Cardiometabolic risk factors and periodontitis: association and preventive and therapeutic implications

Periodontitis has been linked to several systemic diseases, most notably diabetes, for which a clear two-way association has been established. However, whether periodontitis is associated with other metabolic conditions, such as metabolic syndrome (MetS), or with other pre-diabetic hyperglycemic states, such as prediabetes, remains questionable. There is scarce evidence from intervention studies to elucidate if periodontal treatment could reduce the cardiovascular risk in patients with MetS. Furthermore, given the relationship between periodontitis and glycemic control, early detection of both conditions could have a positive impact on their prevention and management. Objectives: The general objective was to evaluate the association between periodontitis and DM and MetS, and in light of this association, to evaluate the positive global synergistic effects of preventive and/or therapeutic strategies aimed at their early diagnosis or management of these diseases. The specific objectives were: (i) to study the association between periodontitis, hyperglycemia (prediabetes and diabetes mellitus) and MetS in a representative sample of the Spanish employed population (Studies #1 and #2); (ii) to determine whether the treatment of periodontitis in patients with MetS could reduce their cardiometabolic risk (Study #3); to develop and validate a predictive model for moderate-to-severe periodontitis using a combination of cardio‐metabolic and socio‐demographic variables (Study #4); to evaluate the efficacy of different protocols for the detection of undiagnosed diabetes or prediabetes in a network of dental clinics (Study #5)..