Modifiable risk factors for the development and progression of periodontal tissue diseases
https://doi.org/10.29413/ABS.2022-7.5-2.19
Abstract
In this review, an analysis of modifiable risk factors for the development and progression of periodontal tissue diseases was carried out. The review highlights the data on the relationship of periodontal infection, tobacco smoking, diabetes mellitus, cardiovascular disease, drug-induced periodontal tissue damage, stress, and obesity with the risk of developing and progression of periodontal tissue diseases. A rather detailed analysis of the mechanisms of pathogenic influence of the microflora of the oral cavity, including in the subgingival plaque, was carried out. The mechanisms of the pathological effect of smoking on the state of periodontal tissues are described. Data on the effect of periodontal treatment on glycemic control in patients with diabetes mellitus are presented. The article emphasizes the importance of the presence of periodontal diseases as a risk factor for cardiovascular and cerebrovascular diseases, describes the mechanisms of the mutual influence of cardiovascular pathology and the inflammatory process in the periodontium. In addition, the article presents the possibilities of the iatrogenic effect of systemic drugs on the state of periodontal tissues. The data on the influence of stress loads on the development of dental diseases are presented. The review article describes in detail the mechanisms of influence of overweight and obesity on the risks of development and progression of periodontal tissue diseases. Based on the results of the scientific research publications presented in the article, it can be stated that not only the dentist, but also doctors of other specialties need to work to change the modifiable risk factors for the development and progression of periodontal diseases.
About the Author
A. I. Sabirova
Kyrgyz-Russian Slavic University named after the first President of the Russian Federation B.N. Yeltsin
Russian Federation
Russian Federation
Aziza I. Sabirova – Cand. Sc. (Med.), Associate Professor at the Department of Surgical Dentistry
Kievskaya str. 44, Bishkek 720065
References
1. American Academy of Periodontology. American Academy of Periodontology statement on risk assessment. J Periodontol. 2008; 79(2): 202. doi: 10.1902/jop.2008.082001
2. Timmerman MF, van der Weijden GA. Risk factors for periodontitis. Int J Dent Hyg. 2006; 4(1): 2-7. doi: 10.1111/j.1601-5037.2006.00168.x
3. Gurevich KG, Fabrikant EG. Health promotion. Moscow: Professional, 2010. (In Russ.).
4. Kolesnikova LR. Arterial hypertension and dental health in children and adolescents (literature review). Acta biomedica scientifica. 2015; (3): 94-99. (In Russ.).
5. Al-Taweel FB, Abdulkareem AA, Abdulbaqi HR. Association of modifiable and non-modifiable risk factors with periodontal disease in Iraqi individuals: A retrospective study. J Stoma. 2019; 72(4): 222-227. doi: 10.5114/jos.2019.93298
6. Kim YT, Choi JK, Kim DH, Jeong SN, Lee JH. Association between health status and tooth loss in Korean adults: Longitudinal results from the National Health Insurance Service-Health Examinee Cohort 2002-2015. J Periodontal Implant Sci. 2019; 49(3): 158-170. doi: 10.5051/jpis.2019.49.3.158
7. Wellapuli N, Ekanayake L. Risk factors for chronic periodontitis in Sri Lankan adults: A population based case-control study. BMC Res Notes. 2017; 10(1): 460. doi: 10.1186/s13104-017-2778-3
8. Chapple ILC, Mealey BL, Van Dyke TE, Bartold PM, Dommisch H, Eickholz P, et al. Periodontal health and gingival diseases and conditions on an intact and a reduced periodontium: Consensus report of workgroup 1 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Periodontol. 2018; 89(1): 74-84. doi: 10.1002/JPER.17-0719
9. Cui X, Monacelli E, Killeen AC, Samson K, Reinhardt RA. Impact of modifiable risk factors on bone loss during periodontal maintenance. Oper Dent. 2019; 44(3): 254-261. doi: 10.2341/18-041-C
10. CDC. Periodontal Disease. 2015; URL: https://www.cdc.gov/oralhealth/periodontal_disease/ [date of access: 26.01.2022].
