This document discusses the relationship between oral infections and systemic diseases. It summarizes three pathways linking oral infections to secondary systemic effects: metastatic spread of infection, effects of circulating oral toxins, and immunological injury from oral microorganisms. Specific diseases discussed include cardiovascular disease, bacterial pneumonia, low birth weight, and diabetes mellitus. Periodontal disease is shown to predispose individuals to cardiovascular disease and coexist with severe diabetes.

1. RELATIONSHIP BETWEEN ORAL INFECTION
AND SYSTEMIC DISEASES
Presented by:
Dr. Shady A. M. Negm
*Bachelor's Degree of Dental
Surgery, School of Dentistry,
Pharos University.
*Professional Diploma of
Infection Control from Oxford
College, UK
*Diploma in General Science 1

2. Introduction
• Recently, it has been recognized that oral
infection, especially periodontitis, may
affect the course and pathogenesis of a
number of systemic diseases, such as
cardiovascular disease, bacterial
pneumonia, diabetes mellitus, and low
birth weight.
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3. pathways linking oral infections to
secondary systemic
• Three mechanisms or pathways linking
oral infections to secondary systemic
effects have been proposed: (i) metastatic
spread of infection from the oral cavity as
a result of transient bacteremia, (ii)
metastatic injury from the effects of
circulating oral microbial toxins, and (iii)
metastatic inflammation caused by
immunological injury induced by oral
microorganisms
3

4. Cardiovascular Disease
• It is clear that periodontal disease is
capable of predisposing individuals to
cardiovascular disease, given the
abundance of gram-negative species
involved, the readily detectable levels of
proinflammatory cytokines, the heavy
immune and inflammatory infiltrates
involved, the association of high peripheral
fibrinogen, and the white blood cell (WBC)
counts
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6. Bacterial Pneumonia
• Microorganisms can infect the lower
respiratory tracts by four possible routes:
aspiration of oropharyngeal contents,
inhalation of infectious aerosols, spread of
infection from contiguous sites, and
hematogenous spread from
extrapulmonary sites of infection.
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8. Low Birth Weight
• Pregnancy can influence gingival health.
Changes in hormone levels during pregnancy
promote an inflammation termed pregnancy
gingivitis. This type of gingivitis may occur
without changes in plaque levels. Oral
contraceptives may also produce changes in
gingival health. Some birth control pill users
have a high gingival inflammation level but a low
plaque level. Birth control pills may cause
changes such as alteration of the
microvasculature, gingival permeability, and
increased synthesis of estrogen PGs
8

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10. Diabetes Mellitus
• Diabetes is commonly categorized as type
1, or insulin dependent, and type 2, non-
insulin dependent. The fundamental
derangement in insulin-dependent
diabetes is the hypoproduction of insulin
due to destruction of the beta cells of the
pancreas. In non-insulin-dependent
diabetes, the derangement involves
resistance of target tissue to insulin action
10

11. • Severe periodontal disease often coexists
with severe diabetes mellitus. Diabetes is
a risk factor for severe periodontal
disease. The converse possibility that
periodontal disease either predisposes or
exacerbates the diabetic condition has
received more and more attention
11

12. • Recently, a new model was presented by
Grossi and Genco, in which severe
periodontal disease increases the severity
of diabetes mellitus and complicates
metabolic control
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