Periodontitis is a chronic inflammatory disease of the periodontal tissues (gingiva, periodontal ligament, alveolar bone) driven by a dysbiotic polymicrobial biofilm in the subgingival pocket. The keystone pathogen is porphyromonas gingivalis, whose zinc-dependent gingipains drive tissue destruction, immune evasion, and systemic dissemination. Periodontitis affects ~50% of adults globally and is increasingly recognized as a driver of systemic disease through the oral-systemic inflammation axis.
Oral-Systemic Disease Connections
- CVD: Periodontal bacteria enter the bloodstream during chewing/procedures → endothelial damage → atherosclerosis [1] [2].
- Alzheimer's: P. gingivalis gingipains found in AD brains; cleave APP and tau → amyloidogenic fragments (see porphyromonas gingivalis).
- T2D: Bidirectional relationship — periodontitis worsens glycemic control; hyperglycemia worsens periodontitis [3] [4].
- Breast cancer: Missing mandibular molars (severe periodontitis marker) → 2.36x breast cancer risk [5].
Metal and Shielding Context
- P. gingivalis is a heme specialist — gingival bleeding provides iron/heme substrate that fuels pathogen expansion.
- functional shielding: C. albicans shields P. gingivalis from immune recognition, amplifying gingipain activity 10-fold and enabling chronic persistence [6].
- cortisol: Stress hormone directly promotes P. gingivalis surface translocation and virulence [7].
Cross-References
- porphyromonas gingivalis — keystone periodontal pathogen
- functional shielding — C. albicans shields P. gingivalis
- cortisol — stress-driven virulence activation
- cardiovascular disease — oral-CVD axis
- alzheimers disease — gingipain-amyloid connection
- breast cancer — periodontitis as risk factor
- iron — heme/iron acquisition drives P. gingivalis expansion