GINGIVITIS is characterized by inflammation and local bleeding of the gums, which if left untreated will eventually lead to bone and tooth loss (PERIODONTITIS). PD is also linked to chronic systemic inflammation as the body’s response. Periodontal inflammation leads to the formation of gingival pockets, which have an ulcerated and permeable epithelial lining. This allows suspected pathogens and/or their by-products to gain access to the blood circulation and trigger a systemic inflammatory response, which may have causality with various systemic diseases and degenerative diseases, either by a process of bacteremia, endotoxemia or transmission of virulent factors to the circulation. If we also take into account the fact that patients with Alzheimer’s disease usually have the worst oral health status, which progressively decreases as dementia progresses, we see the bidirectional relationship between periodontitis and dementia. Thus: on the one hand, the progressive cognitive deterioration of Alzheimer’s disease would limit oral hygiene habits and affect oral health; on the other hand, the chronic immuno-inflammatory process and systemic inflammation secondary to periodontitis could induce neuroinflammatory phenomena coadjuvant to the onset or worsening of Alzheimer’s disease.
Relationships between chronic periodontitis and systemic diseases include:
Cardiovascular disease, Alzheimer’s disease, chronic obstructive pulmonary disease (COPD), pneumonia, diabetes, chronic kidney disease, rheumatoid arthritis, metabolic syndrome, premature births and low birth weight fetuses.
Excellent oral hygiene and regular periodontal therapy will significantly reduce the risk of these diseases.
