Severe gum disease strongly predicts higher mortality in cirrhosis

Posted on: 24th April 2017

EUROPEAN ASSOCIATION FOR THE STUDY OF THE LIVER, April 20, 2017, Amsterdam, The Netherlands:

Results presented today from a prospective study in patients with irreversible scarring of the liver (cirrhosis) demonstrates that severe periodontitis (an inflammatory gum disease) strongly predicts higher mortality in this population, after adjustments for various risk factors. The study was presented at The International Liver Congress™ 2017 in Amsterdam, The Netherlands.

Andrew Langford, Chief Executive of the British Liver Trust, said

“We know that more than 40 people die in the UK every day from liver disease. This is an interesting study that suggests that there is an association between gum disease and the risk of death in patients with liver disease.

What is needed now is further research into the reasons for this correlation and the implications that this might have for patient care.  It raises a number of questions such as whether the aggravation of the gum disease is related to increasing neglect of the teeth and poor dental hygiene as the cirrhotic condition worsens,  or whether improving dental and gum care can improve patient outcomes. Liver disease has seen a huge historical underinvestment in research funding compared with other conditions and this needs to change so that studies such as this offer real options in the future for patient care.”

In Europe, cirrhosis is responsible for 1-2% of all deaths and is the leading cause of liver transplantation. Periodontitis is a bacterially induced inflammatory disease that affects the supporting tissues of the teeth, characterised by the deepening of periodontal pockets due to loss of connective tissue attachment and bone. Untreated, periodontitis may result in tooth loss. Periodontitis is prevalent in the adult population, with over 35% having periodontitis and 10-15% having severe forms of the disease. Several studies have assessed the association between periodontitis and cardiovascular diseases, cirrhosis, chronic kidney disease, diabetes mellitus, and respiratory diseases, and an increasing number of studies have suggested that periodontitis may affect the course of systemic diseases. Poor oral health and periodontitis are very frequent in patients with cirrhosis. In addition, studies have suggested that periodontitis is involved in the progression of liver diseases, and that it has a negative impact on the clinical course after liver transplantation.6,7

Lea Ladegaard Grønkjaer, PhD, RN, Aarhus University Hospital, Denmark, and lead author of the study said "Our study showed that severe periodontitis strongly predicted higher mortality in cirrhosis. Periodontitis may act as a persistent source of oral bacterial translocation, causing inflammation and increasing cirrhosis complications. As it can be treated successfully, however, we hope that our findings motivate more trials on this subject."

To view abstract click here