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Herrera D, Sanz M, Shapira L, Brotons C, Chapple I, Frese T, Graziani F, Hobbs FDR, Huck O, Hummers E, Jepsen S, Kravtchenko O, Madianos P, Molina A, Ungan M, Vilaseca J, Windak A, Vinker S. Periodontal diseases and cardiovascular diseases, diabetes, and respiratory diseases: Summary of the consensus report by the European Federation of Periodontology and WONCA Europe. Eur J Gen Pract 2024; 30:2320120. [PMID: 38511739 PMCID: PMC10962307 DOI: 10.1080/13814788.2024.2320120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 02/05/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Periodontitis is a chronic inflammatory non-communicable disease (NCD) characterised by the destruction of the tooth-supporting apparatus (periodontium), including alveolar bone, the presence of periodontal pockets, and bleeding on probing. OBJECTIVES To outline, for family doctors, the implications of the association between periodontal and systemic diseases; to explore the role of family doctors in managing periodontitis as an ubiquitous non-communicable disease (NCD). METHODS The consensus reports of previous focused collaborative workshops between WONCA Europe and the European Federation of Periodontology (using previously undertaken systematic reviews), and a specifically commissioned systematic review formed the technical papers to underpin discussions. Working groups prepared proposals independently, and the proposals were subsequently discussed and approved at plenary meetings. RESULTS Periodontitis is independently associated with cardiovascular diseases, diabetes, chronic obstructive pulmonary disease, obstructive sleep apnoea, and COVID-19 complications. Treatment of periodontitis has been associated with improvements in systemic health outcomes. The article also presents evidence gaps. Oral health care professionals (OHPs) and family doctors should collaborate in managing these conditions, including implementing strategies for early case detection of periodontitis in primary medical care centres and of systemic NCDs in oral/dental care settings. There is a need to raise awareness of periodontal diseases, their consequences, and the associated risk factors amongst family doctors. CONCLUSION Closer collaboration between OHPs and family doctors is important in the early case detection and management of NCDs like cardiovascular diseases, diabetes mellitus, and respiratory diseases. Strategies for early case detection/prevention of NCDs, including periodontitis, should be developed for family doctors, other health professionals (OHPs), and healthcare funders. Evidence-based information on the reported associations between periodontitis and other NCDs should be made available to family doctors, OHPs, healthcare funders, patients, and the general population.
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Affiliation(s)
- David Herrera
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain
| | - Mariano Sanz
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain
| | - Lior Shapira
- Department of Periodontology, Faculty of Dental Medicine, Hadassah and the Hebrew University Medical Center, Jerusalem, Israel
| | - Carlos Brotons
- Biomedical Research Institute Sant Pau (IIB Sant Pau), Sardenya Primary Health Care Center, Barcelona, Spain
| | - Iain Chapple
- Periodontal Research Group, and Birmingham NIHR Biomedical Research Centre in Inflammation, Institute of Clinical Sciences, College of Medical & Dental Sciences, The University of Birmingham, Birmingham, UK
- Birmingham Community Healthcare NHS Foundation Trust, Birmingham, UK
| | - Thomas Frese
- Institut für Allgemeinmedizin, Medizinische Fakultät der Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Germany
| | - Filippo Graziani
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, School of Dentistry, University of Pisa, Pisa, Italy
| | - F. D. Richard Hobbs
- Oxford Primary Care, Radcliffe Primary Care Building, ROQ, University of Oxford, Oxford, UK
| | - Olivier Huck
- Dental Faculty, University of Strasbourg, Strasbourg, France
| | - Eva Hummers
- Department of General Practice and Family Medicine, University Medical Center Göttingen, Göttingen, Germany
| | - Søren Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University Hospital Bonn, Bonn, Germany
| | | | - Phoebus Madianos
- Department of Periodontology, Faculty of Dentistry, National & Kapodistrian University of Athens, Athens, Greece
