What is the overall systemic response to periodontal disease?
What is the overall systemic response to periodontal disease? Data from human medicine connect the severity of periodontal disease to increased levels of circulating inflammatory mediators and acute-phase proteins, as well as to atherosclerosis, myocardial infarction, and diabetes mellitus. A study conducted at the University of Pennsylvania aimed to evaluate the influence of periodontal disease on organ health and systemic inflammation in dogs.
Thirty-eight healthy client-owned male and female dogs of varying breeds and sizes with mild to severe periodontal disease were included in this study. The results of a physical examination, serum chemistry profile, complete blood count, urine evaluation, serum C-reactive protein concentration measurement, and microalbuminuria test were analyzed before treatment and again at a 30-day follow-up examination.
The dogs were anesthetized, and gingivitis and attachment loss were evaluated for each tooth. A total mouth periodontal score was also assigned. This scoring system accounts for differences in body size and tooth surface area to better equate dogs of different sizes with similar dental health. Next, a thorough oral examination was completed, including intraoral dental radiography when indicated, and appropriate treatments were performed based on the severity of oral disease and individual patient needs.
Correlations were found between attachment loss and platelet number as well as C-reactive protein concentrations before and after treatment. Furthermore, a decreased C-reactive protein concentration after treatment was associated with the severity of periodontal disease. Surprisingly, BUN concentrations were significantly higher after treatment. None of the variables were affected by the use of antimicrobials or the duration of anesthesia.
Some of the expected connections were not seen in the results of this study. Changes in the four systemic subsets evaluated-inflammation, renal function, liver function, and blood glucose-electrolytes-were for the most part unremarkable after applying corrections. The unexpected increase in BUN concentrations after treatment may be attributable to an increase in protein intake with the alleviation of oral pain.
The authors conclude that the study revealed associations between periodontal disease severity and systemic inflammation and that broader, longer-term studies are needed to better understand the effects of this inflammatory disease on systemic health in dogs.
Rawlinson JE, Goldstein RE, Reiter AM, et al. Association of periodontal disease with systemic health indices in dogs and the systemic response to treatment of periodontal disease. J Am Vet Med Assoc 2011;238(5):601-609.
Link to abstract of article: http://avmajournals.avma.org/doi/abs/10.2460/javma.238.5.601