Oral Health and Systemic Diseases
A link between advanced periodontal disease and increased risk of death from all causes was reported in 1998 (Garcia 1998). Since then, the body of research suggesting periodontal disease may be a risk factor for a range of chronic diseases has grown dramatically (Mawardi 2015).
Numerous studies show that chronic periodontitis is associated with increased risk of atherosclerosis, stroke, and coronary artery disease (Kholy 2015; Carramolino-Cuellar 2014; Gulati 2013). Fortunately, treating periodontitis can reduce systemic inflammation, improve cardiovascular health, and reduce stroke risk (Piconi 2009; Tonetti 2007; Fisher 2010; Lee 2013; Jeffcoat 2014; Lockhart 2012; Tonetti 2013). For a detailed discussion of strategies to support cardiovascular health, refer to Life Extension’s Atherosclerosis and Cardiovascular Disease protocol.
Type 2 Diabetes
Periodontal disease is one of the many complications of diabetes (Carramolino-Cuellar 2014; Gulati 2013). More severe periodontitis has been observed in individuals with poorly controlled diabetes compared with those whose diabetes is well managed (Lim 2007). Periodontal disease may also adversely affect blood glucose control and risk of diabetic complications (Negrato 2013); and treatment of periodontal disease may improve blood glucose control and hemoglobin A1C (HbA1C) in diabetics (Moeintaghavi 2012; Gulati 2013; Vergnes 2015; Teeuw 2010).
Periodontal disease is associated with chronic obstructive pulmonary disease (COPD) (Usher 2013; Prasanna 2011; Scannapieco 2003; Martos 2011), and more severe periodontal disease is significantly associated with COPD flare-ups (Liu 2012). Some researchers have proposed that bacteria that cause periodontal disease may be inhaled into the lungs, giving rise to respiratory infections and pneumonia (Bansal, Khatri 2013).
Cognitive Decline and Alzheimer’s Disease
Periodontal disease has chronic infectious and inflammatory components, both of which have been associated with Alzheimer’s disease (Kamer 2008; Abbayya 2015; Watts 2008; Wu 2014; Shaik 2014). One study found elevated levels of antibodies to periodontal disease bacteria years before the onset of cognitive decline (Sparks Stein 2012). Tooth loss and poor oral health have been correlated with poor cognitive function (Luo 2015; Saito 2013; Listl 2014). For a more detailed discussion about cognitive function, refer to Life Extension’s Age-Related Cognitive Decline and Alzheimer’s disease protocols.
Chronic Kidney Disease
People with chronic kidney disease are more likely to have periodontal disease, and periodontal disease is associated with declining kidney function and worsening chronic kidney disease. Treatment of periodontal disease has been shown to reduce markers of systemic inflammation in people with chronic kidney disease, especially those undergoing hemodialysis (Chen 2015; Grubbs 2015; Wahid 2013). Those interested in learning more about ways to support healthy kidney function should review the Kidney Health and Chronic Kidney Disease protocols.
Periodontal disease is common in people with rheumatoid arthritis. And early evidence suggests treatment of periodontal disease may reduce markers of disease activity in rheumatoid arthritis (Mays 2012; Payne 2015; Kaur, Bright 2014). Similarly, treatment of periodontitis in systemic lupus erythematosus (SLE) patients has been shown to improve measures of SLE disease activity (Fabbri 2014). A more thorough discussion of these conditions can be found in Life Extension’s Rheumatoid Arthritis and Lupus protocols.
Several other autoimmune diseases also appear to be related to periodontal disease: Hashimoto’s thyroiditis (Patil, Patil, Gururaj 2011), Sjögren’s syndrome (Olate 2014), psoriasis (Nakib 2013), and scleroderma (systemic sclerosis) (Baron 2015). Dry mouth, a known contributor to tooth decay and periodontal disease, is a symptom of several autoimmune diseases and may underlie their connection with cavities and periodontal disease (Mays 2012; Mortazavi 2014). On the other hand, systemic inflammation triggered by periodontal disease may contribute to autoimmune diseases (Bansal, Rastogi 2013; Gulati 2013).
Certain cancers are more common in people with periodontal disease (Whitmore 2014). These include head and neck (Han 2014; Zeng 2013), pancreatic (Michaud 2013), gastrointestinal, uterine, and prostate cancers (Arora 2010).
Other conditions that may be associated with periodontal disease include osteoporosis, erectile dysfunction, prostatitis, liver disease, and endometriosis (Gulati 2013; Kavoussi 2009; Hajishengallis 2015; Nagao 2014; Yoneda 2012). Also, periodontal disease has been associated with adverse pregnancy outcomes. Early research suggests treatment of periodontal disease in pregnant women leads to fewer pre-term deliveries and better outcomes (Parihar 2015).