The systemic impact of periodontitis in about 100,000 patients: associations with heart diseases, cancer, and mortality

Periodontitis, a chronic inflammatory condition of tooth-supporting tissues, is associated with adverse systemic health outcomes, including cardiovascular disease, malignancies and premature mortality. Large-scale assessments remain limited. We analyzed real-world data of approximately 100,000 matched patients to clarify the broader health impact of periodontitis. In this retrospective study, we identified two cohorts − 47,498 patients each with and without periodontitis (ICD-10-CM: K05.6) - from the TriNetX database, matched by age and gender. We evaluated outcomes over 19 years, including heart inflammations, heart disease, head and neck cancer, C-reactive protein (CRP) levels and overall mortality. Propensity score matching, risk analyses and Kaplan–Meier survival statistics were employed. Compared to controls, patients with periodontitis exhibited higher risks of heart inflammations (OR: 3.06; 95% CI: 2.79–3.35), heart disease (OR: 2.40; 95% CI: 2.33–2.47), overall cancer (OR: 1.64; 95% CI: 1.58–1.71), head and neck cancer (OR: 1.60; 95% CI: 1.31–1.96) and premature mortality (OR: 1.42; 95% CI: 1.36–1.48). Median CRP levels were higher in the periodontitis group (39.30 vs. 35.79; p < 0.001). Periodontitis is associated with significantly increased adverse systemic health outcomes and higher mortality. These findings underscore the importance of preventive oral care and enhanced patient surveillance.