Periodontal Pathogens as Risk Factors of Cardiovascular Diseases, Diabetes, Rheumatoid Arthritis, Cancer, and Chronic Obstructive Pulmonary Disease-Is There Cause for Consideration?

Abstract

Cardiovascular diseases, chronic obstructive pulmonary diseases, diabetes, rheumatoid arthritis, and cancer are the most common noncommunicable diseases (NCDs). These NCDs share risk factors with periodontal disease (PD), a preventable risk factor linked to lifestyle. The discussion regarding the association between these chronic diseases is more complex. There is still a significant knowledge gap particularly of the causal relationship between PD and NCDs. In this paper, we present fundamental knowledge of the mechanisms and roles of putative periodontal bacteria to gather several hypotheses, evidence that clinical studies thus far have not produced. Although the causal hypotheses are not yet clearly established on a biological basis, prevention and prophylactic measures are recommended to prevent even the possibility of such potential risk factors.

Keywords: cancer; cardiovascular diseases; diabetes; noncommunicable disease; periodontal bacteria; periodontal disease; pulmonary diseases.

Figure 1

Process of invasion of the body by periodontal bacteria.

Figure 2

Periodontal pathogens implicated in the most common noncommunicable diseases. The colors in boxes refer to (i) the colors of the Socransky complexes for the purple, green, yellow, orange, and red colors, and (ii) other periodontal bacteria for the gray color. A. actinomycetemcomitans: Aggregatibacter actinomycetemcomitans; C. morbi: Cantonella morbi; D. wimpennyi: Dysgonomonas wimpennyi; F. nucleatum: Fusobacterium nucleatum; H. pylori: Helicobacter pylori; P. gingivalis: Porphyromonas gingivalis; S. noxia: Selenomonas noxia; S. sanguinis: Streptococcus sanguinis; T. denticola: Treponema denticola; T. forsythia: Tannerella forsythia.