How Is Oral Health Linked To Liver Disease?

What does research say?

As part of a study published in United European Gastroenterology Journal, the researchers have examined 184 cirrhosis patients and found that 44% of these patients have periodontitis, a dental condition characterized by severe gum infection and inflammation. This significantly exceeds the average periodontitis prevalence of 10-15% in general population. The study has also revealed that periodontitis is linked to higher mortality in cirrhosis patients.

A study titled “Periodontal therapy favorably modulates the oral-gut-hepatic axis in cirrhosis” has revealed that periodontal therapy in cirrhosis patients improves systemic inflammation, oral and gut dysbiosis, cognitive function, and quality of life in general.

How is periodontitis linked to liver disease?

Periodontitis is a chronic gum disease caused by infection. Periodontitis causes severe inflammation that damages the gum which can lead to tooth loss.

According to the CDC, 47% of adults 30 years and older are affected by periodontitis and 70% of people aged 65 years and older have periodontal disease, seen as periodontitis is progressing with age.

But what does periodontitis have to do with liver disease and specifically cirrhosis? Advanced liver disease such as cirrhosis is usually characterized by severe liver inflammation and scaring. This can increase inflammation levels throughout the body, weaken immune system, cause hepatic encephalopathy (an accumulation of toxins in the brain due the sick liver´s inability to process harmful substances as efficiently as before) and infections. Periodontitis becomes an additional source of infection and inflammation in the body and can lead to severe cirrhosis complications.

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What can you do about it?

Periodontitis is usually caused by bacterial plaque which is why it is extremely important to maintain dental hygiene, regularly clean your teeth, and do not skip appointments with your dentist. Periodontitis can also develop as a result of smoking, stress, diabetes, genetic factors, and hormonal changes. It is usually recommended for liver disease patients to be screened for periodontitis and vice versa.

Sources:

Ladegaard Grønkjær L, Holmstrup P, Schou S, Jepsen P, Vilstrup H. Severe periodontitis and higher cirrhosis mortality. United European Gastroenterol J. 2018;6(1):73-80. doi:10.1177/2050640617715846.

Bajaj JS, Matin P, White MB, et al. Periodontal therapy favorably modulates the oral-gut-hepatic axis in cirrhosis. Am J Physiol Gastrointest Liver Physiol. 2018;315(5):G824-G837. doi:10.1152/ajpgi.00230.2018.