Periodontitis and Metabolic Dysfunction-Associated Steatotic Liver Disease: emphasizing the clinical interplay between hepatologists and dentists

Abstract

This narrative review aims to elucidate the connection between periodontitis and Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), which is currently the most prevalent liver disease. By raising awareness of this link, healthcare providers can enhance their knowledge of the relationship between oral health and liver disease, offering valuable guidance to patients seeking advice from medical and dental professionals. A comprehensive search strategy was implemented to gather relevant literature from various databases, including PubMed, Scopus, and Web of Science. Keywords and controlled vocabulary terms related to MASLD, periodontitis, and their potential connections were used. Emphasis was placed on recent publications to incorporate up-to-date research findings. Various types of studies, such as primary research, systematic reviews, meta-analyses, guidelines, consensus statements, and expert opinions, were considered. The selection of studies focused on understanding the association between MASLD and periodontitis, as well as the underlying mechanisms. Special attention was given to studies exploring the oral–gut–liver axis and the pathogenic links between MASLD and periodontitis. Recent research suggests a possible connection between MASLD and periodontitis, as both conditions share common risk factors such as obesity, insulin resistance, and inflammation. Chronic inflammation associated with periodontitis may contribute to the progression of MASLD by promoting insulin resistance and systemic inflammation. The oral microbiome, which plays a crucial role in periodontitis development, may also influence MASLD pathogenesis. Dysbiosis in the oral microbiome can lead to the translocation of oral bacteria into the bloodstream, triggering systemic inflammation and potentially worsening liver damage in individuals with MASLD. Improving periodontal health can impact the progression of MASLD/MAFLD and enhance patient outcomes. Collaborative care models that integrate dental and medical expertise are crucial for optimal health outcomes in individuals with both conditions.