Association between periodontal pathogens and systemic disease

Abstract

A growing body of literature suggests that there is a link between periodontitis and systemic diseases. These diseases include cardiovascular disease, gastrointestinal and colorectal cancer, diabetes and insulin resistance, and Alzheimer's disease, as well as respiratory tract infection and adverse pregnancy outcomes. The presence of periodontal pathogens and their metabolic by-products in the mouth may in fact modulate the immune response beyond the oral cavity, thus promoting the development of systemic conditions. A cause-and-effect relationship has not been established yet for most of the diseases, and the mediators of the association are still being identified. A better understanding of the systemic effects of oral microorganisms will contribute to the goal of using the oral cavity to diagnose and possibly treat non-oral systemic disease.

Keywords: Chronic disease; Dentistry; Inflammation; Oral pathogens; Periodontal disease; Systemic disease.

Fig. 1

Schematic representation of different systemic diseases and their association with oral pathogens. Periodontal diseases can predispose individuals to several systemic diseases such as cardiovascular disease, oral and colorectal cancer, gastrointestinal diseases, respiratory tract infection and pneumonia, adverse pregnancy outcomes, diabetes and insulin resistance, and Alzheimer's disease. The arrows show systemic diseases that can be affected by the oral cavity, and the periodontal pathogens associated with each systemic disease.