High-Level Evidence to Identify Diseases and Disorders Associated with Periodontal Disease

An interesting article appears in J Can Dent Assoc, 2012, 78:c25, titled ” Separating Fact from Fiction: Use of High-Level Evidence from Research Syntheses to Identify Diseases and Disorders Associated with Periodontal Disease,” by Amir Azarpazhooh and Howard C. Tenenbaum. The article describes how it is known that periodontitis has been correlated with several diseases and attempts to look at the more robust associations.

In the risks of keeping wisdom teeth page http://www.teethremoval.com/risks_of_keeping_wisdom_teeth.html this has been mentioned and several studies are cited. This page states

“These potential systemic diseases that may be associated with periodontal disease include premature delivery of low-birth weight infants, coronary artery disease, coronary heart disease, renal vascular disease, stroke, diabetes, bacterial pneumonia, chronic obstructive lung disease, and Alzheimer’s disease.”

The article discussed above uses meta-analyses and systematic reviews available up to June 2011. This article states

“This high-level evidence indicates that individuals with periodontitis have a significantly higher risk of various other problems, including cardiovascular disease, diabetes mellitus, respiratory disease and preterm low-birth-weight deliveries….The diseases for which an association with periodontitis has been reported include cardiovascular disease (CVD), stroke, respiratory disease, rheumatoid arthritis, pancreatic cancer, diabetes mellitus (types 1 and 2), preterm delivery, low-birth-weight delivery, preeclampsia, osteoporosis and osteoarthritis. On the basis of an initial scan of the literature for high-level evidence, data were analyzed for only a selection of these conditions: CVD, diabetes, adverse outcomes of pregnancy, preeclampsia and respiratory disease.”

The author then goes into a more detailed analysis of 1) cardiovascular disease, 2) diabetes mellitus, 3) adverse outcomes of pregnancy, 4) preeclampsia, and 5) respiratory diseases. Many articles and possible implications are discussed in brief.

The author concludes by saying

“..it remains important to recommend periodontal treatment for all patients, whether or not they have other established general health problems, primarily to improve periodontal health in its own right. Despite some evidence for reversibility, it cannot be guaranteed that treatment of periodontitis will reduce patients’ risk for other diseases. However, the role of periodontal disease as a “risk indicator” or “marker” should not be ignored, since the presence of this condition may serve as a warning to the dentist or dental hygienist that the patient is at risk for other diseases, especially CVD, diabetes, respiratory disease and preterm and/or low-birth-weight delivery.”

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