabetes patients have higher prevalence of periodontal disease, poorer oral hygiene, and increased tooth loss compared to non-diabetic controls.
Papapanou, P. N. (1999). Epidemiology of periodontal diseases: an update. Journal of the International Academy of Periodontology, 1(4).
Reviewing epidemiological data, this study confirms that advanced adult periodontitis affects 10–15% of populations, identifies risk factors including diabetes and smoking, and underscores the importance of multi-factorial models in predicting disease progression.
Sheng, Sally, et al. (2022). Necrotizing periodontal disease in a nutritionally deficient patient: A case report. Frontiers in Dental Medicine, 3.
A case report illustrating necrotizing periodontal disease in a malnourished patient, emphasizing the role of nutrition, smoking cessation, and proper oral care in disease remission.
Manzano, Brena Rodrigues, et al. (2021). A case-control study of oral diseases and quality of life in individuals with rheumatoid arthritis and systemic lupus erythematosus. Clinical Oral Investigations, 25(4).
Individuals with RA and SLE exhibited higher caries and periodontal disease, with xerostomia significantly affecting oral health-related quality of life.
Boylan, Matthew R., et al. (2014). A prospective study of periodontal disease and risk of gastric and duodenal ulcer in male health professionals. Clinical and Translational Gastroenterology, 5.
Periodontal disease is associated with increased risk of gastric and duodenal ulcers, likely mediated by systemic inflammation and oral-gut microbial interactions.
Zheng, Shaowen, et al. (2021). Porphyromonas gingivalis survival skills: Immune evasion. Journal of Periodontal Research, 56(6).
This review describes how P. gingivalis evades host immune defenses, contributing to chronic periodontitis and its systemic effects, including diabetes and rheumatoid arthritis.
Cazzolla, Angela Pia, et al. (2021). The Association between Nutritional Alterations and Oral Lesions in a Pediatric Population: An Epidemiological Study. BioMed Research International, 2021.
An epidemiological study demonstrating links between pediatric nutrition (vitamin/mineral deficiencies or excesses) and oral pathologies including caries, enamel hypoplasia, and periodontal disease.
Swapna, Lingam Amara, et al. (2017). Oral health in diabetic and nondiabetic patients with chronic kidney disease. Saudi Journal of Kidney Diseases and Transplantation, 28(5).
The study shows that diabetic CKD patients are at increased risk of caries and periodontal disease, emphasizing the need for comprehensive oral care.
Pucher, Jeffery J., Otomo-Corgel, Joan (2002). Periodontal disease and systemic health – diabetes. Journal of the California Dental Association, 30(4).
Discusses evidence linking periodontal disease with diabetes, suggesting bidirectional effects on disease progression.
Mariano, Isadora Mirella Gomes, et al. (2022). Relationship between diabetes, hypertension and periodontal diseases: a systematic review of major clinical findings. MedNEXT Journal of Medical and Health Sciences, 3(S6).
Systematic review confirms associations between periodontitis, diabetes, and hypertension, highlighting the importance of community oral health interventions.
Rajkarnikar, J., et al. (2013). Inter-relationship between rheumatoid arthritis and periodontitis. Kathmandu University Medical Journal, 11(41).
Evidence for a link between RA and periodontitis, likely mediated by immune-inflammatory pathways.
Fenesy, Kim E. (1998). Periodontal Disease: An Overview for Physicians. Mount Sinai Journal of Medicine, 65(5).
Overview emphasizing that periodontitis results from bacterial-host interactions, systemic conditions (like diabetes), and behavioral factors, affecting overall health.
Salminen, A., et al. (2024). Systemic Metabolic Signatures of Oral Diseases. Journal of Dental Research, 103(1).
Oral diseases, particularly periodontitis, correlate with systemic inflammatory metabolic profiles, suggesting oral health as a modifiable risk factor for cardiometabolic disorders.
Alhazmi, Yaser A., et al. (2022). Assessment of Knowledge, Attitude and Practice of Diabetic Patients Towards Oral Health: A Cross-sectional Study. World Journal of Dentistry, 13(3).
Demonstrates low awareness among diabetic patients about oral disease risks, highlighting the need for targeted education.
Boggess, Kim A. (2020). Choosing the left fork: Steven Offenbacher and understanding maternal periodontal disease and adverse pregnancy outcomes. Journal of Periodontology, 91.
Reviews evidence linking maternal periodontitis to adverse pregnancy outcomes, including preterm birth and gestational diabetes.
Park, Jun-Beom, et al. (2014). Association Between Alcohol Consumption and Periodontal Disease: The 2008 to 2010 Korea National Health and Nutrition Examination Survey. Journal of Periodontology, 85(11).
Shows alcohol intake in men is positively associated with periodontal treatment needs, independent of systemic conditions.
Maupome, Gerardo, et al. (2003). Oral disorders and chronic systemic diseases in very old adults living in institutions. Special Care in Dentistry, 23(6).
Links oral disorders to systemic conditions like stroke, diabetes, hypertension, and osteoporosis in institutionalized elderly adults.
Tefiku, Urim, et al. (2020). Determination of the Role of Fusobacterium Nucleatum in the Pathogenesis in and Out the Mouth. Prilozi, 41(1).
Highlights Fusobacterium nucleatum’s role in oral and systemic diseases, including periodontitis, RA, colorectal cancer, and adverse pregnancy outcomes.
Yang, Luxi, et al. (2021). Sulfonylureas for Treatment of Periodontitis-Diabetes Comorbidity-Related Complications. Frontiers in Pharmacology, 12.
Explores potential therapeutic effects of sulfonylureas for managing inflammation and bone loss in patients with periodontitis-diabetes comorbidity.
Tamagno, Gabriela Spanholi, et al. (2024). Influence of periodontal treatment on rheumatoid arthritis clinical parameters. Cuadernos de Educación y Desarrollo, 16(2).
Demonstrates that periodontal treatment can improve RA clinical parameters, underscoring the systemic benefit of oral health interventions.
Juncar, R. I., et al. (2020). Odontogenic inflammatory lesions in patients with type 2 diabetes mellitus: A prospective study of 128 cases. Nigerian Journal of Clinical Practice, 23(3).
Shows high incidence of apical periodontal infections in type 2 diabetes patients, irrespective of glycemic control.
Dolinska, et al. (2022). Periodontitis-Related Knowledge and Its Relationship with Oral Health Behavior among Adult Patients Seeking Professional Periodontal Care. Journal of Clinical Medicine, 11.
Reveals that patient knowledge deficits about periodontitis risk factors impact oral health behaviors, despite awareness of bacterial and smoking risks.
Soory, M. (2010). Chronic periodontitis as a risk marker for systemic diseases with reference to cardiometabolic disorders: Common pathways in their progression. Immunology and Immunogenetics Insights, 2(1), doi:10.4137/iii.s5795.
Periodontitis, a chronic inflammatory condition of the supporting structures of teeth, serves as a nidus for systemic inflammation. Common genetic and environmental factors influence both periodontitis and cardiometabolic disorders. Evidence suggests that periodontal treatment can improve systemic inflammatory profiles, emphasizing its importance for overall health.
Tornwall, R. & Chow, A. K. (2012). The association between periodontal disease and the systemic inflammatory conditions of obesity, arthritis, Alzheimer’s and renal diseases. Can J Dent Hygiene, 46(2).
This review highlights associations between chronic periodontal inflammation and systemic inflammatory conditions, including arthritis, obesity, kidney disease, and Alzheimer’s disease. While correlations exist, causation remains unclear, warranting further basic and clinical research.
Segawa, K., Shigeishi, H., Fujii, M., Noumi, K., Yamanaka, F., Kamikawa, K., Arakawa, S., & Sugiyama, M. (2019). Relationship of Salivary Occult Blood With General and Oral Health Status in Employees of a Japanese Department Store. Journal of Clinical Medicine Research, 11(3), doi:10.14740/jocmr3702.
Salivary occult blood was significantly associated with periodontal disease and diabetes among Japanese employees. This study demonstrates the potential utility of salivary testing as a screening tool for oral-systemic health risk evaluation.
Kumari, K. S., Shashirekha, G., Dey, S., Subudhi, E., Behera, R., Jena, S. P., Dash, S., & Praharaj, N. (2020). Bidirectional dynamics between hyperglycemia and periodontal infections. Indian Journal of Forensic Medicine and Toxicology, 14(4), doi:10.37506/ijfmt.v14i4.13027.
Hyperglycemia and periodontal disease share a bidirectional relationship mediated by inflammatory cytokines such as IL-6 and TNF-α. Periodontal infections exacerbate insulin resistance, and glycemic control impacts oral microbiota, highlighting the need for integrated management.