| | - Ana Molina
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain
| | - Mehmet Ungan
- Department of Family Medicine, Ankara University School of Medicine, Ankara, Turkey
| | - Josep Vilaseca
- Department of Medicine, University of Vic–Central Catalonia University, Vic, Spain
- Primary Health Care Service, Althaia Foundation–Healthcare and University Network, Manresa, Spain
| | - Adam Windak
- Department of Family Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Shlomo Vinker
- Department of Family Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Herrera D, Sanz M, Shapira L, Brotons C, Chapple I, Frese T, Graziani F, Hobbs FDR, Huck O, Hummers E, Jepsen S, Kravtchenko O, Madianos P, Molina A, Ungan M, Vilaseca J, Windak A, Vinker S. Association between periodontal diseases and cardiovascular diseases, diabetes and respiratory diseases: Consensus report of the Joint Workshop by the European Federation of Periodontology (EFP) and the European arm of the World Organization of Family Doctors (WONCA Europe). J Clin Periodontol 2023; 50:819-841. [PMID: 36935200 DOI: 10.1111/jcpe.13807] [Citation(s) in RCA: 26] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 03/03/2023] [Accepted: 03/10/2023] [Indexed: 03/21/2023]
Abstract
AIM To explore the implications for dentists and family doctors of the association between periodontal and systemic diseases and the role of dentists and family doctors in managing non-communicable diseases (NCDs) and promoting healthy lifestyles. MATERIALS AND METHODS The consensus reports of the previous Focused Workshops on the associations between periodontitis and diabetes (2017) and periodontitis and cardiovascular diseases (2019) formed the technical reviews to underpin discussions on both topics. For the association with respiratory diseases, a systematic review was specifically commissioned for the Workshop discussions. Working groups prepared proposals independently, and then the proposals were discussed and approved at plenary meetings. RESULTS Periodontitis is independently associated with cardiovascular diseases, diabetes, chronic obstructive pulmonary disease (COPD), obstructive sleep apnea and COVID-19 complications. Dentists and family doctors should collaborate in managing NCDs, implementing strategies for early detection of periodontitis in primary care centres and of cardiovascular diseases or diabetes in dental settings. Family doctors should be informed about periodontal diseases and their consequences, and oral health professionals (OHPs) should be informed about the relevance of NCDs and the associated risk factors. CONCLUSIONS Closer collaboration between OHPs and family doctors is important in the early detection and management of NCDs and in promoting healthy lifestyles. Pathways for early case detection of periodontitis in family medicine practices and of NCDs in dental practices should be developed and evaluated.
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Affiliation(s)
- David Herrera
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain
| | - Mariano Sanz
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain
| | - Lior Shapira
- Department of Periodontology, Faculty of Dental Medicine, Hadassah and the Hebrew University Medical Center, Jerusalem, Israel
| | - Carlos Brotons
- Biomedical Research Institute Sant Pau (IIB Sant Pau), Sardenya Primary Health Care Center, Barcelona, Spain
| | - Iain Chapple
- Periodontal Research Group, Institute of Clinical Sciences, College of Medical & Dental Sciences, The University of Birmingham, Birmingham, UK
- Birmingham Community Healthcare NHS Foundation Trust, Birmingham, UK
| | - Thomas Frese
- Medizinische Fakultät der Martin-Luther-Universität Halle-Wittenberg, Institut für Allgemeinmedizin, Halle (Saale), Germany
| | - Filippo Graziani
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, School of Dentistry, University of Pisa, Pisa, Italy
| | - F D Richard Hobbs
- Oxford Primary Care, Radcliffe Primary Care Building, ROQ, University of Oxford, Oxford, UK
| | - Olivier Huck
- Dental Faculty, University of Strasbourg, Strasbourg, France
| | - Eva Hummers
- Department of General Practice and Family Medicine, University Medical Center Göttingen, Göttingen, Germany
| | - Søren Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University Hospital Bonn, Bonn, Germany
| | | | - Phoebus Madianos
