The Relationship Between Fatty Liver Disease and Periodontal Disease

Objectives: Periodontitis is a highly prevalent and destructive chronic disease. Numerous studies support an association between periodontal disease and other systemic diseases (diabetes, cardiovascular disease, chronic kidney disease, adverse pregnancy outcome, etc). Non-alcoholic fatty liver disease (NAFLD) is a chronic inflammatory disease that has yet to be investigated in association with periodontal disease. A reasonable mechanism in which periodontal disease may play a role in the destruction seen in NAFLD is the remote site infection of periodontal disease and the systemic release of bacterial byproducts following chewing and oral hygiene measures, which may lead to additional systemic inflammatory response. The purpose of this cross-sectional study is to investigate the relationship between periodontal disease and NAFLD.
Methods: Patients diagnosed with varying stages of NAFLD (via liver biopsy) were recruited for this study. All patients had full mouth periodontal examinations (6 sites/tooth) performed by a single calibrated examiner. Clinical measurements included probing depth (PD), clinical attachment level (CAL), bleeding index (BI), and plaque index (PI). Periodontal disease was diagnosed using the CDC-AAP criteria. Percentage of sites with PD ≥5mm and percentage of sites with CAL ≥3mm were used to determine extent of periodontal disease and full mouth mean PD and mean CAL were used to determine severity.
Results: Using preliminary data from 52 patients, no statistical relationship between NAFLD and periodontal disease severity and extent is seen. The current group of subjects is skewed to a less severe liver disease diagnosis, and this may contribute to the discrepancy.
Conclusions: Although systemic links exist to explain a possible association between periodontal disease and NAFLD, these preliminary findings suggest that there may be no association between these two diseases.