Nascimento, G. G., Balan, P., Alves-Costa, S., Bitencourt, F. V., Kalhan, A. C., & Leite, F. R. M. (2024). Oral and systemic health in Singapore: Revisiting the past to define the future. Community Dentistry and Oral Epidemiology, 52(3), doi:10.1111/cdoe.12913.
Singaporean data reveal connections between oral health and systemic conditions, spanning diabetes, pneumonia, and cognitive status. Early-life factors and oral conditions may serve as predictive markers for systemic disease.
Glascoe, A., Brown, R., Robinson, G., & Hailu, K. (2016). Periodontics and Oral-Systemic Relationships: Diabetes. Journal of the California Dental Association, 44(1), doi:10.1080/19424396.2016.12220963.
Periodontal disease, a chronic inflammatory condition, is a recognized risk factor for diabetes, reflecting the reciprocal relationship between oral and systemic health.
Nesse, W., Spijkervat, F. K. L., Abbis, F., & Vissink, A. (2006). [Links between periodontal disease and general health. 2. Preterm birth, diabetes and autoimmune diseases]. Nederlands tijdschrift voor tandheelkunde, 113(5).
Periodontal disease may adversely affect glycemic control and is correlated with preterm birth and autoimmune conditions. Therapeutic interventions may offer systemic health benefits if combined with systemic antibiotics.
Čolak, D., Kučić, A. C., Pintar, T., Gašpirc, B., & Gašperšič, R. (2022). Periodontal and systemic health of morbidly obese patients eligible for bariatric surgery: a cross-sectional study. BMC Oral Health, 22(1), doi:10.1186/s12903-022-02207-0.
Morbidly obese patients exhibited high prevalence of periodontitis, with significant association to hypertension but not to other obesity-related comorbidities, emphasizing the importance of pre-surgical dental evaluation.
Ishikado, A., Kondo, K., Maegawa, H., & Morino, K. (2021). Nutrition and Periodontal Health in the Patients with Diabetes Mellitus: a Review from the Viewpoint of Endothelial Function. Current Oral Health Reports, 8(4), doi:10.1007/s40496-021-00297-3.
Dietary and systemic factors, including hyperglycemia and inflammation, influence periodontal health. Nutritional interventions targeting endothelial dysfunction may help prevent or manage diabetes-associated periodontal disease.
Dennison, D. K. (1998). Heart attacks, strokes, diabetes and periodontal diseases: the relationship between periodontal health and systemic diseases. The Journal of the Greater Houston Dental Society, 69(8).
Periodontal health is implicated in systemic disease risks, including cardiovascular events and diabetes, reflecting the broader health relevance of maintaining oral hygiene.
Dhir, S., Bansal, S., Wangnoo, S., & Jana, D. I. (2022). Periodontitis and diabetes mellitus—an awareness and perception study among endocrinologists and diabetologists. International Journal of Diabetes in Developing Countries, 42(3), doi:10.1007/s13410-021-01014-7.
Although awareness of the bidirectional relationship between periodontitis and diabetes is high among physicians, referral rates to dental care remain low, highlighting the need for collaborative care models.
Hein, C. & Batista, E. L. (2014). Obesity and cumulative inflammatory burden: A valuable risk assessment parameter in caring for dental patients. Journal of Evidence-Based Dental Practice, 14(SUPPL.), doi:10.1016/j.jebdp.2014.03.004.
Obesity amplifies inflammatory burden in periodontal disease, potentially impacting systemic risks. Incorporating inflammatory assessments into dental care may improve overall health outcomes.
Orbak, R., Tezel, A., Çanakçi, V., & Demir, T. (2002). The influence of smoking and non-insulin-dependent diabetes mellitus on periodontal disease. Journal of International Medical Research, 30(2), doi:10.1177/147323000203000203.
Both smoking and diabetes increase susceptibility to periodontal disease, with combined effects exacerbating periodontal tissue destruction.
Montero, J., López-Valverde, N., Ferrera, M. J., & López-Valverde, A. (2017). Changes in crevicular cytokines after application of melatonin in patients with periodontal disease. Journal of Clinical and Experimental Dentistry, 9(9), doi:10.4317/jced.53934.
Topical melatonin reduced gingival inflammation and pro-inflammatory cytokines in diabetic patients with periodontitis, suggesting therapeutic potential in managing oral-systemic inflammatory interactions.
Thomas, B., Prasad, B. R., Kumari, N. S., Radhakrishna, V., & Ramesh, A. (2019). A comparative evaluation of the micronutrient profile in the serum of diabetes mellitus Type II patients and healthy individuals with periodontitis. Journal of Indian Society of Periodontology, 23(1), doi:10.4103/jisp.jisp_398_18.
Serum micronutrient imbalances (Zn, Cu, Se, Fe) correlate with periodontitis and diabetes, indicating systemic manifestations of periodontal disease and potential biomarkers for early detection.
Williams, R. C. (2008). Understanding and Managing Periodontal Diseases: A Notable Past, a Promising Future. Journal of Periodontology, 79(8), doi:10.1902/jop.2008.080182.
The 20th century saw identification of causative bacteria such as Porphyromonas gingivalis and the role of inflammatory mediators. Host-modulating therapies emerged, highlighting oral-systemic health connections including cardiovascular, diabetic, and pregnancy outcomes.
Huang, J. L., Chen, W. K., Lin, C. L., Lai, C. Y., Kao, C. H., Chiang, H. H., Yang, T. Y., & Shih, H. M. (2019). Association between intensive periodontal treatment and spontaneous intracerebral hemorrhage—a nationwide, population-based cohort study. Medicine (United States), 98(10), doi:10.1097/MD.0000000000014814.
Intensive periodontal treatment reduced the risk of spontaneous intracerebral hemorrhage, especially in elderly males, supporting the systemic protective effects of periodontal care.
Han, N., Li, X., Du, J., Xu, J., Guo, L., & Liu, Y. (2023). The impacts of oral and gut microbiota on alveolar bone loss in periodontitis. Journal of Periodontal Research, 58(6), doi:10.1111/jre.13168.
Periodontal pathogens and gut microbiota contribute to alveolar bone loss via inflammatory and immune pathways. Understanding the gut-alveolar bone axis provides insights for targeted periodontal therapy.
Fisketjon, P. M., & Johnson, E. L. (2018). Periodontal disease and diabetes: Perceptions, communication, and referral between rural primary care physicians and dentists. Diabetes Spectrum, 31(2). doi:10.2337/ds17-0049
This study evaluates referral patterns and communication between dentists and physicians regarding diabetes and periodontal disease in rural settings. Physicians were more likely to refer patients to dentists than vice versa, highlighting a need to improve awareness and bidirectional referral practices.
Bermúdez, F. V., Coronado, A. M. E., Pertúz, N. C., Awadallah, A. M., & Estupiñán, C. R. (2021). Influential factors in patients with periodontitis and diabetes mellitus type II. Salud Uninorte, 37(1). doi:10.14482/sun.37.1.616.46
This review highlights the multifactorial relationship between type II diabetes and periodontitis. Socioeconomic, genetic, and systemic factors—including obesity and smoking—affect disease progression. The bidirectional nature of the relationship underscores the importance of interdisciplinary management.
Monsarrat, P., Vergnes, J. N., Cantagrel, A., et al. (2013). Effect of periodontal treatment on the clinical parameters of patients with rheumatoid arthritis: Study protocol of the randomized, controlled ESPERA trial. Trials, 14(1). doi:10.1186/1745-6215-14-253
This randomized controlled trial evaluates whether non-surgical periodontal therapy can improve clinical outcomes and quality of life in patients with rheumatoid arthritis, emphasizing periodontitis as a potential aggravating factor in systemic inflammatory conditions.
Kinane, D. F., & Bartold, P. M. (2007). Clinical relevance of the host responses of periodontitis. Periodontology 2000, 43(1). doi:10.1111/j.1600-0757.2006.00169.x
A comprehensive review of periodontal disease pathogenesis, susceptibility, and systemic modifiers such as diabetes, HIV, smoking, and obesity. Highlights the variability of host responses and implications for clinical management and disease prevention.
Buczko, P., Zalewska, A., & Szarmach, I. (2015). Saliva and oxidative stress in oral cavity and in some systemic disorders. Journal of Physiology and Pharmacology, 66(1)
Saliva serves as a non-invasive diagnostic tool reflecting systemic health. Oxidative stress markers in saliva correlate with periodontal disease, diabetes, rheumatoid arthritis, and other systemic conditions, supporting their potential use in monitoring and therapy.
