Summary and Possible Future Directions

Abstract

As detailed in the preceding chapters, independent of known confounders including age, gender, and smoking, periodontitis has been significantly associated with type 2 diabetes mellitus, atherosclerosis and atherosclerotic complications, renal disease and adverse outcomes of renal hemodialysis maintenance therapy, preterm labor, some forms of pneumonia, Alzheimer’s disease, and rheumatoid arthritis. The strength of the association varies with the disease but appears to be strongest with increasing periodontitis severity. Periodontitis has also been forwarded as a cause or as a risk factor for atherosclerosis and atherosclerotic complications such as myocardial infarction, chronic renal disease, preterm labor, some forms of pneumonia, Alzheimer’s disease, and rheumatoid arthritis. In addition, the association in some cases may be bidirectional since some systemic diseases have also been reported to promote periodontal disease prevalence and severity such as diabetes mellitus and ESRD patients on hemodialysis maintenance therapy.