Systemic Effects of Periodontal Diseases (original) (raw)

2005, Dental Clinics of North America

The possibility that a localized oral condition such as periodontal disease (PD) may have systemic effects seems to be of interest to the average person. The notion that a condition that is often ignored (or dealt with only when causing pain) may have long-term systemic consequences gets people's attention. To some constituencies of the dental profession, this attention is a good thing; perhaps some of those who have ignored their oral health will now pay attention to their mouth and seek regular dental care. This notion has considerable public health significance because if it is true, then treatment of periodontal inflammation would contribute to reduction in the risk of many prevalent, often fatal chronic diseases. To what extent are the putative associations between PD and systemic conditions such as atherosclerosis, myocardial infarction, stroke, pneumonia, diabetes mellitus, and adverse pregnancy outcomes based on proven fact? To what extent can these potential associations be explained by a plausible pathogenic mechanism? Will provision of periodontal therapy reduce the risk of these systemic diseases? The goal of this article is to briefly review the history of this concept, describe the biologically plausible circumstances that may underlie these potential associations, and provide a summary of the published literature that supports or refutes them. History of the focal infection hypothesis The concept that oral infection may contribute to various systemic diseases is not new. Indeed, the possibility that a localized, or focal, infection such as PD could have systemic effects was a popular idea at the turn of the twentieth century [1,2]. A focal infection is a chronic, localized infection that can disseminate microorganisms or toxic microbial products to contiguous or