The Association of Periodontal Disease and Systemic Conditions among Filipino Patients in a University Dental Clinic: A Retrospective Case-control Study

Abstract

Background and Objective. A growing body of evidence points to a positive association between periodontitis and various systemic diseases, including cardiovascular diseases (CVD), hypertension, and rheumatoid arthritis. However, there is limited data on the prevalence and odds of having systemic conditions among Filipino periodontal patients. Thus, this study aimed to determine the association of periodontal disease with systemic conditions among Filipino patients at a university dental clinic. 

Methods. The periodontal and medical charts of all patients who underwent periodontal consult at a university dental clinic within two academic years were reviewed. Periodontal diagnoses which had originally been assigned using the 1999 classification of periodontal diseases were reclassified based on the 2018 European Federation of Periodontology-American Academy of Periodontology classification. Listed medical conditions in the patients’ charts were self-reported. The prevalence of various systemic conditions in 715 periodontitis cases was compared to that of 834 control patients without periodontitis. Fisher’s exact test was performed to evaluate the difference in the prevalence of comorbidities between groups, while adjusted odds ratios (AOR) were computed using logistic regression analysis, accounting for age, sex, educational attainment, and smoking status. 

Results. The prevalence of having at least one systemic condition was significantly higher among periodontitis patients (44.5%) compared to non-periodontitis patients (36.3%). Compared to controls, a significantly higher number of periodontitis cases had two systemic comorbidities (P=0.001). The prevalence of hypertension (18.6% versus 5.04%), CVD including hypertension (20.42% versus 6.95%), arthritis (9.37% versus 3.0%), and diabetes mellitus (5.73% versus 0.84%) were all significantly higher in patients with periodontitis compared to non-periodontitis controls. The odds of having CVD (AOR=1.81), hypertension (AOR=2.14) and diabetes (AOR=3.05) were higher in periodontitis cases. Meanwhile, the prevalence of asthma (9.23% versus 5.31%), respiratory diseases including asthma (12.95% versus 8.25%), and allergies (18.82% versus 13.71%) were significantly higher in non-periodontitis patients compared to periodontitis cases.

Conclusion. Periodontitis patients were more likely to present with CVD, hypertension, and diabetes mellitus. On the other hand, no association was found between periodontitis and respiratory diseases, as well as between periodontitis and asthma.