The impact of periodontitis on physical fitness: a systematic review

This study aimed to review evidence of the impact of periodontitis on physical fitness.

An electronic literature search using MeSH terms and keywords was performed in 6 electronic databases, protocol records, and other sources. Eligibility criteria included observational studies on the impact of periodontitis on physical fitness as primary outcome. No restrictions were placed on the language or date of publication. The quality of primary studies was assessed. GRADE was used to assess the quality of responses.

The initial search identified 5,389 records; of that number, 2,690 duplicates were removed. Following a screening by title and abstract and then full-text review, 7 studies were included for analysis. Six reported a significant relationship between periodontitis or mean probing depth/clinical attachment loss and physical fitness.

The increase in clinical attachment loss and probing depth/clinical attachment loss was associated with decreased handgrip strength and chance to reach the highest physical fitness test score, respectively. Increased mean probing depth was associated with VO_2peak (maximum oxygen consumption over 30 seconds during the test) and exercise duration. Higher VO_2max (maximum oxygen consumption during exercise) was associated with lower risk of severe periodontitis and combined highest VO _2max, and lowest body mass index was associated with lower risk of severe periodontitis. Associations with mean probing depth were most convincing for VO_2peak and exercise duration. The methodological quality of the studies was high, and the level of evidence ranged between 2 and 3.

Periodontitis and unfavourable periodontal parameters were associated with worse physical fitness.