Periodontitis: a Risk Factor for “Lifestyle” Diseases
Dental profession, Inflammation, Lifestyle disease, Metabolic syndrome, Periodontitis
Periodontitis is an inflammatory disease induced by bacterial insult and host immune response. Epidemiological and clinical studies over the past decade have suggested its association with development of atherogenesis, which
may lead to cardiovascular disease and its complications. Lifestyle diseases are non-communicable chronic diseases of longevity that are increasing in frequency as countries become more industrialized and people live longer. The
lifestyle diseases, including for example atherosclerosis, cardiovascular diseases, stroke, type 2 diabetes mellitus, obesity and osteoporosis, are at present increasing at an alarming rate worldwide, and are related largely to diet and the way a person lives. The long office hour and the type of activities we encounter daily in our office make us in the dental professions are at risk for developing lifestyle diseases. Healthy lifestyle factors include good nutrition, regular exercise, non-smoking and body mass index of less than 25 kg/m2
, etc. Because the oral cavity is generally considered the window of systemic health and disease, the lifestyle behaviors that promote oral health also decrease risks for developing lifestyle diseases. Both periodontitis and all of the lifestyle diseases mentioned above are associated with chronic low-grade inflammation. When bacteria in the oral cavity are dysregulated, periodontal diseases will develop, particularly obvious in those suffering systemic diseases like diabetes and other metabolic disorders. Different lines of evidence point to a causal link between periodontitis and some lifestyle diseases. Current proposal regarding the microbial agent for periodontitis is based not on a single species of bacteria like Porphyromonas gingivalis, but on alteration of microbial community at the diseased sites. With this new proposal, periodontitis is therefore considered to be a polymicrobial origin resulting from imbalanced oral microbiota. When microbes in this unhealthy oral microbiota (known as dysbiosis) are dislodged, aspirated or swallowed, they can disturb the balance of microbiota and homeostasis at distant extra-oral sites and can influence systemic health status. Therefore, by carefully controlling the microbial balance, for example, with probiotics by health professionals, may help alleviating both oral and systemic diseases and restoring homeostatic balance of the host. Research to advance the knowledge regarding molecular pathogenesis of periodontitis and “lifestyle” diseases should provide us with ways and means to develop new approaches in
patient management or identify new drug targets that will improve the quality of life of our patients.