Potential Link: Study Connects Periodontal Disease to Liver Damage


 A study presented at the 2017 International Liver Congress in Amsterdam has linked severe cases of periodontitis to cirrhosis of the liver. The study was made up of 184 cirrhosis patients who were tracked for an average of one year to look for causes of cirrohosis, which leaves the liver permanently scarred. Patients in the study were given health assessments, include oral health exams.

Forty-four percent of the study’s participants had severe periodontitis when the study began. Periodontitis is the infection of the tissues around the tooth and the structures that connect the tooth to the jaw.


Patients with periodontitis experience bleeding gums, loose teeth, chronic bad breath, and swelling and redness around the gums. Periodontitis also causes the gums to develop pockets around the tooth that harbor bacteria.

Periodontitis occurs most frequently in patients as a direct result of poor oral hygiene. It begins as gingivitis, a reversible condition caused by dental plaque buildup, in which the gums become irritated and inflamed. Dental plaque contains illness-causing bacteria.

Other causes of periodontitis include the use of certain medications, diabetes and drug use. Pregnant women are also at risk of developing periodontal disease as a result of changes in estrogen levels.

Statistics from the Centers for Disease Control estimate that over 47 percent of the American population over the age of 30 has periodontitis. Over 35 percent of Europeans have the condition.

If gingivitis is not treated and left to progress to periodontitis, patients are at risk of losing both teeth and gum tissue, and face serious health risks, like cirrhosis. Other health concerns include cardiac and pulmonary complications.


The bacteria that cause periodontitis increases the level of inflammation in the body, and dental health researchers believe that this inflammation causes the liver to become damaged, and ultimately fail. Cirrhosis has no cure, and treatments for the condition range from switching to a low sodium diet to surgically-placed shunts to allow the liver to work properly.

Some cirrhosis sufferers require a liver transplant. Earlier researcher has shown that periodontitis may cause complications for liver transplant patients.

Symptoms of cirrhosis include pain, digestive issues, water retention, fatigue, yellowing of the skin or eyes and dark urine. Other indications of the condition include shortness of breath, swelling of the lower extremities and sudden weight gain or weight loss.

Researchers leading the study believe that the constant presence of bacteria in the mouth increases an individual’s risk of developing cirrhosis. They hope their findings encourage more research to successfully treat periodontitis.


Current treatments for periodontitis include antibiotics and below the gum line cleanings known as scaling and root planning. These treatments physically remove calcified plaque, known as tartar or calculus, and pockets of infection from below the gum line.

“Below the gum line cleaning and scaling in combination with oral antibiotics and antibiotic mouth rinses is the current standard protocol for the treatment of periodontitis,” Dr. James Erpenbach, D.D.S., said.

Erpenbach is a Knoxville,Tennessee, dentist at Jim Erpenbach DDS. He is also one of the founders of the American Academy of Oral-Systemic Health, an organization that believes that the health of the mouth and the health of the body are related. The AAOSH believes the impact of periodontal disease on the body is significant.

“The inflammation that periodontitis causes in the body wreaks havoc on the entire body’s system – from the heart to the joints,” Erpenbach said.

After the scaling and root planing procedure, Erpenbach encourages patients to adopt an oral health care routine that includes brushing at least twice per day and flossing at least once per day.

“Practicing good oral hygiene techniques is always important, but it is especially important for patients who just had deep cleanings in order to prevent reinfection and further damage,” Erpenbach said.


Dental Tribune. “Periodontitis linked to higher mortality rate of cirrhosis patients.” 4 May 2017

Center for Disease Control. Periodontal Disease: What is Periodontal Disease. 10 March 2015