Soory, M. (2007). Periodontal disease severity and systemic diseases prevalent in a Caribbean catchment area of patients. West Indian Medical Journal, 56(2). doi:10.1590/S0043-31442007000200017
This study shows a strong correlation between severe periodontitis, smoking, diabetes, and co-existing systemic diseases, suggesting integrated therapeutic strategies to manage oral and systemic health.
Beck, J. D., Philips, K., Moss, K., et al. (2020). Advances in precision oral health. Periodontology 2000, 82(1). doi:10.1111/prd.12314
Precision dentistry uses data-driven stratification to tailor treatment for patients based on risk and phenotype. Unsupervised learning models improve classification of periodontal phenotypes and their systemic associations, facilitating individualized management.
El-Shinnawi, U., & Soory, M. (2013). Associations between Periodontitis and Systemic Inflammatory Diseases: Response to Treatment. Recent Patents on Endocrine, Metabolic & Immune Drug Discovery, 7(3). doi:10.2174/18715303113139990040
Chronic periodontitis contributes to systemic inflammatory burden, affecting conditions like coronary heart disease, insulin resistance, and rheumatoid arthritis. Effective periodontal treatment can reduce systemic inflammation.
Persson, G. R. (2017). Dental geriatrics and periodontitis. Periodontology 2000, 74(1). doi:10.1111/prd.12192
Older adults present unique periodontal features influenced by immune senescence and systemic comorbidities. Slower disease progression and conservative treatment approaches may be appropriate, with emphasis on tailored diagnostic criteria.
Stojilković, M., Gušić, I., Prodanović, D., et al. (2023). Awareness of physicians and dentists in Serbia about the association between periodontitis and systemic diseases: a cross-sectional study. BMC Oral Health, 23(1). doi:10.1186/s12903-023-03143-3
Survey of healthcare providers revealed high awareness of periodontitis-systemic disease links, particularly with diabetes. Physicians had less knowledge than dentists, and higher knowledge was associated with proactive patient questioning and referrals.
Lalla, E., & Papapanou, P. N. (2011). Diabetes mellitus and periodontitis: A tale of two common interrelated diseases. Nature Reviews Endocrinology, 7(12). doi:10.1038/nrendo.2011.106
The review emphasizes the bidirectional relationship between diabetes and periodontitis. Hyperinflammatory responses and impaired repair mechanisms in diabetes accelerate periodontal destruction, while periodontitis adversely affects glycemic control.
Negrato, C. A., Tarzia, O., Jovanović, L., & Chinellato, L. E. M. (2013). Periodontal disease and diabetes mellitus. Journal of Applied Oral Science, 21(1). doi:10.1590/1678-7757201302106
Provides a broad overview of epidemiological and clinical evidence linking diabetes mellitus with periodontal disease. Supports that treating periodontitis can improve glycemic control and reduce diabetes complications.
Äyräväinen, L., Heikkinen, A. M., Kuuliala, A., et al. (2018). Inflammatory biomarkers in saliva and serum of patients with rheumatoid arthritis with respect to periodontal status. Annals of Medicine, 50(4). doi:10.1080/07853890.2018.1468922
Salivary and serum biomarkers (MMP-8, IL-6) reflect periodontal and systemic inflammation in rheumatoid arthritis, highlighting the interplay between oral health and systemic inflammatory status.
Elumalai, A., Leslie, C. C., Anitha, V., et al. (2024). The eminence of nutrition in periodontal health and therapy— a review. Nutrire, 49(1). doi:10.1186/s41110-023-00246-3
Nutrition is a modifiable factor in periodontal health and healing. Adequate macro- and micro-nutrients support tissue repair and immune function, and dietary interventions may mitigate systemic disease impacts such as diabetes.
Gharbi, A., Hamila, A., Bouguezzi, A., et al. (2019). Biochemical parameters and oxidative stress markers in Tunisian patients with periodontal disease. BMC Oral Health, 19(1). doi:10.1186/s12903-019-0912-4
Patients with periodontitis show reduced plasma antioxidant activities, suggesting oxidative stress plays a role in pathogenesis. Modulating oxidative stress may serve as a therapeutic approach for periodontal and systemic health.
Alsalihi, L., Bain, C., Milosevic, A., Hassan, A., Janahi, A. & Sivaramakrishnan, G. Prevalence of periodontitis in obese patients in Bahrain: a cross-sectional study. BMC Oral Health 21, 1 (2021). https://doi.org/10.1186/s12903-021-01720-y
Adult obesity was strongly associated with a high prevalence of periodontitis in Bahraini adults, with 97% of overweight/obese participants affected. While BMI showed no correlation with disease severity, waist circumference showed a weak association, especially in men. Hypertension and diabetes were prevalent comorbidities. The study highlights the need for integrating periodontal screening into nutrition clinics as part of obesity management.
Scher, J. U., Bretz, W. A. & Abramson, S. B. Periodontal disease and subgingival microbiota as contributors for rheumatoid arthritis pathogenesis: modifiable risk factors? Curr Opin Rheumatol 26, 4 (2014). https://doi.org/10.1097/BOR.0000000000000076
Periodontal pathogens, particularly Porphyromonas gingivalis, have been implicated in rheumatoid arthritis (RA) pathogenesis through immune modulation and systemic inflammation. Epidemiological and mechanistic studies underscore shared risk factors, including smoking and dysbiosis. Altered subgingival microbiota in RA patients and smokers suggest potential therapeutic benefits of periodontal therapy as an adjunct in RA management.
Wu, Q., Zhang, W., Lu, Y., Li, H., Yang, Y., Geng, F., Liu, J., Lin, L., Pan, Y. & Li, C. Association between periodontitis and inflammatory comorbidities: the common role of innate immune cells, underlying mechanisms and therapeutic targets. Int Immunopharmacol 128 (2024). https://doi.org/10.1016/j.intimp.2024.111558
This review emphasizes the pivotal role of innate immune cells in linking periodontitis with systemic inflammatory diseases such as atherosclerosis, diabetes, obesity, and RA. Aberrant immune activation via mechanisms like trained immunity, CHIP, and myeloid-derived suppressor cells exacerbates both periodontal and systemic inflammation. Targeting innate immunity offers promising therapeutic avenues for mitigating oral–systemic comorbidity.
Li, Y., Qian, F., Cheng, X., Wang, D., Wang, Y., Pan, Y., Chen, L., Wang, W. & Tian, Y. Dysbiosis of oral microbiota and metabolite profiles associated with type 2 diabetes mellitus. Microbiol Spectr 11, 1 (2023). https://doi.org/10.1128/spectrum.03796-22
Metagenomic and metabolomic analyses revealed that patients with type 2 diabetes, even in the absence of overt oral disease, harbor enriched levels of pathogens such as Porphyromonas gingivalis and Prevotella melaninogenica, alongside altered metabolite profiles including elevated cadaverine and N-acetyldopamine. These changes may predispose T2DM patients to periodontal disease, suggesting microbial–metabolic interactions as early biomarkers
Lee, K. S., Kim, E. K., Kim, J. W., Choi, Y. H., Mechant, A. T., Song, K. B. & Lee, H. K. The relationship between metabolic conditions and prevalence of periodontal disease in rural Korean elderly. Arch Gerontol Geriatr 58, 125–129 (2014). https://doi.org/10.1016/j.archger.2013.08.011
A longitudinal study of 399 older adults in rural Korea found that longer durations of diabetes, hypertension, and obesity significantly increased the likelihood of periodontal disease. The cumulative burden of metabolic syndrome components strongly predicted oral health deterioration. Findings emphasize the need for coordinated systemic and dental care in aging populations with metabolic risk factors.
Cruz, A., Carrera, A., Nuñez, A., Mantilla, P. & Armas, A. C. Relación entre enfermedad periodontal y diabetes mellitus tipo II: Revisión de la literatura. Kiru 15, 3 (2018). https://doi.org/10.24265/kiru.2018.v15n3.08
This literature review highlights the close association between periodontal disease and type II diabetes mellitus. Poor glycemic control was linked to higher prevalence and severity of periodontal disease, with inflammatory mediators and tissue changes exacerbating oral-systemic interactions. The authors underscore the importance of integrated medical-dental management in diabetic populations, especially in older individuals.
Shah, M. A., Sankeshwari, R. M., Ankola, A. V., Kumar, R. S., Santhosh, V. N., Khot, A. J. P. & Varghese, A. S. Relationship between body mass index (BMI) and oral health status among government bus drivers of Belagavi, India: A cross-sectional study. Clin Epidemiol Glob Health 23, 101360 (2023). https://doi.org/10.1016/j.cegh.2023.101360
In this cross-sectional study of 300 bus drivers, high BMI was significantly associated with increased prevalence of dental caries and periodontal disease. Hypertension, diabetes, and oral precancerous lesions were also more common among overweight individuals. The results demonstrate that sedentary lifestyles and obesity not only predispose to systemic disease but also to poor oral health outcomes.
