18 February 2023

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The relationship between liver inflammation and periodontitis

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The study, titled "High prevalence of periodontal disease in patients with NASH-possible association of poor dental health with NASH severity," was published online Jan. 23, 2023, in the journal Annals of Hepatology. Researchers from the departments of medicine, periodontics, preventive and restorative dentistry at the University Medical Center Hamburg-Eppendor and the German Infection Research Center investigated the association in a well-defined cohort.

Among the findings, liver stiffness was found to increase with the severity of periodontitis. This finding also positively correlated with key markers of increasing periodontitis, such as probing bleeding and probing bag depth. The researchers suggest that the results indicate that patients need to be reminded of the importance of regular visits to the dentist.

Data from 132 patients (32 of them with NASH) were examined for detailed periodontal parameters and correlated with relevant liver parameters such as liver stiffness. The researchers found that 87.5% of NASH patients, compared to 47% of the control group, had moderate and severe periodontitis. Hepatic stiffness was significantly correlated with elevated bag probing depths and bleeding on probing.

In addition, 34% of the NASH patients examined did not receive regular dental care. In these patients, alanine transaminase (ALT), the end-stage liver disease model, and liver stiffness were significantly higher than in those who visited the dentist regularly.

Dr Sulaman Anwar, a periodontist and implant surgeon from the U.K., said the relationship between periodontitis and systemic health has been thoroughly researched and is constantly updated.

"There is already a confirmed relationship between a patient's diabetic status and their periodontal health," he said. "There is also strong evidence linking obesity and periodontitis. This recently published pilot study focuses on the liver and highlights an association between nonalcoholic steatohepatitis and periodontitis."

Based on the study, researchers said regular dental care utilization might mitigate the course of NASH, and patients should be reminded by their hepatologists of the importance of regular dental visits. Future studies should investigate the role of regular dental care and additional anti-inflammatory treatments of the oral cavity.

This article was originally published in Odontologia33.