Oxidative Stress and Periodontal Disease

The link between periodontal disease and systemic disease has been clarified, and we are still uncovering new relationships that confirm he importance of maintaining periodontal health. For example inadequately controlled moderate to severe periodontal disease increases the systemic inflammatory load on our bodies. This increased inflammatory load may increase our risk of cardiovascular disease. It has been shown that patient’s who are diagnosed with periodontal disease in their early adult years have a four-fold risk of developing Alzheimer’s disease. There has also been a positive link confirmed between periodontal disease and obesity, as well as the known link with Diabetes.  Active period therapy decreases the amount of systemic inflammatory cytokines, which are directly related to insulin resistance and stabilizing blood sugar in diabetic patients. This is important information that we can share with our patients, to help them understand the whole body value of a healthy periodontium.

Research has shown that the pathogenesis of periodontal disease includes oxidative tissue damage. At the cellular level we know that there is an increase in the amount of reactive oxygen species as a feature of active periodontal disease. These reactive oxygen species and our bodies’ decreased ability to manage them lead to oxidative stress and ultimately tissue damage. Multiple studies have shown a reduced quantity of anti-oxidants in the gingival crevicular fluid and gingival tissues in patients with active periodontal disease. Additionally perio patients have been shown to have lower antioxidant levels in their saliva. The amount of reactive oxygen species is decreased as a consequence of traditional non-surgical therapy for periodontal disease. Therefore not only is the causative agent reduced but also our bodies ability to heal and repair is increased. In addition to periodontal disease, this link has been shown with radiation induced Xerostomia, oral Lichen Planus, adhesion and fibrosis in the temporormandibular joint, and tissue damage from oral tobacco use. Additionally the quantity of reactive oxygen species present in the cells is also increased by environmental factors that include bleaching agents, dental cements, dental composite and dental implants.