Periodontal Disease and Other Adverse Health Outcomes Share Risk Factors, including Dietary Factors and Vitamin D Status

Abstract

For nearly a century, researchers have associated periodontal disease (PD) with risks of other adverse health outcomes such as cardiovascular disease, diabetes mellitus, and respiratory diseases, as well as adverse pregnancy outcomes. Those findings have led to the hypothesis that PD causes those adverse health outcomes either by increasing systemic inflammation or by the action of periodontopathic bacteria. However, experiments largely failed to support that hypothesis. Instead, the association is casual, not causal, and is due to shared underlying modifiable risk factors, including smoking, diet, obesity, low levels of physical activity, and low vitamin D status. Diabetes mellitus is also considered a risk factor for PD, whereas red and processed meat are the most important dietary risk factors for diabetes. Because PD generally develops before other adverse health outcomes, a diagnosis of PD can alert patients that they could reduce the risk of adverse health outcomes with lifestyle changes. In addition, type 2 diabetes mellitus can often be reversed rapidly by adopting an anti-inflammatory, nonhyperinsulinemic diet that emphasizes healthful, whole plant-based foods. This review describes the evidence that proinflammatory and prohyperinsulinemia diets and low vitamin D status are important risk factors for PD and other adverse health outcomes. We also make recommendations regarding dietary patterns, food groups, and serum 25-hydroxyvitamin D concentrations. Oral health professionals should routinely inform patients with PD that they could reduce their risk of severe PD as well as the risks of many other adverse health outcomes by making appropriate lifestyle changes.

The Role of Sulfhydryl (Thiols) Groups in Oral and Periodontal Diseases

“…Gingivitis is an inflammatory condition limited to the gums, but can, in predisposed subjects, evolve towards the more severe and destructive periodontitis [4,5]. The epithelium of the ulcerated periodontal pocket can constitute a direct route for the entry of periodontal pathogens, predominantly Gram-negative anaerobes (Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Fusobacterium nucleatum, Prevotella intermedia), which colonize the subgingival area and pass Biomedicines 2024, 12, 882 2 of 18 into the systemic circulation, potentially affecting other organs [6][7][8][9]. The organism triggers a host response through the establishment of an inflammatory reaction, and responds to biofilm accumulation in dental plaque through the establishment of an inflammatory reaction [10][11][12][13][14][15][16].…”

Influencia de la obesidad sobre la composición de la microbiota subgingival en sujetos con diferente condición periodontal: una revisión sistemática

“…PD has a prevalence of 62% globally, is the sixth most common osteolytic disease affecting humans and in its most severe form can affect up to 23.6% of the world's population 6 . PD is multifactorial and is influenced by modifiable risk factors such as smoking, diet, use of multiple prosthetic restorations with poor marginal fit 7 , low levels of physical activity, low vitamin D status, type 2 diabetes mellitus, and obesity 8 . Undoubtedly, this disease can impair the quality of life of individuals, especially in very advanced stages where tooth loss is imminent, resulting in a strong impact on the patient's oral health and economy 9 ).…”

Influence of Nutrition and Physical Activity on Local and Systemic Inflammatory Signs in Experimentally Induced Gingivitis

“…Consequently, periodontal risk factors affecting the immuno-inflammatory host response play a key role in the pathogenesis of periodontitis. In addition to established periodontal risk factors like smoking and poorly controlled diabetes mellitus, a number of other lifestyleassociated risk factors such as physical inactivity and an unbalanced diet are playing an increasing role in periodontology [4] and also for cardiovascular disease [5,6].…”