11. Albandar JM, Rams TE. Global epidemiology of periodontal diseases: An overview. Periodontol 2000. 2002; 29: 7-10. doi: 10.1034/j.1600-0757.2002.290101.x
12. Stamm JW. Epidemiology of gingivitis. J Clin Periodontol. 1986; 13(5): 360-366. doi: 10.1111/j.1600-051x.1986.tb01473.x
13. Lindhe J, Okamoto H, Yoneyama T, Haffajee A, Socransky SS. Longitudinal changes in periodontal disease in untreated subjects. J Clin Periodontol. 1989; 16(10): 662-670. doi: 10.1111/j.1600-051x.1989.tb01037.x
14. Schätzle M, Löe H, Bürgin W, Anerud A, Boysen H, Lang NP. Clinical course of chronic periodontitis. I. Role of gingivitis. J Clin Periodontol. 2003; 30(10): 887-901. doi: 10.1034/j.1600-051x.2003.00414.x
15. Kinane DF, Attström R. European Workshop in Periodontology group B. Advances in the pathogenesis of periodontitis. Group B consensus report of the fifth European Workshop in Periodontology. J Clin Periodontol. 2005; 32(6): 130-131. doi: 10.1111/j.1600-051X.2005.00823.x
16. 1999 International Workshop for a Classification of Periodontal Diseases and Conditions. Papers. Oak Brook, Illinois, October 30 – November 2, 1999. Ann Periodontol. 1999; 4(1): i, 1-112. doi: 10.1902/annals.1999.4.1.i
17. Tonetti MS, Greenwell H, Kornman KS. Staging and grading of periodontitis: Framework and proposal of a new classification and case definition. J Periodontol. 2018; 89(1): S159-S172. doi: 10.1002/JPER.18-0006
18. Nocini R, Lippi G, Mattiuzzi C. Periodontal disease: The portrait of an epidemic. J Public Health Emerg. 2020; 4: 10. doi: 10.21037/jphe.2020.03.01
19. Corbella S, Veronesi P, Galimberti V, Weinstein R, Del Fabbro M, Francetti L. Is periodontitis a risk indicator for cancer? A meta-analysis. PLoS One. 2018; 13(4): e0195683. doi: 10.1371/journal.pone.0195683
20. Carrizales-Sepúlveda EF, Ordaz-Farías A, Vera-Pineda R, Flores-Ramírez R. Periodontal disease, systemic inflammation and the risk of cardiovascular disease. Heart Lung Circ. 2018; 27(11): 1327-1334. doi: 10.1016/j.hlc.2018.05.102
21. Cowan LT, Lakshminarayan K, Lutsey PL, Folsom AR, Beck J, Offenbacher S, et al. Periodontal disease and incident venous thromboembolism: The Atherosclerosis Risk in Communities study. J Clin Periodontol. 2019; 46(1): 12-19. doi: 10.1111/jcpe.13029
22. Badiger AB, Gowda TM, Chandra K, Mehta DS. Bilateral interrelationship of diabetes and periodontium. Curr Diabetes Rev. 2019; 15(5): 357-362. doi: 10.2174/1573399815666190115144534
23. Bingham CO 3rd, Moni M. Periodontal disease and rheumatoid arthritis: The evidence accumulates for complex pathobiologic interactions. Curr Opin Rheumatol. 2013; 25(3): 345-353. doi: 10.1097/BOR.0b013e32835fb8ec
24. Maurer K, Rahming S, Prvulovic D. Dental health in advanced age and Alzheimer’s disease: A possible link with bacterial toxins entering the brain? Psychiatry Res Neuroimaging. 2018; 282: 132-133. doi: 10.1016/j.pscychresns.2018.06.009
25. Kim DH, Jeong SN, Lee JH. Severe periodontitis with tooth loss as a modifiable risk factor for the development of Alzheimer, vascular, and mixed dementia: National Health Insurance Service-National Health Screening Retrospective Cohort 2002–2015. J Periodontal Implant Sci. 2020; 50(5): 303-312. doi: 10.5051/jpis.2000600030
26. Choi S, Kim K, Chang J, Kim SM, Kim SJ, Cho HJ, et al. Association of chronic periodontitis on Alzheimer’s disease or vascular dementia. J Am Geriatr Soc. 2019; 67(6): 1234-1239. doi: 10.1111/jgs.15828
27. Dioguardi M, Gioia GD, Caloro GA, Capocasale G, Zhurakivska K, Troiano G, et al. The association between tooth loss and Alzheimer’s disease: a systematic review with meta-analysis of case control studies. Dent J (Basel). 2019; 7(2): 49. doi: 10.3390/dj7020049
28. Mattiuzzi C, Lippi G. Worldwide disease epidemiology in the older persons. Eur Geriatr Med. 2020; 11(1): 147-153. doi: 10.1007/s41999-019-00265-2
