Why Periodontal Disease Treatment Should Be Part of Every Chronic Disease Treatment Plan

***Original Article Appeared At Dentaltown.com***

For decades, dentistry and medicine have existed in separate compartments, but growing evidence makes one thing clear: oral health is systemic health. At the center of this evolving conversation is inflammation—a shared driver of chronic diseases such as diabetes, cardiovascular disease, rheumatoid arthritis, and Alzheimer’s.

Periodontal disease, often overlooked, is a significant source of inflammation in the body. Its prevalence and impact on systemic conditions underscore its critical role in interdisciplinary care, demanding immediate attention and action.

“As dentists, we are often the first to identify chronic inflammation in the body,” emphasizes Dr. Marielaina Perrone, DDS, a general and cosmetic dentist practicing in Henderson, NV. “Periodontal disease is not just about the gums—it provides a crucial insight into a patient’s overall inflammatory burden, highlighting our integral role in the healthcare system.”

Understanding the Oral-Systemic Inflammation Pathway

Periodontitis is a chronic inflammatory condition initiated by dysbiosis in the oral microbiome. As pathogenic bacteria like P. gingivalis and T. forsythia colonize the gingival sulcus, they trigger an immune response that leads to:          

• Destruction of connective tissue         

• Loss of alveolar bone         

• Systemic release of pro-inflammatory cytokines, including IL-6, TNF-a, and CRP

These mediators do not stay confined to the oral cavity. Instead, they enter the bloodstream, amplifying systemic inflammation and potentially accelerating the pathogenesis of comorbid conditions.

“We now understand that untreated gum disease may worsen blood sugar control in diabetics and contribute to endothelial dysfunction in heart disease,” Marielaina Perrone, DDS explains. “The oral cavity is not isolated—part of a whole-body system.”

The Case for Integration: Chronic Conditions Affected by Periodontal Disease

Diabetes Mellitus

There is a bidirectional relationship between periodontitis and diabetes. Poor glycemic control increases periodontal breakdown, while advanced periodontal disease impairs insulin sensitivity.

Cardiovascular Disease

Studies show a correlation between periodontitis and increased risk of atherosclerosis, stroke, and myocardial infarction. Bacteremia and systemic inflammation are key contributors.

Neurodegenerative Disorders

Oral pathogens have been identified in the brains of Alzheimer’s patients. Chronic periodontal inflammation may accelerate neuroinflammation and cognitive decline.

Adverse Pregnancy Outcomes

Elevated levels of inflammatory markers in periodontal disease have been linked to preterm birth, low birth weight, and preeclampsia.

“For medically complex patients, periodontal therapy should not be optional—it should be integrated into their disease management plan,” says Marielaina Perrone, DDS.

Implementingn Periodontal Disease Treatment as a Systemic Health Strategy

Dentists have a unique opportunity—and responsibility—to contribute meaningfully to patients' systemic health by not just treating teeth, but also managing periodontal inflammation. This proactive approach can significantly impact the overall health and well-being of their patients.

1. Early Detection & Risk Assessment

Regular periodontal charting and radiographic analysis are not just essential, but proactive measures in patient care. Medical histories should be thorough, screening for chronic inflammatory diseases, and dental professionals should be vigilant for potential oral-systemic red flags, taking a responsible approach to patient care.

2. Salivary & Biomarker Testing

Salivary diagnostics can identify pathogenic bacteria, inflammatory markers, and oral HPV. These tools allow for earlier intervention and more personalized care.

3. Non-Surgical Periodontal Therapy

Scaling and root planing, combined with antimicrobial rinses or localized antibiotics, remain the gold standard for initial treatment. Therapy should be aggressive and closely monitored for systemic-risk patients.

4. Interprofessional Collaboration

Dentists should establish communication channels with primary care providers, endocrinologists, cardiologists, and OB-GYNs to co-manage at-risk patients.

“We’re no longer working in isolation,” Dr. Perrone notes. “Referring back and forth with physicians is a smart strategy for improving outcomes on both ends.”

Educating Patients on the Inflammation Link

While dental professionals embrace the systemic implications of oral disease, many patients are unaware of the risks. Clear, digestible education at the chairside can bridge this gap and empower patients to take control of their health. When patients understand the connection between their gums and their health, they become more engaged and compliant, leading to better treatment outcomes.

Key points to share:         

• Gum disease can worsen existing chronic conditions        

• Treating inflammation in the mouth may improve systemic markers          

• Preventive care is essential even in the absence of pain or bleeding

“When patients understand the connection between their gums and their health, they become more engaged and compliant,” Dr. Perrone says. “That’s a win for everyone.”

Conclusion: Periodontal Therapy as Preventive Medicine

As the understanding of inflammation grows across medicine and dentistry, it is time to position periodontal therapy not just as a dental service but as a form of systemic disease prevention. With millions affected by chronic inflammatory conditions, dentists can play a frontline role in reducing risk, managing inflammation, and improving quality of life.

“We’re not just treating teeth—we’re treating the patient as a whole,” Dr. Perrone concludes. “And periodontal therapy is one of the most powerful tools to influence systemic health.”

About the Author

Dr. Marielaina Perrone, DDS, is an experienced general and cosmetic dentist in Green Valley, Henderson, NV. With over 20 years of clinical experience, she offers comprehensive periodontal therapy, aesthetic dentistry, and integrative oral-systemic care. Dr. Perrone is passionate about patient education and elevating the role of dental professionals in preventive medicine.