Proton pump inhibitors are associated with reduced periodontal disease severity

Proton pump inhibitors (PPIs), such as omeprazole, esomeprazole, and pantoprazole, are frequently prescribed to treat acid-related gastrointestinal diseases. PPIs inhibit the hydrogen potassium-adenosine triphosphatase proton pump in gastric parietal cells, decreasing acid release. However, PPIs also affect bone metabolism by altering mineralization and resorption rates and inducing changes in the gastrointestinal microbiota. Therefore, the authors assessed whether PPIs also might be associated with periodontal pathogenesis.

Medical and dental records (N = 1,017) of patients seeking treatment at the School of Dental Medicine at the State University of New York, University at Buffalo Postgraduate Periodontics Clinic (2010-2017) were reviewed to obtain periodontal status, medication history, systemic diseases and conditions, and demographic information. Patients who received a diagnosis of generalized periodontitis stages III through IV, grades B through C were further assessed in this study (n = 518).

A statistically significant inverse relationship was found between the use of PPIs and the percentage of teeth with 6 mm or greater probing depths. That relationship persisted after adjusting for diabetes, smoking, and the presence of systemic factors. The prevalence of pocket depths 6 mm or greater was 13.1% in patients taking PPIs vs 19.9% in patients not taking PPIs (group difference, 6.8%; 34.2% decrease; 95% CI, 2.1% to 11.6%; P = .006). There were no statistically significant differences in oral hygiene efficacy or age in the PPI vs non-PPI groups (P > .05), implying that either potentially confounding factor did not influence the observed results.

The use of PPIs is associated with less severe periodontal disease.