Systemic Diseases Caused by Oral Infection

Abstract

SUMMARY Recently, it has been recognized that oral infection, especially periodontitis, may affect the course and pathogenesis of a number of systemic diseases, such as cardiovascular disease, bacterial pneumonia, diabetes mellitus, and low birth weight. The purpose of this review is to evaluate the current status of oral infections, especially periodontitis, as a causal factor for systemic diseases. Three mechanisms or pathways linking oral infections to secondary systemic effects have been proposed: (i) metastatic spread of infection from the oral cavity as a result of transient bacteremia, (ii) metastatic injury from the effects of circulating oral microbial toxins, and (iii) metastatic inflammation caused by immunological injury induced by oral microorganisms. Periodontitis as a major oral infection may affect the host's susceptibility to systemic disease in three ways: by shared risk factors; subgingival biofilms acting as reservoirs of gram-negative bacteria; and the periodontium acting as a reservoir of inflammatory mediators. Proposed evidence and mechanisms of the above odontogenic systemic diseases are given.

Production of antibody against a synthetic peptide of Porphyromonas gingivalis 40-kDa outer membrane protein

“…Several studies have reported that immunization with whole P. gingivalis cells, cell extracts, or outer membrane preparations can reduce tissue destruction caused by a P. gingivalis challenge in animal models (13)(14)(15)(16). Furthermore, immunization with whole P. gingivalis cells or sonicated cell surface extracts reduces bone loss in the rat (17) and nonhuman primate (18) Recently, it has been recognized that oral infections, especially periodontitis, may affect the course and pathogenesis of several systemic diseases, such as cardiovascular disease, bacterial pneumonia, diabetes mellitus, and low birth weight (19). Although the importance of systemic diseases caused by periodontitis has been recognized by the dental profession, the general public still believes that periodontal diseases do not possess the potential to affect lethal diseases.…”

From focal sepsis to periodontal medicine: a century of exploring the role of the oral microbiome in systemic disease

“…The studies reviewed above and several others have suggested that oral bacteria may cause respiratory diseases when (i) oral bacteria or respiratory pathogens from oral reservoirs are aspirated into the lower respiratory tract, (ii) salivary enzymes released during chronic periodontal disease or smoking modify the oral mucosa and lead to increased adhesion by respiratory pathogens, and/or (iii) circulating pro‐inflammatory cytokines released as a consequence of periodontal inflammation modify the respiratory mucosa (Li et al . ; Paju & Scannapieco, ).…”

Hospitalisation impacts on oral hygiene: an audit of oral hygiene in a metropolitan health service

“…The most common method of controlling plaque build‐up is through mechanical removal with a toothbrush. Plaque build‐up has been associated with systemic infections , cardiovascular disease , adverse pregnancy outcomes , respiratory diseases and aspiration pneumonia .…”