The systemic impact of periodontitis in about 100,000 patients: associations with heart diseases, cancer, and mortality

Abstract

Objectives: Periodontitis, a chronic inflammatory condition of tooth-supporting tissues, is associated with adverse systemic health outcomes, including cardiovascular disease, malignancies and premature mortality. Large-scale assessments remain limited. We analyzed real-world data of approximately 100,000 matched patients to clarify the broader health impact of periodontitis. Study design: In this retrospective study, we identified two cohorts − 47,498 patients each with and without periodontitis (ICD-10-CM: K05.6) - from the TriNetX database, matched by age and gender. We evaluated outcomes over 19 years, including heart inflammations, heart disease, head and neck cancer, C-reactive protein (CRP) levels and overall mortality. Propensity score matching, risk analyses and Kaplan–Meier survival statistics were employed. Results: Compared to controls, patients with periodontitis exhibited higher risks of heart inflammations (OR: 3.06; 95% CI: 2.79–3.35), heart disease (OR: 2.40; 95% CI: 2.33–2.47), overall cancer (OR: 1.64; 95% CI: 1.58–1.71), head and neck cancer (OR: 1.60; 95% CI: 1.31–1.96) and premature mortality (OR: 1.42; 95% CI: 1.36–1.48). Median CRP levels were higher in the periodontitis group (39.30 vs. 35.79; p < 0.001). Conclusion: Periodontitis is associated with significantly increased adverse systemic health outcomes and higher mortality. Clinical relevance: These findings underscore the importance of preventive oral care and enhanced patient surveillance.