Evaluation of Blood Parameters in Patients With Chronic Periodontitis for Signs of Anemia

Abstract

Results of the present study show that patients suffering from chronic periodontitis have a lower number of erythrocytes and hemoglobin compared to healthy controls. Thus, based on these results it can be concluded that, like any other chronic condition, chronic periodontitis can lead to anemia.

The Relation between Periodontitis and Anemia Asso‌ciated Parameters

“…(12)(13)(14) Because of similar cytokines a role in pathogenesis of ACD and periodontitis, and also the role of periodontitis as a chronic infection, a relationship between these two diseases was proposed. In studies conducted by Yamamato et al (15) , Naik et al (16) and Gokhaleet al (7) a significant correlation between periodontitis and anemia was found. Also, other studies by Pradeep et al (17) and Malhotra et al (18) concluded that treatment of periodontal disease is associated with improving the anemic condition.…”

“…This type of anemia occurs despite adequate iron stores and no bone marrow dysfunction. (7) ACD is usually identified as normocytic or microcytic anemia. (8) As the level of SI and TIBC is low or normal, but high or normal Serum ferritin level is normal or high, ACD patients have a distinctive pattern regarding the Iron distribution.…”

Anemia and Periodontitis: An Enigma?

“…Studies have associated periodontitis with atherosclerosis, cardiovascular diseases, and stroke. 5,6 These studies indicate that periodontitis leads to low-grade systemic inflammation. However, the association of periodontitis with anemia has not been very clear so far.…”

“…The ulcerated epithelium acts as a portal of entry for the bacteria to enter the connective tissue and thus into the systemic circulation. Bacteremia has been observed in patients with periodontitis and has been directly related to the severity of inflammation 1,6 .The subgingival microbiota in patients with periodontitis poses a significant and persistent Gram-negative bacterial challenge to the host. Acute-phase proteins, such as C-reactive protein, have been shown to be elevated in patients with periodontitis.…”

“…Anemia is defined as the deficiency in the oxygen carrying capacity of blood either due to reduced hemoglobin %(Hb%) or reduced Red Blood Corpuscles( RBC )count. Many studies have seen association of anemia in periodontitis patients and the possible etiology cited for decreased blood counts was the downregulation of erythropoiesis in the bone marrow by proinflammatory cytokines released due to periodontal disease 6,7 This condition is termed as anemia of chronic disease (ACD) and is defined as the anemia occurring in chronic infections, inflammatory conditions or neoplastic disorders that is not caused by marrow deficiencies or other diseases, and occurring despite the presence of adequate iron stores and vitamins 8 It is a type of microcytic anemia. 9,10 H The present study was undertaken to investigate any association between periodontitis and anemia in healthy, gingivitis and periodontitis patients.…”