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Periodontal disease and neuroinflammation in multiple sclerosis: a systematic review of current evidence
Srijanani Santhanakrishnan1, Karunanidhi Kannappan1, Chandrasekaran Krithika2
1Department of Research, Meenakshi Academy of Higher Education and Research, Chennai, India.
Background:
Multiple Sclerosis (MS) is a chronic, immune-mediated neurological disorder characterized by demyelination and neurodegeneration. Emerging evidence suggests a link between MS and Periodontal Diseases (PD) through shared immune-inflammatory pathways. This review assesses the association between periodontal diseases and multiple sclerosis, focusing on immune-inflammatory interactions and clinical correlations. Despite emerging evidence, the strength of association remains unclear due to methodological heterogeneity.
Aim:
To review and evaluate the literature on the epidemiological association between PD and MS in adults.
Materials And Methods:
A systematic search was conducted in PubMed, Scopus, and Cochrane. Studies with full text articles that are available in English, without time restrictions, that assessed periodontitis, oral microbiome, and salivary biomarkers in relation to MS were included. Observational studies evaluating clinical, microbiological, or immunological associations were selected. Data extraction covered periodontal parameters, salivary biomarkers, periodontal pathogens and disease severity. The risk of bias was evaluated using Newcastle-Ottawa Scale.
Results:
The findings indicated that patients with MS had poorer periodontal health, when compared to healthy controls. Dysbiosis in the oral microbiome was observed, with a higher abundance of periodontal pathogens. Patients with MS exhibited elevated neutrophil-lymphocyte ratios and total oxidative stress, indicating a potential link between systemic inflammation and periodontal dysbiosis. While some studies established positive association between PD and MS, others highlighted the need for further investigation due to inconsistent findings in periodontal parameters between MS patients and controls.
Conclusion:
Despite methodological heterogeneity, the available limited evidence indicates the association between periodontitis and MS. This highlights the need for standardized periodontal assessments in research involving MS and suggests that periodontal care may hold potential as an adjunct in management of MS.
Insights
People with Multiple Sclerosis (MS) show poorer periodontal health and oral microbiome changes. This suggests a link between gum disease and MS, warranting further research and potential oral care interventions.
Area of Science:
- Neurology
- Immunology
- Periodontology
Background:
- Multiple Sclerosis (MS) is a chronic neurological disorder involving demyelination and neurodegeneration.
- Emerging evidence links MS and Periodontal Diseases (PD) via shared immune-inflammatory pathways.
- This review assesses the association between PD and MS, focusing on immune-inflammatory interactions.
Purpose of the Study:
- To review and evaluate the existing literature on the epidemiological association between Periodontal Diseases (PD) and Multiple Sclerosis (MS) in adults.
Main Methods:
- Systematic literature search across PubMed, Scopus, and Cochrane databases.
- Inclusion of full-text English articles assessing periodontitis, oral microbiome, and salivary biomarkers in relation to MS.
- Evaluation of observational studies using the Newcastle-Ottawa Scale for risk of bias assessment.
Main Results:
- Patients with MS exhibited poorer periodontal health compared to controls.
- Oral microbiome dysbiosis was observed in MS patients, with increased periodontal pathogens.
- Elevated neutrophil-lymphocyte ratios and oxidative stress in MS patients suggest a link between systemic inflammation and periodontal dysbiosis.
Conclusions:
- Limited evidence indicates an association between periodontitis and MS, despite methodological heterogeneity.
- Standardized periodontal assessments are needed in MS research.
- Periodontal care may serve as an adjunct therapy in managing MS.
