Periodontal disease and women’s health

Abstract

Background: Periodontal disease (PD) is a multifactorial inflammatory condition in which inappropriate interaction between the host immune response and specific groups of bacterial pathogens leads to destruction of connective and bone tissues supporting the tooth. Dissemination of pathogens, toxins, and immune complexes from and to periodontal lesions is at the basis of the increasingly recognized association between PD and various systemic diseases (SDs). Considering the growing attention of the medical community to “gender medicine”, this review focuses on the association between PD and six systemic conditions heavily impacting women’s health, with the aim of providing evidence in support of a joint effort between physicians and dentists to improve clinical management of these conditions.

Methods: We considered systematic reviews, meta-analyses and narrative reviews evaluating all possible associations between periodontitis, systemic diseases and women.

Results: Gender prevalence for PD is discordant, but the literature strongly supports an association between PD and female infertility and adverse pregnancy outcomes. Moreover, PD is bidirectionally linked to several systemic diseases characterized by an established female gender bias, i.e. osteoporosis (OP), cardiovascular diseases (CVD), autoimmunity, Alzheimer’s disease (AD) and cancer.

Conclusions: Overall, the literature data reviewed here provides a strong foundation for further characterization of molecular and microbial drivers of PD and of several female-prevalent systemic diseases, highlighting the possible importance of a good oral condition in preventing or attenuating women’s systemic diseases.

Keywords:

• Cancer
• cardiovascular diseases
• infertility
• osteoporosis
• periodontal disease
• systemic diseases
• women’s health

Transparency

Declaration of funding

The authors have received no payment in preparation of this manuscript.

Author contributions: conception and design: F.M.; study selection: M.L.M. and M.M.; data extraction and analysis: M.L.M.; quality assessment: E.M.; writing paper: M.L.M.; manuscript revision: F.M., M.L.B., P.N. and E.M.

Declaration of financial/other relationships

F.M., M.L.B., M.M., P.N., E.M., and M.L.M. have disclosed that they have no significant relationships with or financial interests in any commercial companies related to this study or article.

CMRO peer reviewers on this manuscript have no relevant financial or other relationships to disclose.