Faculty of Dentistry, National University of Singapore, Singapore.
Ann Acad Med Singap. 2022 Sep;51(9):567-574. doi: 10.47102/annals-acadmedsg.2021503.
Chronic periodontal disease is a highly prevalent dental condition affecting tooth-supporting tissues. Scientific evidence is accumulating on links between periodontal disease and various systemic conditions. This narrative review provides a holistic yet succinct overview that would assist medical practitioners to deliver integrated care for better clinical outcomes.
Scientific evidence on associations between periodontal disease and systemic conditions was synthesised and critically appraised. Key findings of latest prospective cohort studies, randomised clinical trials, and meta-analysis were closely assessed and compiled.
A bidirectional relationship has been established, indicating that diabetes and periodontal disease are closely linked and amplify one another, if not successfully controlled. Existing evidence also supports the associations of periodontal disease with cardiovascular diseases and adverse pregnancy outcomes. Successful treatment of periodontal disease and dental prophylaxis has been shown to improve clinical outcomes in these systemic conditions. Other systemic conditions associated with periodontal disease include respiratory diseases, Alzheimer's disease, rheumatoid arthritis and chronic kidney disease. Although the underlying mechanisms remain to be fully elucidated, it is generally accepted that the inflammatory burden of chronic periodontal disease has an important systemic impact.
Oral-systemic links are multifaceted and complex. While evidence linking periodontal disease with a variety of systemic conditions is still emerging, the nature of the relationship is becoming clearer. The updated understanding of these associations warrants the attention of medical experts and policymakers for a concerted effort to develop a patient-centric, integrated model for the treatment of comorbid dental and medical conditions.
慢性牙周病是一种高发的牙齿疾病，影响牙齿支持组织。越来越多的科学证据表明牙周病与各种全身状况之间存在关联。本文综述提供了一个全面而简洁的概述，将帮助医疗从业者提供综合护理，以实现更好的临床效果。
综合并批判性评估了牙周病与全身状况之间关联的科学证据。仔细评估和编译了最新前瞻性队列研究、随机临床试验和荟萃分析的主要发现。
已经建立了双向关系，表明糖尿病和牙周病密切相关，如果不能得到有效控制，两者会相互加剧。现有证据还支持牙周病与心血管疾病和不良妊娠结局之间的关联。牙周病的成功治疗和口腔预防已被证明可以改善这些全身疾病的临床结果。与牙周病相关的其他全身疾病包括呼吸道疾病、阿尔茨海默病、类风湿性关节炎和慢性肾病。虽然潜在机制仍有待充分阐明，但人们普遍认为慢性牙周病的炎症负担对全身有重要影响。
口腔-全身联系是多方面且复杂的。虽然牙周病与多种全身状况相关的证据仍在不断涌现，但这种关系的性质变得越来越清晰。对这些关联的最新理解引起了医学专家和政策制定者的关注，需要共同努力制定以患者为中心的、综合的治疗共患口腔和医疗疾病的模式。
