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BIRMINGHAM, UK: In a recent study, researchers from the University of Birmingham examined the records of patients having a history of periodontal disease, including gingivitis and periodontitis. They reported that periodontal disease is associated with chronic diseases such as cardiovascular disease, cardiometabolic disease, autoimmune disease and mental ill health. The study highlights the importance of implementing preventative approaches for periodontal disease management and the need for improved communication between medical and dental staff in order to minimise the risk of developing ill health.
The research was partly funded by the Medical Research Council Versus Arthritis Centre for Musculoskeletal Ageing Research based at the University of Birmingham and supported by the National Institute for Health Research (NIHR) Birmingham Biomedical Research Centre.
In the study, the researchers looked at the records of 64,379 patients who had a GP-inputted recorded history of periodontal disease, including 60,995 patients having gingivitis and 3,384 having periodontitis. The patients’ records were then compared with those of 251,161 patients having no record of periodontal disease in order to establish how many patients with periodontal disease and how many patients without periodontal disease go on to develop cardiovascular disease, cardiometabolic disorders, autoimmune conditions and mental ill health, including depression, anxiety and serious mental illness, over an average of three years.
Periodontal disease and increased chronic disease morbidity
The findings provided crucial data that helped to confirm and strengthen the link between periodontal disease and other chronic diseases, especially mental ill health.
According to the data, patients having a recorded history of periodontal disease at the start of the study were almost twice as likely to develop mental ill health, at 37%. Additionally, 33% of patients were at an increased risk of developing autoimmune disease, 18% more likely to develop cardiovascular disease and 7% more likely to have a cardiometabolic disorder. Among cardiometabolic disorders, the risk of developing Type 2 diabetes was much higher, at 26%.
Commenting on the study, co-author Dr Joht Singh Chandan, NIHR academic clinical lecturer in public health at the University of Birmingham’s Institute of Applied Health Research, said in a press release: “Poor oral health is extremely common, both here in the UK and globally.” He added: “When oral ill health progresses, it can lead to a substantially reduced quality of life. However, until now, not much has been known about the association of poor oral health and many chronic diseases, particularly mental ill health.”
Dr Chandan further explained that the prevalence of periodontal disease is relatively high, and the fact that it might put people at an increased risk of developing other chronic diseases may present a major public health issue.
Senior author Prof. Krish Nirantharakumar from the Institute of Applied Health Research at the university noted that, in light of the findings, there is a strong need to build rapport between medical and dental teams: “An important implication of our findings is the need for effective communication between dental and other healthcare professionals to ensure patients obtain an effective treatment plan targeting both oral and wider health to improve their existing overall health and reduce the risk of future illness.”
The study is only one among many to associate periodontal disease with other diseases, and the findings reinforce the importance of prevention, early identification and treatment of periodontitis.
Periodontal disease as a risk factor for arthritis
According to the Global RA Network, over 350 million people have arthritis globally. The National Health Service stated that, in the UK, over ten million people have arthritis or a similar condition that affects the joints and that osteoarthritis and rheumatoid arthritis are the two most common types of arthritis in the country. As previously mentioned, a staggeringone-third of patients having periodontal disease in the study were found to be more at risk of developing arthritis, a finding that appears rather alarming to Dr Caroline Aylott, who is head of research delivery at Versus Arthritis.
“Some of the biggest challenges of arthritis, especially autoimmune conditions like rheumatoid arthritis (RA) which affects 400,000 people in the UK, is being able to know who is more at risk of developing it, and finding ways to prevent it,” she commented in a press release.
According to Dr Aylott, previous studies have found that people having RA were four times more likely to develop periodontal disease compared with people who are RA-free and that the disease manifestations were often more severe. Therefore, she advised healthcare professionals to look closely for early signs of periodontal disease in patients and to consider taking a holistic approach when treating them.
The study, titled “Burden of chronic diseases associated with periodontal diseases: a retrospective cohort study using UK primary care data”, was published online on 19 December 2021 in BMJ Open.