Why should a doctor be interested in oral disease?

Abstract

Oral health has been implicated in systemic disease throughout the ages; however, the understanding of the relationship between oral disease and systemic diseases such as cardiovascular disease and Type 2 diabetes mellitus is still emerging today. Chronic periodontal disease is widespread in the general population and a significant proportion of adults suffer from the most severe form of the disease. Dental plaque biofilm is necessary for the development of chronic periodontal disease with genetic and environmental factors contributing towards the pathogenesis. The putative biological mechanisms of the association between oral disease and atherogenesis are discussed, although there is insufficient evidence to establish causality at this time. Regardless of a direct causal relationship between oral disease and cardiovascular disease, treatment of oral disease leads to both a reduction in the systemic inflammatory burden as reflected in inflammatory markers and an improvement in endothelial function and hence improved overall health outcomes. A brief overview of periodontal disease including etiology, pathogenesis, screening and therapeutic implications is presented.

Keywords::

• cardiovascular disease
• inflammation
• molecular mimicry
• periodontal disease

Financial & competing interests disclosure

A workshop to collaborate on this topic was funded by an unconditional educational grant from Colgate Oral Care, Australia. The opinions reported are entirely independent and are the result of the analysis and the review of the current literature by the authors. Sarah Raphael is a consultant to Colgate Oral Care, Australia. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Notes

Affirmative answers to the above questions are positive predictors of a clinical diagnosis of moderate/severe periodontitis and, in addition to signs of oral inflammation, may assist doctors in periodontal disease screening [84].