The Potential Association between Tuberculosis and Periodontitis: Implications for Public Health | [Liaquat National Journal of Primary Care • 2025]

Author(s):

1. Ashek Elahi noor: Department of Dental Public Health, Sapporo Dental College and Hospital, Dhaka, Bangladesh Department of Dental Research, Center for Global Health Research, Saveetha Institute of Medical and Technical Sciences, Chennai, India

2. Boyapati Ramanarayana: Department of Periodontology, Sibar Institute of Dental Sciences,Takkellapadu, Guntur,India

3. Enis Veseli: Department of Prosthodontics, Dental School, Faculty of Medicine, University of Pristina,Pristina, Kosovo,

Abstract:

Tuberculosis and periodontitis are two chronic diseases that have traditionally been viewed as unrelated. However, emerging research indicates a potential association between these conditions, which are significant public health concerns. Tuberculosis, caused by Mycobacterium tuberculosis, primarily afects the lungs but can manifest systemically. Periodontitis is a chronic inflammatory disease of the supporting tissues of the teeth, driven by oral pathogens. Both diseases share common risk factors such as smoking, diabetes, malnutrition, and HIV co-infection, which may exacerbate the bidirectional relationship between the immune system and systemic inflammation. This paper explores the potential pathophysiological connections between tuberculosis and periodontitis and discusses the implications for public health strategies. A literature review was conducted to identify studies linking tuberculosis and periodontitis, focusing on shared immunological pathways, risk factors, and systemic inflammatory processes. Epidemiological studies examining co-occurrence of the diseases in high-risk populations were also analyzed. The findings suggest that chronic inflammation caused by periodontitis may exacerbate systemic conditions like tuberculosis by increasing levels of circulating inflammatory markers, such as C-reactive protein, IL-6, and TNF-a. Likewise, individuals with tuberculosis may have a weakened immune system, increasing their susceptibility to periodontal infections. Shared risk factors, particularly smoking, diabetes, and malnutrition, further amplify the burden of both diseases. The immunological dysregulation present in tuberculosis, particularly in the case of immune exhaustion, may impair the body's response to periodontal pathogens, leading to worse oral health outcomes. By adopting a more integrated approach to patient care, dental professionals can help mitigate the systemic impacts of these diseases, reduce the burden of tuberculosis in afected populations, and improve overall patient outcomes.

Page(s): 192-196

DOI: 10.37184/lnjpc.2707-3521.7.29

Published: Journal: Liaquat National Journal of Primary Care, Volume: 7, Issue: 2, Year: 2025

Keywords:

Tuberculosis , Public health , inflammation , Immune system , periodontitis

References:

[1] Swain S,Kumar A,Vishwakarma VK,Aayilliath K A,Mittal A,Wig N. .2024 .Diagnosis and management of latent tuberculosis infection: updates. Infect Disord Drug Targets, 24(4) : 12-9.

[2] Papapanou PN,Sanz M,Buduneli N,Dietrich T,Feres M,Fine DH .2018 .. Periodontitis: Consensus report of workgroup 2 of the 2017 World Workshop on the classification of periodontal and periimplant diseases and conditions. J Periodontol, 89 : 0721-82.

[3] Lin P,Liu A,Tsuchiya Y,Noritake K,Ohsugi Y,Toyoshima K .2023 .Association between periodontal disease and chronic obstructive pulmonary disease. Jpn Dent Sci Rev, 10 : 389-402.

[4] Sharma A,Garg H,Khattri S,Sharma S. .2016 .Periodontal status of tuberculosis patients-Is there a two-way link?. Indian J Tuberc, 09(4) : 225-9.

[5] Veseli E.,Metaverse E. .2024 .: a promise avenue for enhancing dental care. Khyber Med Univery J, 16(1) : 1-2.

[6] Strom JL Egede LE. .2012 .The impact of social support on outcomes in adult patients with type 2 diabetes: a systematic review. Current diabetes reports, 12(6) : 769-81.

[7] Acunzo ,Limiroli E,Pagni G,Dudaite A,Consonni D,Rasperini G .2016 .Gingival margin stability after mucogingival plastic surgery. The efect of manual versus powered toothbrushing: a randomized clinical trial. J Periodontol, 87(10) : 1186-94.

[8] Jha V,Garcia-Garcia G,Iseki K,Li Z,Naicker S,Plattner B .2013 .Chronic kidney disease: global dimension and perspectives. Lancet, 6736(13) : 60687-72.