Singh, V., Nettemu, S., Nettem, S., Hosadurga, R. & Nayak, S. Oral health and erectile dysfunction. J Hum Reprod Sci 10, 184–190 (2017). https://doi.org/10.4103/jhrs.JHRS_87_17
This review evaluates evidence linking chronic periodontitis to erectile dysfunction (ED). Shared risk factors and systemic inflammation driven by periodontal pathogens contribute to endothelial dysfunction, a key mechanism underlying ED. The authors suggest that periodontal therapy may improve not only oral health but also erectile function, emphasizing oral health’s role in systemic disease prevention.
van Winkelhoff, A. J., Rams, T. E. & Slots, J. Systemic antibiotic therapy in periodontics. Periodontol 2000 10, 45–78 (1996). https://doi.org/10.1111/j.1600-0757.1996.tb00068.x
This seminal review outlines the role of systemic antibiotics in managing periodontal infections. While mechanical therapy reduces bacterial load, invasive pathogens such as Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis may persist in inaccessible niches. Antibiotic regimens—single or combination therapies—can enhance clinical outcomes when tailored to microbial and host factors. The paper underscores the importance of precision in diagnosis and treatment planning.
Barros, S. P., Suruki, R., Loewy, Z. G., Beck, J. D. & Offenbacher, S. A cohort study of the impact of tooth loss and periodontal disease on respiratory events among COPD subjects: Modulatory role of systemic biomarkers of inflammation. PLoS One 8, e68592 (2013). https://doi.org/10.1371/journal.pone.0068592
In COPD patients, edentulism and periodontal disease were associated with higher incidence of respiratory-related hospitalizations and mortality. Elevated systemic inflammatory markers, particularly interleukin-6, further increased risk. The study highlights the interaction between oral health and systemic inflammation, suggesting periodontal status as a significant modifier of COPD outcomes.
Kinane, D. F., Peterson, M. & Stathopoulou, P. G. Environmental and other modifying factors of the periodontal diseases. Periodontology 2000 40, 1–143 (2006). https://doi.org/10.1111/j.1600-0757.2005.00136.x
Microbial dental plaque initiates periodontal disease, but environmental, genetic, and systemic factors modify disease severity. Drugs, hormonal changes, immunosuppression, smoking, and stress influence periodontal outcomes. Although diabetes, HIV, and smoking are well-established modifiers, more research is needed to clarify other environmental and genetic effects.
Irum, B., Asif, M., Mumtaz, B. & Aslam, N. Effect of dental proximal restorations on periodontal health in patients. Journal of Ayub Medical College 34, 10454 (2022). https://doi.org/10.55519/JAMC-04-S4-10454
Dental proximal restorations were associated with increased periodontal attachment loss. Longer duration of restorations correlated with higher frequency of pathologic pockets, particularly in molars. Proper restoration design, oral hygiene, and supportive periodontal therapy are essential to minimize periodontal risk.
Alzogibi, A., Al-Shubrumi, F., Bhattacharjee, S. & Prabhu, V. Awareness of the association between periodontal health and diabetes mellitus among middle-aged population in Burridah, Saudi Arabia. International Journal of Life Science and Pharma Research 10, L1–L6 (2022). https://doi.org/10.22376/ijpbs/lpr.2020.10.1.l1-6
Among middle-aged individuals, awareness of the link between diabetes and periodontal health was limited (~46%). Awareness was higher in women with higher education, positive family history of diabetes, and frequent physician visits. The study highlights the need for increased education regarding oral-systemic health connections.
Glurich, I., Acharya, A., Shukla, S. K., Nycz, G. R. & Brilliant, M. H. The oral-systemic personalized medicine model at Marshfield Clinic. Oral Diseases 19, 1–13 (2013). https://doi.org/10.1111/j.1601-0825.2012.01921.x
This review presents a personalized medicine model linking periodontal disease and diabetes via micro-inflammatory processes. The Marshfield Clinic integrates clinical, informatics, and bio-repository resources to advance oral-systemic health interventions, aiming to reverse chronic disease trends.
Kuwamura, Y., Sakamoto, E., Sumikawa, M., Matsuhisa, M., Hinode, D., Uemura, H. & Kishida, S. Assessing the oral health of in-patients with diabetes using a clinical version of the diabetes oral health assessment tool© and its association with dental examinations. Journal of Medical Investigation 66, 328–336 (2019). https://doi.org/10.2152/jmi.66.328
The clinical Diabetes Oral Health Assessment Tool (C-DiOHAT) effectively identified oral health issues in diabetic in-patients. Use of supplementary tools and awareness of systemic-oral health links were strongly associated with dental examination findings, suggesting the tool’s utility for nurses in identifying periodontal risks.
Noble, J. M., Borrell, L. N., Papapanou, P. N., Elkind, M. S. V., Scarmeas, N. & Wright, C. B. Periodontitis is associated with cognitive impairment among older adults: Analysis of NHANES-III. Journal of Neurology, Neurosurgery and Psychiatry 80, 1106–1111 (2009). https://doi.org/10.1136/jnnp.2009.174029
Serological markers of periodontitis (P. gingivalis IgG) were associated with impaired delayed memory and calculation among older adults. These findings suggest a potential link between periodontal infection and cognitive decline, supporting further investigation into oral health as a modifiable factor for dementia risk.
Martu, M. A., Maftei, G. A., Luchian, I., Stefanescu, O. M., Scutariu, M. M. & Solomon, S. M. The effect of acknowledged and novel anti-rheumatic therapies on periodontal tissues—a narrative review. Pharmaceuticals 14, 1209 (2021). https://doi.org/10.3390/ph14121209
Rheumatoid arthritis and periodontal disease share inflammatory and genetic risk factors. Anti-rheumatic therapies may influence periodontal tissues, but the precise effects are unclear. Understanding these interactions can guide periodontal management in RA patients and improve overall prognosis.
Zambon, M., Mandò, C., Lissoni, A., Anelli, G. M., Novielli, C., Cardellicchio, M., Leone, R., Monari, M. N., Massari, M., Cetin, I. & Abati, S. Inflammatory and oxidative responses in pregnancies with obesity and periodontal disease. Reproductive Sciences 25, 1764–1775 (2018). https://doi.org/10.1177/1933719117749758
Obesity and periodontal disease in pregnancy synergistically increase local and systemic inflammation and oxidative stress, particularly in gestational diabetes. Periodontal status interacts with maternal BMI to exacerbate inflammatory markers, emphasizing the importance of oral health management in high-risk pregnancies.
Zekeridou, A., Gilbert, B., Finckh, A., Giannopoulou, C. (2022) Periodontitis in First Degree-Relatives of Individuals With Rheumatoid Arthritis: A Short Narrative Review. Frontiers in Oral Health, 3, 895753. doi:10.3389/froh.2022.895753
This narrative review highlights the bi-directional relationship between periodontal disease (PD) and rheumatoid arthritis (RA), focusing on first-degree relatives of RA patients (FDR-RA). Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans are proposed as microbial triggers for RA through citrullination mechanisms, mediated by PPAD and LtxA. Genetic, behavioral, and inflammatory risk factors are discussed, emphasizing periodontal disease as a potential screening target in FDR-RA.
Zhao, P., Xu, A., Leung, W. K. (2022) Obesity, Bone Loss, and Periodontitis: The Interlink. Biomolecules, 12(7), 0865. doi:10.3390/biom12070865
This review explores the interplay between obesity, bone metabolism, and periodontitis, describing systemic and local mechanisms including hyperinflammation, immune dysregulation, and microbial dysbiosis. Obesity-driven alveolar bone loss is highlighted, with implications for managing periodontal disease in obese individuals through both systemic and oral interventions.
Johannsen, A., Susin, C., Gustafsson, A. (2014) Smoking and inflammation: Evidence for a synergistic role in chronic disease. Periodontology 2000, 64(1). doi:10.1111/j.1600-0757.2012.00456.x
This article reviews the detrimental effects of tobacco smoking on periodontal health, demonstrating a hyperinflammatory response mediated by reactive oxygen species, collagenase, and proinflammatory cytokines. Smoking is linked to multiple chronic inflammatory diseases, and the work emphasizes gene-smoking interactions in periodontal tissue destruction.
Fabri, G. M. C., Savioli, C., Siqueira, J. T., Campos, L. M., Bonfá, E., Silva, C. A. (2014) Periodontal disease in pediatric rheumatic diseases. Revista Brasileira de Reumatologia, 54(4), 18094570. doi:10.1016/j.rbr.2013.11.004
This narrative review summarizes gingivitis and periodontitis in pediatric rheumatic diseases (PRD) such as JIA, C-SLE, and JDM. Gingivitis was common, while periodontitis was rare, influenced by chronic arthritis, immunoinflammatory dysregulation, and medication use. The findings underline the need for oral health monitoring in PRD management.
