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Interaction of lifestyle, behaviour or systemic diseases with dental caries and periodontal diseases: consensus report of group 2 of the joint EFP / ORCA workshop on the boundaries between caries and periodontal diseases
Open accessAbstract
Periodontal diseases and dental caries are the most common diseases of humans and the main cause of tooth loss. Both diseases can lead to nutritional compromise and negative impacts upon self-esteem and quality of life. As complex chronic diseases, they share common risk factors, such as a requirement for a pathogenic plaque biofilm, yet they exhibit distinct pathophysiologies. Multiple exposures contribute to their causal pathways, and susceptibility involves risk factors that are inherited (e.g. genetic variants), and those that are acquired (e.g. socio-economic factors, biofilm load or composition, smoking, carbohydrate intake). Identification of these factors is crucial in the prevention of both diseases as well as in their management. AIM: To systematically appraise the scientific literature to identify potential risk factors for caries and periodontal diseases. METHODS: One systematic review (genetic risk factors), one narrative review (role of diet and nutrition) and reference documentation for modifiable acquired risk factors common to both disease groups, formed the basis of the report. RESULTS & CONCLUSIONS: There is moderately strong evidence for a genetic contribution to periodontal diseases and caries susceptibility, with an attributable risk estimated to be up to 50%. The genetics literature for periodontal disease is more substantial than for caries and genes associated with chronic periodontitis are the vitamin D receptor (VDR), Fc gamma receptor IIA (Fc-γRIIA) and Interleukin 10 (IL10) genes. For caries, genes involved in enamel formation (AMELX, AMBN, ENAM, TUFT, MMP20, and KLK4), salivary characteristics (AQP5), immune regulation and dietary preferences had the largest impact. No common genetic variants were found. Fermentable carbohydrates (sugars and starches) were the most relevant common dietary risk factor for both diseases, but associated mechanisms differed. In caries, the fermentation process leads to acid production and the generation of biofilm components such as Glucans. In periodontitis, glycaemia drives oxidative stress and advanced glycation end-products may also trigger a hyper inflammatory state. Micronutrient deficiencies, such as for vitamin C, vitamin D or vitamin B12, may be related to the onset and progression of both diseases. Functional foods or probiotics could be helpful in caries prevention and periodontal disease management, although evidence is limited and biological mechanisms not fully elucidated. Hyposalivation, rheumatoid arthritis, smoking/tobacco use, undiagnosed or sub-optimally controlled diabetes and obesity are common acquired risk factors for both caries and periodontal diseases.
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“A seminary investigation has indicated that refined carbohydrates are a risk factor for both caries and periodontal disease. [78].”
From A Cross-Talk between Diet and the Oral Microbiome: Balance of Nutrition on Inflammation and Immune System’s Response during Periodontitis (2022) · cites this paper as [78]
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Metadata
- Authors
- Chapple, I. L. C., Bouchard, P., Cagetti, M. G., Campus, G., Carra, M., Cocco, F., Nibali, L., Hujoel, P., Laine, M. L., Lingström, P., Manton, D. J., Montero, E., Pitts, N., Rangé, H., Schlueter, N., Teughels, W., Twetman, S., Van Loveren, C., Van der Weijden, F., Vieira, A. R., & Schulte, A. G.
- Affiliations
- University of Birmingham (GB)
- Hôpital Rothschild (FR)
- World Health Organization - Italy (IT)
- University of Sassari (IT)
- Inserm (FR)
- Queen Mary University of London (GB)
- University of Washington (US)
- Academic Center for Dentistry Amsterdam (NL)
- Department of Cariology Institute of Odontology Gothenburg Sweden
- The University of Melbourne (AU)
- Universidad Complutense de Madrid (ES)
- King's College London (GB)
- University of Freiburg (DE)
- KU Leuven (BE)
- University of Copenhagen (DK)
- Department of Cariology Academic Centre for Dentistry Amsterdam Amsterdam the Netherlands
- Department of Periodontology Academic Centre for Dentistry in Amsterdam Amsterdam the Netherlands
- University of Pittsburgh (US)
- Witten/Herdecke University (DE)
- Corresponding author
- Chapple, Iain L.C.
- ORCID
- Chapple, Iain L.C.
- Bouchard, Philippe
- Cagetti, Maria Grazia
- Campus, Guglielmo
- Carra, Maria‐Clotilde
- Cocco, Fabio
- Nibali, Luigi
- Hujoel, Philippe
- Laine, Marja L.
- Lingström, Peter
- Manton, David J.
- Montero, Eduardo
- Pitts, Nigel
- Rangé, Hélène
- Schlueter, Nadine
- Teughels, Wim
- Twetman, Svante
- Vieira, Alexandre R.
- Schulte, Andreas G.
- Venue
- Journal Of Clinical Periodontology
- Publisher
- Wiley
- Published
- 2017-03
- Volume
- 44
- Issue
- S18
- Pages
- S39-S51
- ISSN
- 0303-6979 (ISSN-L)
- 1600-051X
- OpenAlex
- W2593228368
- Cited by
- 488
- References
- 96
- Citations by year
- 2026: 38 · 2025: 51 · 2024: 62 · 2023: 67 · 2022: 70 · 2021: 73 · 2020: 49 · 2019: 32 · 2018: 33 · 2017: 12
- FWCI
- 47.54
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal Of Clinical Periodontology (publishedVersion)
- PubMed (publishedVersion)
- UvA-DARE (University of Amsterdam) (publishedVersion)
- Lirias (KU Leuven) (submittedVersion, other-oa)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
- UnissResearch (Università degli Studi di Sassari) (submittedVersion)
- Minerva Access (University of Melbourne) (submittedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- University of Birmingham Research Portal (University of Birmingham) (submittedVersion, other-oa)
- Queen Mary Research Online (Queen Mary University of London) (submittedVersion)
- VU Research Portal (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- Colgate Palmolive
- Topics
- Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
- Health Sciences › Dentistry › General Dentistry › Dental Health and Care Utilization
- Health Sciences › Dentistry › General Dentistry › Oral Health Pathology and Treatment
- Keywords
- dental caries, periodontal disease, chronic periodontitis, genetic risk factors, dietary risk factors, fermentable carbohydrates, micronutrient deficiency, saliva, dental plaque, vitamin D receptor, FCGR2A, IL-10, probiotics, functional foods, rheumatoid arthritis, hyposalivation, smoking, tooth loss, dental caries prevention
- MeSH terms
- Dental Caries, Humans, Life Style, Periodontal Diseases, Risk Factors, Health Behavior
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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