J Periodontol. 2026 Aug 13. doi: 10.1002/jper.70177. Online ahead of print.
ABSTRACT
BACKGROUND: Periodontitis has been associated with other systemic inflammatory diseases, such as cardiovascular disease, diabetes mellitus, and rheumatoid arthritis; through the translocation of oral bacteria and local inflammatory mediators systemically. Establishing potential associations between periodontitis and gastric disorders may contribute to the prevention and management of both conditions. This study has three aims: Aim 1, investigate associations between functional dyspepsia and periodontitis; Aim 2, assess the association between gastric Helicobacter pylori and periodontitis; Aim 3, evaluate the effect of periodontal treatment on the eradication of gastric H. pylori.
METHODS: Medline, EMBASE, other databases, and Google Scholar were electronically searched during March 2026. All observational and trial studies conducted on adult humans were selected. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was employed to assess the overall body of evidence. The Newcastle-Ottawa Scale and the Risk of Bias2 tool were applied to assess risk of bias in the included studies. Meta-analysis was conducted using Review Manager 5.4.
RESULTS: Fourteen papers were selected. Most studies demonstrated an association between periodontitis and various gastric problems. Meta-analysis for aims 2 and 3 showed an association between periodontitis and gastric H. pylori, pooled odds ratio (POR) = 1.66 (95% confidence interval [CI] 1.22-2.27). Additionally, a positive effect of combining periodontal and systemic therapy on complete eradication of H. pylori was observed, POR = 2.94 (95% CI 1.15-7.51).
CONCLUSION: An association between periodontitis and several gastric disorders, particularly H. pylori gastritis has been demonstrated. Moreover, adding non-surgical periodontal treatment to the standard systemic antibiotic regimen showed to enhance eradication of gastric H. pylori. Future research is needed.
PLAIN LANGUAGE SUMMARY: Gum disease, particularly periodontitis, is linked to other health problems, such as diabetes, heart disease, and rheumatoid arthritis. This review looked at whether there is a link between gum disease and stomach disorders. Three aims were set: Aim 1, to look at the possible connection between gum disease and indigestion (functional dyspepsia); Aim 2, to look at the possible connection between gum disease and stomach infection with Helicobacter pylori; and Aim 3, to see if treating gum disease can help clear stomach infection if combined with the standard stomach infection treatment with antibiotics. Medical databases were searched for relevant studies up to March 2026. As a result, 14 studies were included. Most of these included studies showed a connection between gum disease and stomach infection (odds ratio 1.66). Studies showed that combining gum disease treatment with the standard treatment for stomach infection can help in complete clearance of H. pylori infection (odds ratio 2.94). This review showed a connection between gum disease and stomach problems, and combining gum disease treatment with the standard treatment of stomach infection helps in completely clearing H. pylori infection. However, further research is needed to confirm these findings.
PMID:42596532 | DOI:10.1002/jper.70177