29. Blandino G, Milazzo I, Fazio D, Puglisi S, Pisano M, Speciale A, et al. Antimicrobial susceptibility and beta-lactamase production of anaerobic and aerobic bacteria isolated from pus specimens from orofacial infections. J Chemother. 2007; 19(5): 495-499. doi: 10.1179/joc.2007.19.5.495
30. Paster BJ, Olsen I, Aas JA, Dewhirst FE. The breadth of bacterial diversity in the human periodontal pocket and other oral sites. Periodontol 2000. 2006; 42: 80-87. doi: 10.1111/j.1600-0757.2006.00174.x
31. Haffajee AD, Socransky SS. Microbial etiological agents of destructive periodontal diseases. Periodontol 2000. 1994; 5: 78-111. doi: 10.1111/j.1600-0757.1994.tb00020.x
32. Kou Y, Inaba H, Kato T, Tagashira M, Honma D, Kanda T, et al. Inflammatory responses of gingival epithelial cells stimulated with Porphyromonas gingivalis vesicles are inhibited by hop-associated polyphenols. J Periodontol. 2008; 79(1): 174-180. doi: 10.1902/jop.2008.070364
33. Lovegrove JM. Dental plaque revisited: Bacteria associated with periodontal disease. J N Z Soc Periodontol. 2004; (87): 7-21.
34. Huang DM, Ling JQ, Fu CH, Luo HX, Zhou XD. Colonization relationship between Porphyromonas gingivalis and Bacteroides forsythus in the infected root canals with chronic apical periodontitis. Shanghai Kou Qiang Yi Xue. 2005; 14(5): 531-535. (in Chinese).
35. Tanabe S, Bodet C, Grenier D. Peptostreptococcus micros cell wall elicits a pro-inflammatory response in human macrophages. J Endotoxin Res. 2007; 13(4): 219-226. doi: 10.1177/0968051907081869
36. Saito Y, Fujii R, Nakagawa KI, Kuramitsu HK, Okuda K, Ishihara K. Stimulation of Fusobacterium nucleatum biofilm formation by Porphyromonas gingivalis. Oral Microbiol Immunol. 2008; 23(1): 1-6. doi: 10.1111/j.1399-302X.2007.00380.x
37. Kubota M, Tanno-Nakanishi M, Yamada S, Okuda K, Ishihara K. Effect of smoking on subgingival microflora of patients with periodontitis in Japan. BMC Oral Health. 2011; 11: 1. doi: 10.1186/1472-6831-11-1
38. Zini A, Sgan-Cohen HD, Marcenes W. Socio-economic position, smoking, and plaque: A pathway to severe chronic periodontitis. J Clin Periodontol. 2011; 38(3): 229-235. doi: 10.1111/j.1600-051X.2010.01689.x
39. Shchipkova AY, Nagaraja HN, Kumar PS. Subgingival microbial profiles of smokers with periodontitis. J Dent Res. 2010; 89(11): 1247-1253. doi: 10.1177/0022034510377203
40. Bergström J. Oral hygiene compliance and gingivitis expression in cigarette smokers. Scand J Dent Res. 1990; 98(6): 497-503. doi: 10.1111/j.1600-0722.1990.tb01004.x
41. Jensen JA, Goodson WH, Hopf HW, Hunt TK. Cigarette smoking decreases tissue oxygen. Arch Surg. 1991; 126(9): 1131-1134. doi: 10.1001/archsurg.1991.01410330093013
42. Wang QY, Cai C, Duan YZ, Wang XJ. Nicotinic acetylcholine receptor but not acetylcholinesterase plays an important role in nicotine-related periodontitis. Med Hypotheses. 2010; 74(5): 954-955. doi: 10.1016/j.mehy.2009.12.013
43. Stegeman CA. Oral manifestations of diabetes. Home Healthc Nurse. 2005; 23(4): 233-240. doi: 10.1097/00004045-200504000-00009
44. Seppälä B, Seppälä M, Ainamo J. A longitudinal study on insulin-dependent diabetes mellitus and periodontal disease. J Clin Periodontol. 1993; 20(3): 161-165. doi: 10.1111/j.1600-051x.1993.tb00338.x
45. Thorstensson H, Hugoson A. Periodontal disease experience in adult long-duration insulin-dependent diabetics. J Clin Periodontol. 1993; 20(5): 352-358. doi: 10.1111/j.1600-051x.1993.tb00372.x
46. Pucher J, Stewart J. Periodontal disease and diabetes mellitus. Curr Diab Rep. 2004; 4(1): 46-50. doi: 10.1007/s11892-004-0011-y
47. Grossi SG, Genco RJ. Periodontal disease and diabetes mellitus: A two-way relationship. Ann Periodontol. 1998; 3(1): 51-61. doi: 10.1902/annals.1998.3.1.51
48. Perrino MA. Diabetes and periodontal disease: An example of an oral/systemic relationship. N Y State Dent J. 2007; 73(5): 38-41.
