2024 Volume 67 Issue 1 Pages 10-19
There are two pathways by which periodontal disease affects systemic health: local periodontal lesion-derived bacteria, inflammatory cytokines and mediators that affect distant tissues via systemic circulation and the gastrointestinal tract; and periodontal disease-derived tooth upset and loss, poor eating habits with reduced chewing ability due to occlusal pain, and nutritional status. This review examines whether the restoration of chewing function by periodontal treatment contributes to glycemic control and other whole-body health. We conducted a philological study with a particular focus on dietary habits and nutritional improvement. Regarding the relationship between chewing ability and glycemic control in patients with periodontal disease, it is considered that periodontal disease improvement is important for systemic health, including glycemic control by improving chewing function by periodontal treatment, although there is currently little evidence. Regarding eating habits and nutrition as risk factors for periodontal disease, inappropriate dietary intake associated with deterioration of chewing function, i. e., deterioration of dietary balance and eating habits, promotes gingival inflammation and dysbiosis of oral flora, suggesting that periodontal disease is a risk factor. On the other hand, intake of anti-inflammatory foods has been shown to reduce periodontal tissue inflammation regardless of plaque adhesion or the presence or absence of oral cleaning, and anti-inflammatory healthy eating patterns may enhance the effectiveness of standard oral cleaning and periodontal treatment. In fact, a program that combines improving lifestyle eating habit and periodontal disease care in collaboration with medical and dental departments has been shown to significantly improve glycemic control along with clinical symptoms of periodontal disease. From the above, when periodontal disease is viewed from the perspective of lifestyle-related diseases, it is necessary to give guidance on dietary habits and dietary nutrition in response to the risk factors for the progression of periodontal disease. In addition, periodontal disease and diabetes have a bidirectional relationship, and dietary guidance related to improving masticatory function from both perspectives is considered reasonable from the viewpoint of disease burden.