Larvin, H., Kang, J., Aggarwal, V. R., Pavitt, S., Wu, J. (2022) Systemic Multimorbidity Clusters in People with Periodontitis. Journal of Dental Research, 101(11). doi:10.1177/00220345221098910
Using AI-based network analysis, this study identifies multimorbidity clusters in 3,736 adults with periodontitis. Hypertension, obesity, and diabetes were central to multimorbidity patterns. The severity of clinical attachment loss (CAL) influenced the prominence of systemic diseases, highlighting the interplay between periodontal disease and systemic health.
Borgnakke, W. S. (2019) IDF Diabetes Atlas: Diabetes and oral health – A two-way relationship of clinical importance. Diabetes Research and Clinical Practice, 157, 107839. doi:10.1016/j.diabres.2019.107839
This review emphasizes the bidirectional relationship between diabetes mellitus (DM) and oral health. Dysglycemia exacerbates oral diseases, while periodontal infections impact glycemic control. Management of oral inflammation is proposed as a tool to improve metabolic outcomes.
Segura-Egea, J. J., Castellanos-Cosano, L., Machuca, G., López-López, J., Martín-González, J., Velasco-Ortega, E., Sánchez-Domínguez, B., López-Frías, F. J. (2012) Diabetes mellitus, periapical inflammation and endodontic treatment outcome. Medicina Oral, Patologia Oral y Cirugia Bucal, 17(2). doi:10.4317/medoral.17452
Chronic oral inflammatory conditions like apical periodontitis share microbial and inflammatory characteristics with PD, potentially affecting systemic disorders such as DM. Evidence suggests periapical disease may worsen diabetic metabolic control and influence endodontic treatment outcomes.
Chang, P. C., Lim, L. P. (2012) Interrelationships of periodontitis and diabetes: A review of the current literature. Journal of Dental Sciences, 7(3). doi:10.1016/j.jds.2012.02.002
This review elaborates on the bidirectional relationship between periodontitis and diabetes, detailing mechanisms including AGEs formation, proinflammatory cytokines, and insulin resistance. Maintaining periodontal health is crucial for glycemic control, suggesting therapeutic targeting of inflammatory pathways.
Khan, T. Z., Mobin, T. (2023) Unraveling the Link Between Periodontal Disease and High Cholesterol: A Cross-Sectional Study. Cureus. doi:10.7759/cureus.43463
This large-scale cross-sectional study demonstrates a weak positive association between high cholesterol and periodontal disease prevalence in US adults, controlling for confounding factors. Findings suggest systemic metabolic status may influence periodontal health, though causality cannot be inferred.
Beslar Leny Sang Surya, S. (2019) Relation of local factors, systemic factors and behavioral factors to the incidence of periodontal disease in Indonesia (Riskesdas Analysis). Makassar Dent J, 8(2)
Analysis of 2013 Indonesian health survey data highlights local factors (calculus, missing teeth, crowding), systemic factors (DM, stress, BMI), and behavioral factors (tooth brushing, smoking) as determinants of periodontal disease, emphasizing comprehensive prevention strategies.
Mathew, J. E., Jacob, J. J., Kalra, S. (2021) Periodontitis management in diabetes care. JPMA. The Journal of the Pakistan Medical Association, 71(8)
Periodontitis is framed as the fourth chronic microvascular complication of DM. Effective management, including scaling, antibiotics, and oral education, improves glycemic control and reduces systemic inflammatory burden.
Khade, A. M., Khade, J., Nagdeve, R., Phadnaik, M., Noman, O. (2023) An Unusual Simultaneous Occurrence of Diabetes and Hypothyroidism in a Periodontitis Patient: A Case Report. Cureus. doi:10.7759/cureus.33844
This case report documents simultaneous periodontitis, diabetes, and hypothyroidism, illustrating complex interactions between systemic and oral health and highlighting the importance of an interdisciplinary management approach.
Norrman, A. E., Tervahartiala, T., Sahlberg, E., Sorsa, T., et al. (2021) Salivary biomarkers and oral health in liver transplant recipients, with an emphasis on diabetes. Diagnostics, 11(4), 0662. doi:10.3390/diagnostics11040662
Study shows salivary biomarkers (MMP-8, MMP-8/TIMP-1 ratio) reflect periodontal inflammation in liver transplant recipients, with diabetes exacerbating periodontal impairment. Biomarkers may guide monitoring and early intervention.
Kaur, T., Uppoor, A., Naik, D. (2016) Parkinson's disease and periodontitis – the missing link? A review. Gerodontology, 33(4), 17412358. doi:10.1111/ger.12188
This review hypothesizes a potential link between Parkinson’s disease and periodontal disease via systemic inflammation. Evidence is currently indirect, highlighting the need for cohort and case-control studies to evaluate causality.
Chatzaki, N., Zekeridou, A., Paroz, E., Gastaldi, G., Giannopoulou, C. (2023) Knowledge and practice attitudes regarding the relationship between diabetes and periodontitis: a survey among Swiss endocrinologists and general physicians. BMC Primary Care, 24(1). doi:10.1186/s12875-023-02184-5
Survey reveals awareness of diabetes-periodontitis links among Swiss physicians is high, but referral practices are limited. Emphasizes the importance of interdisciplinary education and collaboration for optimal patient outcomes.
Vellayappan, R., Vellayappan, R., Varghese, S. S. (2017) A survey on knowledge, attitude and practice among the doctors towards systemic health possibly influenced by periodontitis. International Journal of Applied Dental Sciences, 3(2)
This cross-sectional study shows 79% of doctors recognized the systemic impact of periodontitis, especially with diabetes mellitus, but only 58% referred patients for dental care, highlighting gaps between awareness and practice.
Roberts, F. A. & Darveau, R. P. (2015). Microbial protection and virulence in periodontal tissue as a function of polymicrobial communities: Symbiosis and dysbiosis. Periodontology 2000, 69(1). DOI: 10.1111/prd.12087.
This review highlights how oral polymicrobial communities influence periodontal health and disease. Commensal bacteria support tissue structure and function, while dysbiosis—via overgrowth or host response changes—can drive tissue destruction. Understanding these microbial-host interactions may reveal how systemic factors like diabetes or smoking exacerbate periodontitis.
Nazir, G. & Amin, J. (2021). Diabetes mellitus and periodontal diseases: A two-way relationship. International Journal of Dentistry Research, 6(2). DOI: 10.31254/dentistry.2021.6205.
This paper reviews the bidirectional relationship between diabetes mellitus and periodontitis, showing that hyperglycemia worsens periodontal health, while periodontitis can impair glycemic control. Periodontal therapy improves glycemic outcomes, emphasizing the systemic implications of oral health.
Grubbs, V. et al. (2020). Nonsurgical Periodontal Therapy in CKD: Findings of the Kidney and Periodontal Disease (KAPD) Pilot Randomized Controlled Trial. Kidney Medicine, 2(1). DOI: 10.1016/j.xkme.2019.09.005.
The KAPD trial explored intensive nonsurgical periodontal therapy in patients with chronic kidney disease and periodontitis. While adherence and treatment effects were limited, the study demonstrates feasibility for high-risk populations and potential reductions in systemic inflammatory biomarkers.
Molina, C. A. et al. (2016). Diabetes and Periodontal Diseases: An Established Two-Way Relationship. Journal of Diabetes Mellitus, 6(4). DOI: 10.4236/jdm.2016.64024.
This review confirms diabetes as a risk factor for periodontitis and vice versa. It emphasizes interdisciplinary management between endocrinologists and dentists for early diagnosis and treatment of both conditions.
Eriksson, K. et al. (2019). Periodontal health and oral microbiota in patients with rheumatoid arthritis. Journal of Clinical Medicine, 8(5). DOI: 10.3390/jcm8050630.
In patients with rheumatoid arthritis, moderate to severe periodontitis correlates with altered subgingival microbiota, elevated systemic and local inflammatory mediators, and ACPA positivity, suggesting shared immunoinflammatory pathways between RA and periodontal disease.
Davison, E. et al. (2021). The subgingival plaque microbiome, systemic antibodies against bacteria and citrullinated proteins following periodontal therapy. Pathogens, 10(2). DOI: 10.3390/pathogens10020193.
This study shows that periodontal therapy reduces Porphyromonas gingivalis antibody titres but has limited impact on systemic inflammation markers. Presence of P. gingivalis in subgingival plaques correlates with higher anti-P. gingivalis IgG and ACPA, linking oral pathogens to systemic immune responses.
