Periodontal disease and Systemic Disease Flashcards
What is the relationship between periodontal disease and diabetes?
There is an establish bidirectional risk between the two diseases, they are risk factors for each other.
Patients with diabetes have a 2-3 times risk of periodontitis, and patients with severe periodontitis have a higher risk of developing diabetes.
What effect can treating severe periodontal disease have in a patient with diabetes?
It can decrease blood glucose levels, and HbA1c levels, the two key biomarkers which indicate how well a patients diabetes is managed.
Describe the mechanism behind the risk factor relation between diabetes and periodontal disease.
High glucose levels in saliva promote the growth of bacteria that cause gum disease.
Diabetes causes delayed wound healing and links with periodontal disease due to the abnormal glucose regulation resulting in advanced glycerin end products being produced.
These interact with cell surface receptors causing increased permeability and adhesion molecules of endothelial cells, increased chemotaxis and release of IL-6 and TNF alpha by macrophages, increased MMPs and decreased collagen
production by fibroblasts.
Diabetes causes impaired neutrophil function, heightened inflammatory response, alteration of collagen metabolism, microangiopathy and impaired wound healing.
What is the relationship between periodontal disease and cardiovascular disease?
Periodontitis leads to an increased risk of cardiovascular disease.
What is the effect of treating periodontal disease in a patient who suffering from or at risk of cardiovascular disease?
It can lead to a reduction in blood pressure, a key risk factor for cardiovascular disease.
It can also lead to reduction in systemic inflammatory markers, which also are correlated to CVD risk.
Describe the mechanism behind the risk factor relation between periodontal disease and cardiovascular disease.
Periodontal disease is classified as low-grade inflammation, which has a link to cardiovascular disease risk.
Periodontal disease can indirectly encourage endothelial dysfunction, and cause an increase risk of bacteremia formation - a particular risk in infective endocarditis.
What is the relationship between periodontal disease and pregnancy?
Pregnancy can lead to an increased risk of periodontal disease, and can potentially have severe health impacts for mother and child such as increasing the risk of:
Low birth weight
Preterm birth
Spontaneous abortion
Maternal complications
What is the effect of treating periodontal disease in a patient who is pregnant?
The periodontal disease can be managed until the pregnancy has come to term, lowering the risk of poor health outcomes for mother and child.
Describe the mechanism behind the risk factor relation between periodontal disease and pregnancy.
Accumulation of dental plaque, which can increase due to hormonal action.
Changes in a pregnant woman’s oral microbiome may also contribute to the development of periodontal disease.
Signs of periodontal disease can be exacerbated in pregnancy.
Women with periodontal disease may be at risk of adverse pregnancy outcomes, such giving birth to a pre-term or low-birth weight baby.
What is the relationship between periodontal disease and rheumatoid arthritis?
A bidirectional link is present, with RA being a risk factor for periodontal disease, and vice versa.
What is the effect of treating periodontal disease in a patient who is suffering from or at risk of rheumatoid arthritis?
It will increase the effectiveness of the treatment for rheumatoid arthritis, and may decrease the severity of the disease.
Describe the mechanism behind the risk factor relation between periodontal disease and rheumatoid arthritis.
The inflammatory periodontal microenvironment may play a role in the development of rheumatoid arthritis, or augment systemic inflammation and immune responses in disease propagation.
Specific strains of oral bacteria, including P. gingivalis, and localized inflammatory responses may result in citrullination events that serve to break immunological tolerance.
Rheumatoid arthritis can disrupt the RANK/OPG system modulating bone formation/resorption, including the periodontal bone.
What is the relationship between periodontal disease and Alzheimer’s disease?
There is some indication that periodontal disease can be a risk factor for periodontal disease, however the research is ongoing. It is likely that the two could have a bidirectional relationship.
What is the effect of treating periodontal disease in a patient who is suffering from Alzheimer’s disease?
The link between the two disease is not fully established, however it may have the effect of lowering systemic inflammation which has a role in the progress of Alzheimer’s.
Describe the mechanism behind the risk factor relation between diabetes and rheumatoid arthritis.
A patient with Alzheimer’s may struggle with proper oral hygiene, leading to an increase risk of periodontal disease.
The chronic inflammation and increased risk of infection are also risk factors for Alzheimer’s disease.
Both diseases also share common risk factors, such as age, genetics, and lifestyle factors.