49. Negrato CA, Tarzia O, Jovanovič L, Chinellato LE. Periodontal disease and diabetes mellitus. J Appl Oral Sci. 2013; 21(1): 1-12. doi: 10.1590/1678-7757201302106
50. Kinane DF, Lowe GD. How periodontal disease may contribute to cardiovascular disease. Periodontol 2000. 2000; 23: 121-126. doi: 10.1034/j.1600-0757.2000.2230112.x
51. Stein JM, Smeets R, Reichert S, Chrobot J, Fickl S, Stanzel S, et al. The role of the composite interleukin-1 genotype in the association between periodontitis and acute myocardial infarction. J Periodontol. 2009; 80(7): 1095-1102. doi: 10.1902/jop.2009.080639
52. Geiss LS, Herman WH, Goldschmid MG, DeStefano F, Eberhardt MS, Ford ES, et al. Surveillance for diabetes mellitus – United States, 1980–1989. MMWR CDC Surveill Summ. 1993; 42(2): 1-20.
53. Wu T, Trevisan M, Genco RJ, Dorn JP, Falkner KL, Sempos CT. Periodontal disease and risk of cerebrovascular disease: The first national health and nutrition examination survey and its followup study. Arch Intern Med. 2000; 160(18): 2749-2755. doi: 10.1001/archinte.160.18.2749
54. Garcia RI. No association between ischemic heart disease and periodontitis in women. Evid Based Dent. 2010; 11(1): 20-21. doi: 10.1038/sj.ebd.6400706
55. Trevisan M, Dorn J. The relationship between periodontal disease (pd) and cardiovascular disease (cvd). Mediterr J Hematol Infect Dis. 2010; 2(3): e2010030. doi: 10.4084/MJHID.2010.030
56. Saini R, Saini S, Saini SR. Periodontal diseases: A risk factor to cardiovascular disease. Ann Card Anaesth. 2010; 13(2): 159-161. doi: 10.4103/0971-9784.62936
57. Rose LF, Genco RJ, Cohen DW, Mealey BL. Periodontal Medicine. Hamilton: B.C. Decker Inc; 2000.
58. Chaudhry S, Jaiswal R, Sachdeva S. Dental considerations in cardiovascular patients: A practical perspective. Indian Heart J. 2016; 68(4): 572-575. doi: 10.1016/j.ihj.2015.11.034
59. Cohen DW. Periodontal medicine in the next millennium. Int J Periodontics Restorative Dent. 2000; 20(1): 6-7.
60. Rees TD, Levine RA. Systematic drugs as a risk factor for periodontal disease initiation and progression. Compendium. 1995; 16(1): 20-26.