Gheonea, T. C. et al. (2024). Dipeptidyl-Peptidase-4 and Glucagon-like-Peptide-1: A Link in the Connection between Periodontitis and Diabetes Mellitus. Journal of Clinical Medicine, 13(3). DOI: 10.3390/jcm13030903.
This scoping review connects periodontitis, DPP-4, and GLP-1 with type 2 diabetes. Elevated DPP-4 levels in periodontal disease worsen glucose metabolism, while GLP-1 receptor agonists offer anti-inflammatory and bone-protective benefits, supporting integrated diabetic-periodontal care.
Lyons, K. M. & Darby, I. (2017). Interdisciplinary periodontics: the multidisciplinary approach to the planning and treatment of complex cases. Periodontology 2000, 74(1). DOI: 10.1111/prd.12187.
Periodontal care intersects multiple dental and medical disciplines. This review emphasizes the benefits of interdisciplinary approaches in managing patients with complex dental and systemic conditions, highlighting risks of isolated treatment.
Rosier, B. T. et al. (2022). The Importance of Nitrate Reduction for Oral Health. Journal of Dental Research, 101(8). DOI: 10.1177/00220345221080982.
Oral bacteria capable of reducing nitrate to nitrite support systemic health (e.g., blood pressure, diabetes) and promote oral eubiosis by suppressing pathogens such as Prevotella and Veillonella, suggesting therapeutic potential for nitrate-based interventions.
Georgiou, T. O. et al. (2004). Prevalence of systemic diseases in Brisbane general and periodontal practice patients. Australian Dental Journal, 49(4). DOI: 10.1111/j.1834-7819.2004.tb00070.x.
This study shows higher prevalence of systemic diseases in periodontal patients, especially in public care settings. Advanced periodontitis associates with increased comorbidities like bronchitis, hepatitis, and rheumatoid arthritis, supporting the oral-systemic disease link.
Teng, Y. T. A. et al. (2002). Periodontal health and systemic disorders. Journal (Canadian Dental Association), 68(3).
Highlights mild to moderate associations between periodontitis and systemic disorders such as diabetes, heart disease, pneumonia, and preterm birth, emphasizing molecular and immunological underpinnings beyond traditional clinical signs.
Furuta, M. et al. (2019). Periodontal status and self-reported systemic health of periodontal patients regularly visiting dental clinics in Japan. Journal of Oral Science, 61(2). DOI: 10.2334/josnusd.18-0128.
A cross-sectional study linking diabetes and hypertension to worse periodontal outcomes (PPD ≥5 mm), reinforcing the importance of systemic health screening in maintenance dental care.
Thouvenot, K. et al. (2022). Links between Insulin Resistance and Periodontal Bacteria: Insights on Molecular Players and Therapeutic Potential of Polyphenols. Biomolecules, 12(3). DOI: 10.3390/biom12030378.
Summarizes molecular mechanisms by which periodontal bacteria contribute to insulin resistance and type 2 diabetes. Polyphenols may reduce systemic inflammation, oxidative stress, and bacterial impact, highlighting adjunctive therapeutic strategies.
Chan, A. K. Y. et al. (2021). Common medical and dental problems of older adults: A narrative review. Geriatrics (Switzerland), 6(3). DOI: 10.3390/geriatrics6030076.
Older adults face high prevalence of periodontal disease, dental caries, and systemic conditions such as diabetes, dementia, and rheumatoid arthritis. Oral-systemic interactions must be considered in geriatric dental care.
Negrini, T. de C. et al. (2021). Interplay Among the Oral Microbiome, Oral Cavity Conditions, the Host Immune Response, Diabetes Mellitus, and Its Associated-Risk Factors. Frontiers in Oral Health, 2. DOI: 10.3389/froh.2021.697428.
This review maps complex interactions between the oral microbiome, systemic conditions (diabetes, obesity, hypertension), and immune responses, emphasizing bidirectional effects on periodontal and metabolic health and advocating multidisciplinary management.
Yap, A. (2017). Oral Health Equals Total Health: A Brief Review. Journal of Dentistry Indonesia, 24(2). DOI: 10.14693/jdi.v24i2.1122.
Oral health is integral to systemic health. Periodontitis and caries influence cardiovascular, metabolic, and obstetric outcomes. Early dental care is essential to reduce systemic complications and improve quality of life.
Alwan, A. H. et al. (2023). Evaluation of the Effect of Patient Related Factors on Periodontal Condition in a Sample of Iraqi Population: A Retrospective Study. Journal of Medicinal and Chemical Sciences, 6(5). DOI: 10.26655/JMCHEMSCI.2023.5.8.
This study finds periodontal disease prevalence increases with age and is higher in males. Local factors (plaque, restorations) and systemic factors (diabetes, smoking) significantly affect periodontal outcomes.
Corrêa, J.D., Fernandes, G.R., Calderaro, D.C., et al. Oral microbial dysbiosis linked to worsened periodontal condition in rheumatoid arthritis patients. Scientific Reports 9, 1 (2019). doi:10.1038/s41598-019-44674-6.
This study demonstrates that rheumatoid arthritis (RA) patients exhibit oral microbial dysbiosis, increased bacterial load, and higher prevalence of periodontal pathogens. Dysbiosis correlates with worsened RA severity, suggesting a bi-directional relationship between systemic inflammation and periodontal disease. Monitoring periodontal health in RA patients may be clinically important.
Rapone, B., Corsalini, M., Converti, I., et al. Does periodontal inflammation affect type 1 diabetes in childhood and adolescence? A meta-analysis. Frontiers in Endocrinology 11, 278 (2020). doi:10.3389/fendo.2020.00278.
A meta-analysis of studies on children and adolescents with type 1 diabetes (T1DM) shows that periodontal inflammation correlates with higher disease severity. While evidence suggests a potential association, methodological limitations of cross-sectional studies restrict firm conclusions.
Tan, W.C., Tay, F.B.K., Lim, L.P. Diabetes as a risk factor for periodontal disease: Current status and future considerations. Annals of the Academy of Medicine Singapore 35, 571–579 (2006). doi:10.47102/annals-acadmedsg.v35n8p571.
Reviewing epidemiologic and clinical studies, the authors discuss diabetes as a risk factor for periodontal disease. Evidence supports a complex, possibly bi-directional link, emphasizing the need for integrated management of diabetes and periodontal health.
Monsarrat, P., Grado, G.F., Constantin, A., et al. The effect of periodontal treatment on patients with rheumatoid arthritis: The ESPERA randomised controlled trial. Joint Bone Spine 86, 5 (2019). doi:10.1016/j.jbspin.2019.02.006.
This RCT shows periodontal treatment improves oral inflammation but does not significantly alter RA activity (DAS28-ESR). The study supports safe periodontal care in RA patients, highlighting the importance of integrated patient-centered approaches involving rheumatologists and dental professionals.
Khosravi, R., Ka, K., Huang, T., et al. Tumor necrosis factor-α and interleukin-6: Potential interorgan inflammatory mediators contributing to destructive periodontal disease in obesity or metabolic syndrome. Mediators of Inflammation 2013, 728987 (2013). doi:10.1155/2013/728987.
The review posits that obesity and metabolic syndrome increase levels of TNF-α and IL-6, promoting destructive periodontal disease. Interorgan inflammation may serve as a common pathogenic pathway linking metabolic disorders with periodontitis.
Oates, T.W., Guy, V., Ni, K., et al. Meta-regression Analysis of Study Heterogeneity for Systemic Outcomes after Periodontal Therapy. JDR Clinical and Translational Research 8, 1 (2023). doi:10.1177/23800844211070467.
Meta-regression reveals that inconsistent study designs largely explain variable effects of periodontal therapy on glycemic control and preterm birth. Stringent methodological standards are crucial for understanding systemic benefits of periodontal interventions.
Kalakonda, B., Koppolu, P., Baroudi, K., et al. Periodontal systemic connections—novel associations—a review of the evidence with implications for medical practitioners. Int J Health Sci 10, 2 (2016). doi:10.12816/0048820.
This review highlights emerging evidence linking periodontal diseases with systemic conditions, including Alzheimer’s disease, schizophrenia, psoriasis, and erectile dysfunction, reinforcing the importance of interdisciplinary collaboration between medical and dental practitioners.
Atanasova, K.R., Yilmaz, Ö. Prelude to oral microbes and chronic diseases: Past, present and future. Microbes and Infection 17, 7 (2015). doi:10.1016/j.micinf.2015.03.007.
The authors describe Porphyromonas gingivalis and Fusobacterium nucleatum as central players in the pathogenesis of systemic diseases such as cancer, rheumatoid arthritis, and diabetes, highlighting oral pathogens’ role beyond traditional periodontal infections.