[9] Cairo F,Carnevale G,Nieri M,Mervelt J,Cincinelli S,Martinolli C .2013 .Benefits of fibre retention osseous resective surgery in the treatment of shallow infrabony defects: a double-blind, randomized, clinical trial describing clinical, radiographic and patient-reported outcomes. J Clin Periodontol, 40(2) : 163-71.

[10] Kohale BR,Agrawal AA,Raut CP .2018 .Efect of low-level laser therapy on wound healing and patients' response after scalpel gingivectomy: a randomized clinical split-mouth study. J Indian Soc Periodontol, 239(5) : 18-26.

[11] Srivastava K.C.,Shrivastava D. .2016 .6(Suppl 3): S213-8. J Int Soc Prevent Commun Dent, : 197195-0762.

[12] Kassahun A,Gashe F,Mulisa E,Rike WA .2016 .Nonadherence and factors afecting adherence of diabetic patients to anti-diabetic medication in Assela General Hospital, Oromia Region, Ethiopia. J Pharm Bioallied Sci, 8(2) : 171696-7406.

[13] Jing ,Jiao J,Xu L,Hou J-X,Li X-T,Wang X-X .2020 .Periodontal soft- and hard-tissue changes after augmented corticotomy in Chinese adult patients with skeletal Angle Class III malocclusion: a non-randomized controlled trial. J periodontol, 91(11) : 0522-28.

[14] Furin J,Cox H,Pai M.,Tuberculosis M. .2019 .. Lancet, 6736(19) : 30308-3.

[15] Saquib Abullais S,Wykole Y,Abdul Khader M,Mohamed Shamsudeen S,Alanazi S,Ullah Khateeb S .2023 .Estimation of serum C-reactive protein activity in periodontal health and disease and response to treatment: a clinico-biochemical study. PeerJ, 11 : .

[16] Veseli E,Noor AE,Veseli K,Tovani-Palone MR .2024 .Early childhood caries detection using smartphone artificial intelligence. Eur Arch Paediatr Dent, 25(2) : 285.

[17] Giannobile WV .2008 .Host-response therapeutics for periodontal diseases. J Periodontol, 79 : 1592-600.

[18] Albandar JM,Rams TE JM .2002 .Global epidemiology of periodontal diseases: an overview. Periodontol, 290101 : 0757-10.

[19] Yang TW,Park HO,Jang HN,Yang JH,Kim SH,Moon SH .2017 .: e7482. Medicine (Baltimore), 96(28) : .

[20] Kumar C,Dhadse PV,Agarwal AA,Kale BV,Sigh BS .2018 .Oral and periodontal status in patients with tuberculosis in Vidarbha region of Central India. J Int Clin Dent Res Organ, 3(2) : 18-7.

[21] Alshiddi IF,AlMubarak AM,Alqutub MN,Alqarawi FK,Alshahrani FA,Javed F .2021 .Peri-implant sulcular fluid galectin-1, soluble urokinase plasminogen activator receptor and IL-1β levels under peri-implant inflammatory conditions. Oral Health Prev Dent, 19 : 503-10.

[22] Javed F,Al-Askar M,Al-Hezaimi K .2011 .Cytokine profile in the gingival crevicular fluid of periodontitis patients with and without type 2 diabetes: a literature review. J Periodontol, 83(2) : 156-61.

[23] Mazurek-Mochol M,Bonsmann T,Mochol M,PoniewierskaBaran A,Pawlik A .2024 .The role of interleukin 6 in periodontitis and its complications. Int J Mol Sci, 25(4) : 2146.

[24] Bhuyan R,Bhuyan SK,Mohanty JN,Das S,Juliana N,Abu IF .2022 .Periodontitis and its inflammatory changes linked to various systemic diseases: a review of its underlying mechanisms. Biomedicines, 10(10) : 2659.

[25] Carabalí-Isajar ML,Rodríguez-Bejarano OH,Amado T,Patarroyo MA,Izquierdo MA,Lutz JR .2023 .Clinical manifestations and immune response to tuberculosis. World J Microbiol Biotechnol, 39(8) : 206.

[26] Schwarz C,Hajdu AI,Dumitrescu R,Sava-Rosianu R,Bolchis V,Anusca D .2023 .Link between oral health, periodontal disease, smoking, and systemic diseases in Romanian patients. InHealthcare, 11(16) : 2354.

Citations

Downloads

Views