61. Dolic M, Bailer J, Staehle HJ, Eickholz P. Psychosocial factors as risk indicators of periodontitis. J Clin Periodontol. 2005; 32(11): 1134-1140. doi: 10.1111/j.1600-051X.2005.00838.x
62. Merchant AT, Pitiphat W, Ahmed B, Kawachi I, Joshipura K. A prospective study of social support, anger expression and risk of periodontitis in men. J Am Dent Assoc. 2003; 134(12): 1591-1596. doi: 10.14219/jada.archive.2003.0104
63. Marcenes WS, Sheiham A. The relationship between work stress and oral health status. Soc Sci Med. 1992; 35(12): 1511-1520. doi: 10.1016/0277-9536(92)90054-t
64. Moss ME, Beck JD, Kaplan BH, Offenbacher S, Weintraub JA, Koch GG, et al. Exploratory case-control analysis of psychosocial factors and adult periodontitis. J Periodontol. 1996; 67(10): 1060-1069. doi: 10.1902/jop.1996.67.10s.1060
65. Nguyen DM, El-Serag HB. The epidemiology of obesity. Gastroenterol Clin North Am. 2010; 39(1): 1-7. doi: 10.1016/j.gtc.2009.12.014
66. Suvan J, D’Aiuto F, Moles DR, Petrie A, Donos N. Association between overweight/obesity and periodontitis in adults. A systematic review. Obes Rev. 2011; 12(5): e381-e404. doi: 10.1111/j.1467-789X.2010.00808.x
67. Chaffee BW, Weston SJ. Association between chronic periodontal disease and obesity: A systematic review and metaanalysis. J Periodontol. 2010; 81(12): 1708-1724. doi: 10.1902/jop.2010.100321
68. Dalla Vecchia CF, Susin C, Rösing CK, Oppermann RV, Albandar JM. Overweight and obesity as risk indicators for periodontitis in adults. J Periodontol. 2005; 76(10): 1721-1728. doi: 10.1902/jop.2005.76.10.1721
69. Neiva RF, Steigenga J, Al-Shammari KF, Wang HL. Effects of specific nutrients on periodontal disease onset, progression and treatment. J Clin Periodontol. 2003; 30(7): 579-589. doi: 10.1034/j.1600-051x.2003.00354.x
70. Toprak D, Toprak A, Chen W, Xu JH, Srinivasan S, Berenson GS. Adiposity in childhood is related to C-reactive protein and adiponectin in young adulthood: From the Bogalusa Heart Study. Obesity (Silver Spring). 2011; 19(1): 185-190. doi: 10.1038/oby.2010.75
71. Jeemon P, Prabhakaran D, Ramakrishnan L, Gupta R, Ahmed F, Thankappan K, et al. Association of high sensitive C-reactive protein (hsCRP) with established cardiovascular risk factors in the Indian population. Nutr Metab (Lond). 2011; 8(1): 19. doi: 10.1186/1743-7075-8-19
72. Faucher G, Guénard F, Bouchard L, Garneau V, Turcot V, Houde A, et al. Genetic contribution to C-reactive protein levels in severe obesity. Mol Genet Metab. 2012; 105(3): 494-501. doi: 10.1016/j.ymgme.2011.11.198
73. Weatherall DJ, Ledingham JG, Warrell DA. The acute phase response and C-reactive protein. In: Oxford textbook of Medicine. 3rd edition. New York, Oxford; 1996: 1527-1533.
74. Saito T, Murakami M, Shimazaki Y, Oobayashi K, Matsumoto S, Koga T. Association between alveolar bone loss and elevated serum C-reactive protein in Japanese men. J Periodontol. 2003; 74(12): 1741-1746. doi: 10.1902/jop.2003.74.12.1741
75. Ay ZY, Kırzıoğlu FY, Tonguç MO, Sütçü R, Kapucuoğlu N. The gingiva contains leptin and leptin receptor in health and disease. Odontology. 2012; 100(2): 222-231. doi: 10.1007/s10266-011-0043-0
76. Johnson RB, Serio FG. Leptin within healthy and diseased human gingiva. J Periodontol. 2001; 72(9): 1254-1257. doi: 10.1902/jop.2000.72.9.1254
77. Karthikeyan BV, Pradeep AR. Leptin levels in gingival crevicular fluid in periodontal health and disease. J Periodontal Res. 2007; 42(4): 300-304. doi: 10.1111/j.1600-0765.2006.00948.x
78. Ermolaeva LA, Sevbitov AV, Pen’kovoi EA, Shishkin AN, Sheveleva NA, Sheveleva MA, et al. Etiopathogenetic mechanisms of the development of inflammatory periodontal diseases in patients with obesity. Vestnik of Saint Petersburg University. Medicine. 2017; 12(4): 385-395. (In Russ.). doi: 10.21638/11701/spbu11.2017.407
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For citations:
Sabirova A.I. Modifiable risk factors for the development and progression of periodontal tissue diseases. Acta Biomedica Scientifica. 2022;7(5-2):182-192. (In Russ.) https://doi.org/10.29413/ABS.2022-7.5-2.19
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