Periodontitis affects around 50% of adults worldwide. In its most severe form and in its final consequences (edentulism, the loss of all teeth), it is the sixth most widespread disease, affecting 9.8% of the global adult population.
Several epidemiological, experimental and interventional studies have shown an independent association between periodontitis and systemic diseases, in particular with a number of chronic non-communicable diseases (cardiovascular disease, diabetes, hypertension, obesity, chronic kidney disease, obstructive lung disease and pneumonia, cancer).
These associations are rooted in shared risk factors and shared pathways of chronic inflammation. As a consequence, periodontitis could be a risk factor associated with the ultimate medical outcome: the patient’s death.
The cytokines produced by inflamed gum tissue can in fact enter the bloodstream and trigger the host response, increasing the body’s overall inflammatory burden.
The systematic review examined 57 studies involving 48 cohorts and 5.71 million participants. Periodontitis and its consequences in the most advanced cases (edentulism) were independently associated with an increased risk of all-cause and cause-specific mortality. The meta-analysis showed that periodontitis was associated with (all-cause) mortality with a relative risk of 1.46 (95% CI, 1.15–1.85; P=0.002), while for edentulism, the extreme consequence of periodontitis, the relative risk rose to 1.64 (95% CI, 1.45–1.86; P<0.001).
Despite the possible limitations of this first systematic review of the literature (related to possible limitations of the studies included and examined, or to residual confounding factors), the study demonstrated an association between periodontitis and mortality.
The research also reports that the association between periodontitis and all-cause mortality, and between edentulism and cardiovascular mortality, is stronger in people over the age of 65.
Source: M. Romandini, G. Baima, G. Antonoglou, J. Bueno, E. Figuero, and M. Sanz, Periodontitis, Edentulism, and Risk of Mortality: A Systematic Review with Meta-analyses, Journal of Dental Research 2021, Vol. 100(1) 37–49
Credits: Photo by Camilo Jimenez on Unsplash
