Association between proton pump inhibitors and periodontal disease severity

Abstract

Objectives: Proton pump inhibitors (PPIs) are commonly prescribed for the management of acid-related gastrointestinal disorders. PPIs modulate osteoclast function, reduce gastric acid secretion, and are associated with the establishment of a more diverse gastrointestinal microbiota. Periodontitis is characterized by microbeassociated host-mediated inflammation that results in loss of periodontal attachment.The aim of this study was to assess whether a relationship exists between PPIs and periodontal disease. Materials and methods:A retrospective analysis was performed using patient records from a faculty periodontal practice. The proportion of elevated probing depths was used to measure periodontitis severity. Statistical analysis was performed using independent sample t-tests, and Chi-square tests of independence.Results: Records from 1093 patients were initially assessed. Fourteen percent of teeth were associated with ≥6 mm probing depths among PPI users, in contrast to 24% for patients not using PPIs (P = 0.030). Similarly, 27% of teeth exhibited ≥5 mm probing depths among PPI users versus 40% for non-PPI users (P = 0.039). Conclusions:The results suggest that PPIs are associated with a reduced proportion of elevated probing depths. Future prospective studies are indicated to elucidate possible mechanisms through which PPIs might affect, and potentially be used in the treatment of, periodontitis.

The influence of proton pump inhibitors on tissue attachment around teeth and dental implants: A scoping review

“…A 2022 cross‐sectional study retrospectively analyzed patients from a university‐based faculty periodontics practice (Chawla et al, 2022 ). The proportion of probing depths ≥ 5 mm or ≥ 6 mm was measured for patients diagnosed with generalized periodontitis, stage III to IV, grade B to C, among PPI users compared to non‐users.…”

“…The literature describing the relationship of PPIs and teeth was more limited than the relationship between PPIs and implants. We were able to identify five studies describing the effects of PPIs on tissue attachment around teeth, which found an inverse relationship between PPIs and severity of periodontal disease (Chawla et al, 2022; Herrmann et al, 2022b; Yerke & Cohen, 2019; Yerke et al, 2019, 2021). There were no studies that described the effects of PPIs on bone levels around teeth.…”

“…A 2021 thesis (Chawla & Yerke, 2021) that was comprised of two subsequently submitted manuscripts was excluded from the qualitative analysis: one manuscript was a preliminary version of this scoping review. The second manuscript was a cross-sectional study published after completion of the thesis (Chawla et al, 2022), and is critiqued separately in the qualitative analysis, below. implants in 568 nonusers) evaluated the effect of PPI intake on the osseointegration of dental implants using patient-and implant-level models.…”

“…An abstract by , described patients with generalized, chronic, moderate-to-severe periodontitis using, or not using, PPIs. They found an inverse relationship between the use of A 2022 cross-sectional study retrospectively analyzed patients from a university-based faculty periodontics practice (Chawla et al, 2022). The proportion of probing depths ≥ 5 mm or ≥ 6 mm was measured for patients diagnosed with generalized periodontitis, stage III to IV, grade B to C, among PPI users compared to non-users.…”

The influence of systemic condition and medications on alveolar bone loss and tooth attrition

“…Certain modi able risk factors, such as medications: antiresorptive bone agents [12], antihypertensive drugs [13], statins [14], psychiatric drugs, and proton pump inhibitors [15,16], have been reported to have an impact on periodontal status.…”