Schievelbein, B.S., Casarin, R.P., Kruger, M.S., et al. Systemic Profile and Periodontal Condition of Hospitalized Women with High-Risk Pregnancy: A Cross-Sectional Study. Maternal and Child Health Journal 27, 7 (2023). doi:10.1007/s10995-023-03659-8.
Cross-sectional analysis of high-risk pregnant women revealed high levels of gingival inflammation despite no direct association with systemic conditions, emphasizing the need for routine oral care during pregnancy.
Bansal, M., Rastogi, S., Vineeth, N.S. Influence of periodontal disease on systemic disease: inversion of a paradigm: a review. J Med Life 6, 2 (2013).
This review discusses the evolution of periodontal medicine, highlighting connections between periodontal disease and systemic conditions including cardiovascular disease, diabetes, and maternal/offspring health.
Borgnakke, W.S. Current scientific evidence for why periodontitis should be included in diabetes management. Front Clin Diabetes Healthc 4, 1257087 (2023). doi:10.3389/fcdhc.2023.1257087.
Evidence supports bi-directional links between periodontitis and hyperglycemia, suggesting that routine periodontal care can help manage blood glucose and reduce diabetes-related complications.
Araújo, P.C., Garbín, C.A., Moimaz, S.A., et al. Perception and attitude about systemic health and periodontal disease among dentistry undergraduates. Oral Health Prev Dent 11, 4 (2013).
The study highlights gaps in dental students’ understanding of oral-systemic links, suggesting a need for enhanced education to foster holistic patient care.
Scannapieco, F.A., Cantos, A. Oral inflammation and infection, and chronic medical diseases: implications for the elderly. Periodontology 2000 72, 1 (2016). doi:10.1111/prd.12129.
This review connects poor oral health with systemic outcomes including atherosclerosis, diabetes, neurodegenerative diseases, and pneumonia, particularly in elderly populations.
Nazir, M.A., Izhar, F., Akhtar, K., et al. Dentists' awareness about the link between oral and systemic health. J Fam Community Med 26, 3 (2019). doi:10.4103/jfcm.JFCM_55_19.
Surveyed dentists largely recognized connections between periodontal disease and systemic health conditions including diabetes, cardiovascular disease, and rheumatoid arthritis, suggesting patient education could improve access to care.
Biloklytska, G.F., Viala, S.Y. Resources to improve the effectiveness of periodontal treatment in patients with diabetes mellitus. Wiad Lek 74, 3 (2021). doi:10.36740/wlek202103225.
The authors developed a Medico-sociological map identifying systemic and local risk factors for periodontal disease in type 1 and type 2 diabetic patients, showing improved treatment outcomes with interdisciplinary collaboration.
Alzammam, N. & Almalki, A. Knowledge and awareness of periodontal diseases among Jordanian University students: A cross-sectional study. J. Indian Soc. Periodontol. 23, 6 (2019). doi:10.4103/jisp.jisp_424_18.
A survey of 906 Jordanian university students revealed poor knowledge of periodontal disease etiology and conventional treatment, despite regular toothbrushing habits. Females and medical students had higher awareness of gum inflammation and systemic links (smoking, diabetes, heart disease) than males and non-medical students. Emphasizes the need for improved oral health education.
Chang, Y. et al. Improved oral hygiene is associated with decreased risk of new-onset diabetes: a nationwide population-based cohort study. Diabetologia 63, 5 (2020). doi:10.1007/s00125-020-05112-9.
Analysis of 188,013 Korean adults demonstrated that periodontal disease and missing teeth increased the risk of new-onset diabetes, whereas frequent toothbrushing (≥3/day) reduced this risk. Supports oral hygiene as a modifiable factor in diabetes prevention.
Kato, T. et al. Oral Administration of Porphyromonas gingivalis Alters the Gut Microbiome and Serum Metabolome. mSphere 3, 5 (2018). doi:10.1128/msphere.00460-18.
Oral administration of P. gingivalis in mice altered gut microbiota composition and serum amino acid profiles associated with diabetes and obesity risk. Suggests a gut-mediated systemic pathway linking periodontal infection to metabolic disease.
Schulze, A. & Busse, M. Long-term training improves clinical signs of periodontal disease in type 2 diabetic patients: a pilot trial. J. Sports Med. Phys. Fitness 63, 3 (2023). doi:10.23736/S0022-4707.22.14197-6.
Six months of recreational exercise in type 2 diabetic patients improved periodontal inflammation markers and reduced HbA1c, independent of weight changes, highlighting systemic benefits of physical activity on oral health.
Su, C. Y. et al. Detection of oral bacteria on the tongue dorsum using PCR amplification of 16S ribosomal RNA and its association with systemic disease in middle-aged and elderly patients. Biomed. Rep. 10, 1 (2019). doi:10.3892/br.2018.1175.
Detection of P. gingivalis on the tongue correlated with periodontal disease and systemic conditions (hypertension, diabetes, stroke, heart disease), suggesting oral bacterial colonization may reflect broader systemic health risks.
Chatzopoulos, G. S. et al. Association between periodontal disease and systemic inflammatory conditions using electronic health records: A pilot study. Antibiotics 10, 4 (2021). doi:10.3390/antibiotics10040386.
In 4,890 patients, severity of periodontal bone loss correlated with systemic inflammatory diseases (hypertension, arthritis, asthma, diabetes, HIV), reinforcing the bidirectional link between oral and systemic inflammation.
Gorgun, E. P. & Yurttaş, M. R. Knowledge Levels and Attitudes of Internists about the Relationship between Periodontal Disease and Diabetes. Cumhuriyet Dent. J. 25 (2022). doi:10.7126/cumudj.1061217.
Survey of 112 internists in Turkey revealed strong awareness of diabetes-periodontal disease links, yet gaps in referrals and medical education were identified. Highlights the need for integrating oral-systemic health concepts in medical training.
Lin, E. C. et al. Unraveling the Link between Periodontitis and Coronavirus Disease 2019: Exploring Pathogenic Pathways and Clinical Implications. Biomedicines 11, 10 (2023). doi:10.3390/biomedicines11102789.
Review suggests periodontitis may increase susceptibility to COVID-19 via oral ACE2 expression and systemic inflammation (IL-17 mediated). Emphasizes oral health management as a potential strategy to mitigate COVID-19 severity.
Tonguç, M. Ö. et al. Investigation of the relationship between periodontal and systemic inflammation in children with Sickle Cell Disease: A case-control study. Cytokine 149 (2022). doi:10.1016/j.cyto.2021.155724.
Children with Sickle Cell Disease had elevated salivary and serum inflammatory markers despite similar oral health to controls, indicating systemic inflammation may exacerbate oral inflammatory responses.
Seymour, G. J. et al. Relationship between periodontal infections and systemic disease. Clin. Microbiol. Infect. 13, Suppl. 4 (2007). doi:10.1111/j.1469-0691.2007.01798.x.
Comprehensive review linking periodontal infections to systemic diseases (cardiovascular, diabetes, adverse pregnancy outcomes). Mechanisms include systemic inflammation, molecular mimicry, and microbial dissemination. Emphasizes oral disease control as integral to systemic health.
Hascoët, E. et al. New insights into inflammatory osteoclast precursors as therapeutic targets for rheumatoid arthritis and periodontitis. Bone Res. 11, 1 (2023). doi:10.1038/s41413-023-00257-w.
Review highlights shared immunopathogenic mechanisms between RA and periodontitis, focusing on pro-inflammatory osteoclast precursors. Suggests targeting these precursors may prevent pathological bone resorption in both conditions.
Kane, S. F. The effects of oral health on systemic health. Gen. Dent. 65, 6 (2017).
Reviews the bidirectional relationship between oral health and systemic diseases, including atherosclerotic vascular disease, pulmonary disease, diabetes, pregnancy complications, osteoporosis, and kidney disease. Highlights the importance of primary prevention and interdisciplinary collaboration to improve overall patient outcomes.
Paurobally, N., Kruger, E., & Tennant, M. Awareness About the Oral and Systemic Complications of Diabetes Among a Cohort of Diabetic Patients of the Republic of Mauritius. Int. Dent. J. 71, 5 (2021). doi:10.1016/j.identj.2020.12.019
Assesses awareness of diabetic patients regarding oral and systemic complications of diabetes. Finds limited knowledge of oral complications and emphasizes the need for targeted health education programs to improve patient awareness and care.
