Dental News - Periodontitis linked to higher mortality rate of cirrhosis patients

Dental Tribune International

Thu. 4. May 2017

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AARHUS, Denmark: Several studies have indicated associations between periodontitis and other conditions, including cardiovascular disease, chronic kidney disease, diabetes mellitus and respiratory disease. Now researchers at Aarhus University Hospital have found that severe periodontitis predicted higher all-cause mortality of patients with cirrhosis, irreversible scarring of the liver. Mortality was mostly attributable to complications of cirrhosis.

Previous studies have found poor oral health and periodontitis to be very frequent in patients with cirrhosis. In addition, research has suggested that periodontitis is involved in the progression of liver diseases and that it negatively affects the outcome of liver transplantation. The study thus focused on the association between periodontitis and the risk of death in patients with cirrhosis.

The study enrolled 184 consecutive patients, whose oral health was assessed, and 44 per cent were found to have severe periodontitis. The patients had clinical follow-up for one year on average and almost half of them died over this period.

The analysis demonstrated that severe periodontitis was associated with higher all-cause mortality. The association was adjusted for various risk factors, including age, sex, cirrhosis aetiology, smoker status, alcohol use and co-morbidity.

“Periodontitis may act as a persistent source of oral bacterial translocation, causing inflammation and increasing cirrhosis complications,” said lead author of the study Dr Lea Ladegaard Grønkjær. “As it can be treated successfully, however, we hope that our findings motivate more trials on this subject.”

Cirrhosis is the leading cause of liver transplantation and is responsible for 1–2 per cent of all deaths in Europe. Periodontitis is characterised by the deepening of the periodontal pockets due to loss of connective tissue attachment and bone. Ultimately, untreated periodontitis may result in tooth loss. It affects over 35 per cent of the adult population, with 10–15 per cent having severe forms.

Further studies are needed to determine whether better gingival care can improve outcomes in patients with cirrhosis.

The study was presented at the 2017 International Liver Congress, held in April in Amsterdam in the Netherlands.