Bilateral relation between periodontal and systemic disease

1. Impact of periodontal infection on systemic health
Prof( Dr) Vivek kr Sharma
Part-II
1

2. OSTEOPOROSIS
2

3. OSTEOPOROSIS
•A disease that causes bones to lone
and break easily.
•Osteoporosis means porous bone.
3

4. Osteoporosis and periodontitis are both diseases characterized
by bone resorption.
Osteoporosis features systemic degenerative bone loss that leads to loss of
skeletal cancellous microstructure and subsequent fracture,
whereas,
Periodontitis involves local inflammatory bone loss, following an
infectious breach of the alveolar cortical bone, and it may result in tooth loss.
4

5. Multiple shared risk factors
age, genetics, hormonal change, smoking, as
well as calcium and vitamin D deficiency.
Both diseases could also be risk factors for each other and
have a mutual impact that requires concomitant
management.
5

6. Osteoporosis is a systemic bone-resorbing disease affecting mostly cancellous
bone, whereas periodontal disease involves a local infection of the
periodontium that first attacks the cortical bone and results in a dimensional
change of the alveolar ridge.
Since there is a strong association between systematic and local
osteoporotic changes in the jaw , osteoporosis of the alveolar bone may
constitute a “weakened resistance” of the periodontium to infectious
challenge
6

7. How does osteoporosis affect periodontium
Tooth loss
Less resistance to
periodontal disease
Weaker alveolar
bone
Resorption of the alveolar bone may influence clinical periodontal parameters, such as tooth loss, probing
depth (PD), or clinical attachment loss (CAL)
7

8. Suggested mechanisms underlying the linkage are disruption of the
homeostasis concerning bone remodeling, hormonal balance, and
inflammation resolution
8

9. 9

10. Periodontitis
&
Coronary Heart Disease /Artherosclerosis
10

11. 11

12. 12

13. 13

14. 14

15. 15

16. The degree of chronic inflammation in the oral
cavity during periodontitis is sufficient to induce
systemic inflammatory reactions by stimulation of
humoral and cell-mediated pathways
16

17. 17

18. 18

19. 19

20. Periodontal infection
&
STRESS/DEPRESSION
20

21. Stress is an equated response to constant adverse stimuli. At one point or another everybody
suffers from stress.
Stress is compatible with good health, being necessary to cope with the challenges of
everyday life.
Problems start when the stress response is inappropriate to the intensity of the
challenge.
Psychological stress can down regulate the cellular immune response.
** Communication between the central nervous system and the immune system
occurs via a complex network of bidirectional signals linking the nervous,
endocrine, and immune systems. Stress disrupts the homeostasis of this network,
which in turn, alters immune function
21

22. Periodontal disease and depression are sharing common risk factors within the context of the wider socio-
environmental milieu and adopting a collaborative approach (e.g., the common risk factor approach) is more
rational than one that is disease specific
The prevalence and severity of both periodontitis and depression, are associated with several social
determinants such as older age, low socioeconomic status, low socioeconomic status, and ethnicity
Unhealthy lifestyles, such as smoking and alcohol consumption have been shown to be risk factors
for periodontal disease , and also for depression
Moreover, scientific reports have shown that poor diet and a lack of exercise contribute to the
genesis and course of depression (Jacka and Berk, 2012) and are associated with a higher periodontitis
prevalence
22

23. STRESS
• Studies to date suggest
that
stress, distress, and
inadequate
coping are risk indicators
for
periodontal disease.
23

24. 24

25. 25

26. Inflammation is likely to be a general risk factor that makes mental illness more
likely: it is found at significantly higher levels on average in people with any
mental illness.
26
The specific condition triggered—depression or anxiety or other—is determined by other factors such as life events and their
timing, or genetics or preexisting tendencies. Thus it is possible to be generally inflamed, but mentally healthy, if someone is
psychologically resilient

27. Secondly, taking DEPRESSION as an example, only about one third to a half of
people with depression have raised inflammation levels, so inflammation cannot be "the
cause" of depression (or anything else). At most, inflammation might be the cause of some
depression, or a cause in combination with other factors for some depression.
However, it is now clear that inflammation can play a
direct role in the development of mental illness, so there is
a two-way relationship
27

28. 28

29. GOOD ORAL HEALTH
MEANS GOOD
SYSTEMIC HEALTH
29