Periodontal disease linked to kidney function decline in Hispanic, Latino patients

Diana Macri, RDH, BSDH, MSEd

The Hispanic Community Health Study/Study of Latinos `is the first large-scale study to sample various ethnicities — representing Cuban, Dominican, Mexican, Puerto Rican, Central American and South American people — from diverse socioeconomic and acculturation backgrounds.

Investigators enrolled 16,415 participants from randomly selected households in four U.S. field centers — Bronx, NY, Chicago, Miami and San Diego — from 2008 to 2011. Comprehensive clinical examinations (which included medical, oral, behavioral and sociodemographic variables) were conducted and followed up by telephone interviews for 3 years after. Researchers used these data to conduct the observational cohort study referenced earlier, which sought to discover any connections between periodontal disease and reduced kidney function.

The findings by Stephanie M. Toth-Manikowski, MD, and colleagues indicate that specific markers of periodontal disease were associated with estimated glomerular filtration rate decline during a 6-year period.

These results supplement existing findings from a 2019 systematic review showing an increased incidence of periodontal disease in patients with CKD.

Tyrone Rodriguez

Periodontal disease, commonly known as “gum disease,” is a chronic inflammatory disease that destroys the soft and hard tissues that support and protect teeth. The prevalence of periodontal disease in the United States is highest among ethnic minorities, affecting 63.5% of Hispanic-Americans. The most severe form affects 11% of the world population, and its prevalence increases with age.

As a chronic inflammatory disease, its progression and severity is dependent on a variety of factors including genetics, age, behaviors (tobacco smoking, oral hygiene habits), stress, medications, obesity and nutrition. Healthy People 2030 lists oral health as one of the 23 leading health indicators, although many fail to recognize the importance of oral health and its impact on overall health and quality of life.

Chronic inflammatory diseases are the most significant cause of death in the world and the greatest threat to human health. Clearly, it is of vital importance to prevent periodontitis by educating the public and providing access to care for all.

Periodontal disease is preventable, and the Hispanic Dental Association (HDA) has long advocated for the funding of public programs that provide education and access to care to underserved populations — those who need it most.

Although this research furthers our understanding of periodontitis and overall systemic health, additional research (especially randomized control trials) is necessary in order to form more direct links between periodontitis and systemic, including, but not limited to, diabetes, cardiovascular disease, neurological disorders and mental health disorders.

Currently, the HDA is planning the creation of an institutional review board to provide opportunities for researchers to examine and discover the links between oral health and systemic health in Hispanic populations.

References:

Beck JD, et al. J Clin Periodontol. 2015;doi:10.1902/jop.2015.140520.

Deschamps‐Lenhardt S, et al. Oral Dis. 2019:doi:10.1111/odi.12834.

Eke PI, et al. Gum disease risk factors. American Academy of Periodontology.

www.perio.org/consumer/gum-disease-risk-factors

U.S. Department of Health and Human Services. Office of Disease Prevention and Health Promotion. Healthy People 2030. https://health.gov/healthypeople/objectives-and-data/browse-objectives/oral-conditions/evidence-based-resources

Furman D, et al. Nat Med. 2019:doi:10.1038/s41591-019-0675-0.

Disclosures: Macri and Rodriguez report no relevant financial disclosures.