Posada-López, A., Botero, J. E., Pineda-Tamayo, R. A., & Agudelo-Suárez, A. A. The Effect of Periodontal Treatment on Clinical and Biological Indicators, Quality of Life, and Oral Health in Rheumatoid Arthritis Patients: A Quasi-Experimental Study. Int. J. Environ. Res. Public Health 19, 3 (2022). doi:10.3390/ijerph19031789
Demonstrates that non-surgical periodontal therapy improves quality of life and self-perceived health in rheumatoid arthritis patients, though clinical RA activity remains largely unchanged. Supports the integration of periodontal care in systemic disease management.
Alade, G. O., & Orikpete, E. V. Assessment of Knowledge of the Relationship between Periodontal Disease and Systemic Disease among Dental Students and Its Impact on Oral Hygiene Practices. Open J. Stomatol. 12, 1 (2022). doi:10.4236/ojst.2022.121002
Evaluates dental students’ knowledge of periodontal-systemic links and their oral hygiene practices. Finds generally fair knowledge, with clinical students showing higher awareness. Suggests improved educational strategies to enhance systemic health counseling.
Teles, F., Wang, Y., Hajishengallis, G., Hasturk, H., & Marchesan, J. T. Impact of systemic factors in shaping the periodontal microbiome. Periodontol. 2000 85, 1 (2021). doi:10.1111/prd.12356
Explores how systemic factors—including diseases, pregnancy, menopause, stress, genetics, and ethnicity—modulate the periodontal microbiome. Highlights mechanisms linking systemic health and oral microbial composition and the implications for patient management.
Ouchi, T., & Nakagawa, T. Mesenchymal stem cell-based tissue regeneration therapies for periodontitis. Regen. Ther. 14 (2020). doi:10.1016/j.reth.2019.12.011
Reviews stem cell-based periodontal tissue regeneration, emphasizing the developmental biology and intercellular signaling required for effective regeneration. Highlights the potential of regenerative medicine in restoring periodontal health.
Jeffcoat, M. K., Jeffcoat, R. L., Gladowski, P. A., Bramson, J. B., & Blum, J. J. Impact of periodontal therapy on general health: Evidence from insurance data for five systemic conditions. Am. J. Prev. Med. 47, 2 (2014). doi:10.1016/j.amepre.2014.04.001
Shows that periodontal therapy reduces medical costs and hospitalizations for type 2 diabetes, coronary artery disease, cerebrovascular disease, and pregnancy, supporting a systemic health benefit of oral care.
Tsuchida, S. Proteome analysis of molecular events in oral pathogenesis and virus: A review with a particular focus on periodontitis. Int. J. Mol. Sci. 21, 15 (2020). doi:10.3390/ijms21155184
Reviews proteomic approaches to study oral pathogenesis and viral interactions in periodontitis. Highlights the systemic implications of periodontal disease and molecular pathways linking oral and systemic health.
Beck, J. D., Moss, K. L., Morelli, T., & Offenbacher, S. Periodontal profile class is associated with prevalent diabetes, coronary heart disease, stroke, and systemic markers of C-reactive protein and interleukin-6. J. Periodontol. 89, 2 (2018). doi:10.1002/JPER.17-0426
Introduces the Periodontal Profile Class system, linking periodontal phenotypes to systemic conditions and inflammatory markers, providing insights for targeted treatment strategies.
Petersen, P. E., & Ogawa, H. The global burden of periodontal disease: Towards integration with chronic disease prevention and control. Periodontol. 2000 60, 1 (2012). doi:10.1111/j.1600-0757.2011.00425.x
Summarizes the global prevalence of periodontal disease and its shared risk factors with chronic diseases. Advocates for integrated public health strategies addressing oral and systemic disease prevention.
Thomas, C., Timofeeva, I., Bouchoucha, E., et al. Oral and periodontal assessment at the first trimester of pregnancy: The PERISCOPE longitudinal study. Acta Obstet. Gynecol. Scand. 102, 6 (2023). doi:10.1111/aogs.14529
Reports high prevalence of undiagnosed periodontitis in early pregnancy, emphasizing early assessment to prevent periodontal disease progression and reduce systemic inflammation affecting pregnancy outcomes.
Müller, F., Srinivasan, M., Krause, K. H., & Schimmel, M. Periodontitis and peri-implantitis in elderly people experiencing institutional and hospital confinement. Periodontol. 2000 90, 1 (2022). doi:10.1111/prd.12454
Highlights the challenges of maintaining periodontal and peri-implant health in elderly populations and discusses systemic consequences, including chronic inflammation and aspiration pneumonia.
Umeizudike, K. A., Iwuala, S. O., Ozoh, O. B., et al. Association between periodontal diseases and systemic illnesses: A survey among internal medicine residents in Nigeria. Saudi Dent. J. 28, 1 (2016). doi:10.1016/j.sdentj.2015.03.005
Reveals inadequate knowledge among medical residents regarding periodontal-systemic links, emphasizing the need for enhanced education in medical training.
Graves, D. T., Corrêa, J. D., & Silva, T. A. The Oral Microbiota Is Modified by Systemic Diseases. J. Dent. Res. 98, 2 (2019). doi:10.1177/0022034518805739
Demonstrates that systemic inflammatory diseases such as diabetes, RA, and SLE disrupt the oral microbiota, with IL-17 mediating disease-associated microbial dysbiosis.
Alsalleeh, F., Alhadlaq, A. S., Althumiri, N. A., et al. Public Awareness of the Association between Periodontal Disease and Systemic Disease. Healthcare (Switz.) 11, 1 (2023). doi:10.3390/healthcare11010088
Assesses public knowledge of periodontal-systemic links in Saudi Arabia, finding low awareness and highlighting the need for targeted public health education programs.
Taşdemir, Z., & Alkan, B. A. Knowledge of medical doctors in Turkey about the relationship between periodontal disease and systemic health. Braz. Oral Res. 29, 1 (2015). doi:10.1590/1807-3107BOR-2015.vol29.0055
Evaluates Turkish medical doctors’ awareness of periodontal-systemic associations, showing a gap between perceived knowledge and clinical practice, especially in basic medical sciences.
Himammi, A. N., & Hartono, B. T. Ekstraksi Gigi Posterior dengan Kondisi Periodontitis Kronis Sebagai Persiapan Pembuatan Gigi Tiruan Lengkap pada Pasien Diabetes Mellitus. J. Kesehat. Gigi 8, 1 (2021). doi:10.31983/jkg.v8i1.6572
Discusses the impact of diabetes mellitus on periodontal health and the considerations for posterior tooth extraction in patients with chronic periodontitis.
Yamazaki, K. Oral-gut axis as a novel biological mechanism linking periodontal disease and systemic diseases: A review. Jpn. Dent. Sci. Rev. 59 (2023). doi:10.1016/j.jdsr.2023.08.003
Reviews the oral-gut axis as a pathway connecting periodontal disease with systemic conditions, highlighting the role of bacterial translocation, endotoxins, and gut dysbiosis in systemic disease progression.
Chatzopoulos, G. S., Jiang, Z., Marka, N., & Wolff, L. F. Periodontal Disease, Tooth Loss, and Systemic Conditions: An Exploratory Study. Int. Dent. J. 74, 2 (2024). doi:10.1016/j.identj.2023.08.002
Analyzes over 100,000 dental records linking periodontitis and tooth loss to systemic conditions including hypertension, diabetes, smoking, and other less commonly reported conditions.
Soulissa, A. G. A Review of the Factors Associated with Periodontal Disease in the Elderly. J. Indones. Dent. Assoc. 3, 1 (2020). doi:10.32793/jida.v3i1.448
Reviews systemic, physiological, and lifestyle factors influencing periodontal disease in the elderly, highlighting the importance of multidisciplinary management strategies.
Ludovichetti, F. S., Signoriello, A. G., Gobbato, E. A., et al. Can periodontal disease affect conception? A literature review. Reprod. Fertil. 2, 1 (2021). doi:10.1530/RAF-20-0043
Discusses potential impacts of periodontal disease on female fertility, including systemic dissemination of pathogens and inflammatory mediators that may affect conception.
Pitones-Rubio, V., Chávez-Cortez, E. G., Hurtado-Camarena, A., et al. Is periodontal disease a risk factor for severe COVID-19 illness? Med. Hypotheses 144 (2020). doi:10.1016/j.mehy.2020.109969
Explores the potential link between periodontal disease and severe COVID-19, suggesting shared risk factors and inflammatory pathways that may contribute to disease severity.
Sedghi, L. M., Bacino, M., & Kapila, Y. L. Periodontal Disease: The Good, The Bad, and The Unknown. Front. Cell. Infect. Microbiol. 11 (2021). doi:10.3389/fcimb.2021.766944
Comprehensive review on the progression of periodontal disease, highlighting microbial, immunological, genetic, and systemic factors, as well as implications for systemic disease and novel therapeutic approaches.