- Department of Periodontology, Faculty of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Ana Molina
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain
| | - Mehmet Ungan
- Department of Family Medicine, Ankara University School of Medicine, Ankara, Turkey
| | - Josep Vilaseca
- Department of Medicine, University of Vic - Central Catalonia University. Vic, Barcelona, Spain
- Primary Health Care Service, Althaia Foundation - Healthcare and University Network, Manresa, Spain
| | - Adam Windak
- Department of Family Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Shlomo Vinker
- Department of Family Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Adachi N, Adamovitch V, Adjovi Y, Aida K, Akamatsu H, Akiyama S, Akli A, Ando A, Andrault T, Antonietti H, Anzai S, Arkoun G, Avenoso C, Ayrault D, Banasiewicz M, Banaśkiewicz M, Bernardini L, Bernard E, Berthet E, Blanchard M, Boreyko D, Boros K, Charron S, Cornette P, Czerkas K, Dameron M, Date I, De Pontbriand M, Demangeau F, Dobaczewski Ł, Dobrzyński L, Ducouret A, Dziedzic M, Ecalle A, Edon V, Endo K, Endo T, Endo Y, Etryk D, Fabiszewska M, Fang S, Fauchier D, Felici F, Fujiwara Y, Gardais C, Gaul W, Gurin L, Hakoda R, Hamamatsu I, Handa K, Haneda H, Hara T, Hashimoto M, Hashimoto T, Hashimoto K, Hata D, Hattori M, Hayano R, Hayashi R, Higasi H, Hiruta M, Honda A, Horikawa Y, Horiuchi H, Hozumi Y, Ide M, Ihara S, Ikoma T, Inohara Y, Itazu M, Ito A, Janvrin J, Jout I, Kanda H, Kanemori G, Kanno M, Kanomata N, Kato T, Kato S, Katsu J, Kawasaki Y, Kikuchi K, Kilian P, Kimura N, Kiya M, Klepuszewski M, Kluchnikov E, Kodama Y, Kokubun R, Konishi F, Konno A, Kontsevoy V, Koori A, Koutaka A, Kowol A, Koyama Y, Kozioł M, Kozue M, Kravtchenko O, Kruczała W, Kudła M, Kudo H, Kumagai R, Kurogome K, Kurosu A, Kuse M, Lacombe A, Lefaillet E, Magara M, Malinowska J, Malinowski M, Maroselli V, Masui Y, Matsukawa K, Matsuya K, Matusik B, Maulny M, Mazur P, Miyake C, Miyamoto Y, Miyata K, Miyata K, Miyazaki M, Molȩda M, Morioka T, Morita E, Muto K, Nadamoto H, Nadzikiewicz M, Nagashima K, Nakade M, Nakayama C, Nakazawa H, Nihei Y, Nikul R, Niwa S, Niwa O, Nogi M, Nomura K, Ogata D, Ohguchi H, Ohno J, Okabe M, Okada M, Okada Y, Omi N, Onodera H, Onodera K, Ooki S, Oonishi K, Oonuma H, Ooshima H, Oouchi H, Orsucci M, Paoli M, Penaud M, Perdrisot C, Petit M, Piskowski A, Płocharski A, Polis A, Polti L, Potsepnia T, Przybylski D, Pytel M, Quillet W, Remy A, Robert C, Sadowski M, Saito M, Sakuma D, Sano K, Sasaki Y, Sato N, Schneider T, Schneider C, Schwartzman K, Selivanov E, Sezaki M, Shiroishi K, Shustava I, Śniecińska A, Stalchenko E, Staroń A, Stromboni M, Studzińska W, Sugisaki H, Sukegawa T, Sumida M, Suzuki Y, Suzuki K, Suzuki R, Suzuki H, Suzuki K, Świderski W, Szudejko M, Szymaszek M, Tada J, Taguchi H, Takahashi K, Tanaka D, Tanaka G, Tanaka S, Tanino K, Tazbir K, Tcesnokova N, Tgawa N, Toda N, Tsuchiya H, Tsukamoto H, Tsushima T, Tsutsumi K, Umemura H, Uno M, Usui A, Utsumi H, Vaucelle M, Wada Y, Watanabe K, Watanabe S, Watase K, Witkowski M, Yamaki T, Yamamoto J, Yamamoto T, Yamashita M, Yanai M, Yasuda K, Yoshida Y, Yoshida A, Yoshimura K, Żmijewska M, Zuclarelli E. Measurement and comparison of individual external doses of high-school students living in Japan, France, Poland and Belarus-the 'D-shuttle' project. J Radiol Prot 2016; 36:49-66. [PMID: 26613195 DOI: 10.1088/0952-4746/36/1/49] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Twelve high schools in Japan (of which six are in Fukushima Prefecture), four in France, eight in Poland and two in Belarus cooperated in the measurement and comparison of individual external doses in 2014. In total 216 high-school students and teachers participated in the study. Each participant wore an electronic personal dosimeter 'D-shuttle' for two weeks, and kept a journal of his/her whereabouts and activities. The distributions of annual external doses estimated for each region overlap with each other, demonstrating that the personal external individual doses in locations where residence is currently allowed in Fukushima Prefecture and in Belarus are well within the range of estimated annual doses due to the terrestrial background radiation level of other regions/countries.
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Affiliation(s)
- N Adachi
- Adachi High School, 2-347 Kakunai, Nihonmatsu, Fukushima 964-0904, Japan
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