Is severe periodontitis a pre-indicator of abnormal systemic conditions?

Abstract

Objectives: Our recent retrospective study provides the first evidence that periodontal status reflects overall host susceptibility to onset of systemic diseases/disorders, and herein we further investigated whether periodontitis occurrence could represent the current systemic abnormality. Methods: Totally, 938 dental hospital attendees (35-75 yrs) completed a questionnaire on demographic characteristics, medical history, and health awareness. Of them, 205 ‘self-claimed generally healthy’ subjects received further periodontal assessment, and they were then classified as ‘Severe Periodontitis’ (generalized Stages 3-4, AAP/EFP 2017) and ‘Non-Severe Periodontitis’ groups. 50 pairs (36 females and 14 males) were included in the study with matched age, gender, and tobacco use. 17 medical diagnostic tests/parameters (e.g., cardiovascular disease, diabetes, dyslipidemia, hyperuricemia, and kidney dysfunction) were undertaken, and their mental/emotional conditions were evaluated. Results: The mean age of the ‘Severe Periodontitis’ and ‘Non-Severe Periodontitis’ groups was 56.1±9.3 and 56.0±9.4 yrs, respectively. Tobacco use was compatible in both groups (8 pairs with comparable pack-years). Moreover, they had similar covariate profiles, including income and education levels, lifestyles (e.g., physical exercise frequency, sleep quality and assumption of sweets and alcohol), oral hygiene behaviors, mental state, and emotional conditions. Overall, 98 subjects exhibited at least one abnormal testing result. The prevalence of elevated systolic pressure and increased arterial stiffness was significantly higher in the subjects with severe periodontitis, as compared with their counterparts (76.0% vs 56.0% and 44.0% vs 24.0%, respectively; P < 0.05). Notably, a greater number of severe periodontitis patients presented ≥6 abnormal testing results than the controls (66% vs 42%, P =0.016), and the diagnostic abnormality (≥6 positively tested) was independently associated with generalized Stages 3-4 periodontitis (OR 3.44, P =0.016). Conclusions: This pioneering study suggests that severe periodontitis may be a pre-indicator of existing abnormal systemic conditions, and proactive professional education/care are crucial for promoting oral health and general wellbeing.