Patients with diabetes and cardiovascular conditions experienced more than double the risk of severe gum disease, and even stronger links were seen in those with dementia and HIV. The large U.S. study was published in the Journal of Periodontology.
This study not only reinforces the importance of oral health as a part of overall health but also the need for doctors and dentists to collaborate when managing patients with chronic diseases, the authors wrote.
“Overall, this study emphasizes that periodontitis escalating severity may serve as a valuable clinical marker for heightened comorbid disease risk,” wrote the authors, led by Dr. Muhammad H. A. Saleh of the University of Michigan School of Dentistry in Ann Arbor, MI (J Periodontol, August 8, 2025).
To explore potential correlations between gum disease and multiple systemic conditions, including diabetes, cardiovascular disease, and HIV, and whether they increase the severity of periodontitis, a cross-sectional analysis was conducted using an electronic health record repository from nine U.S. dental schools. It included 264,913 adults receiving periodontal therapy between 2013 and 2023. Of those, 98,706 had gum disease.
Periodontitis severity was determined, and associations with 24 systemic conditions were evaluated using weighted uni- and multivariate multinomial logistic regressions, according to the study.
Overall, the study demonstrated that as the severity of gum disease rises, the correlations with systemic diseases become more pronounced, the authors wrote.
For instance, diabetes showed odds ratios of 2.20 (mild/moderate) versus 5.59 (severe). The odds ratios for cardiovascular disease were 1.53 versus 2.21, HIV was 2.25 versus 4.07, and Alzheimer's disease was 1.84 versus 3.20, Saleh and co-author Dr. Hamoun Sabri of the University of Michigan wrote.
Nevertheless, the study had limitations, including that the reliance on treatment codes was used as a proxy for the severity of clinical diagnoses, the authors wrote.
Though the findings could not determine a causal relationship, they shine a light on a pattern that individuals with systemic conditions may be more likely to have more serious gum problems, they wrote.
“The results of this population-based study demonstrate that as periodontitis severity escalates, positive and negative associations with systemic conditions become more pronounced,” Saleh and Sabri wrote.
