Often referred to as the ‘gateway to the body’, the health of the mouth is intrinsically linked with the health of the body. The presence of oral disease increases the risk of systemic infection, with several organ systems affected. The gastrointestinal system is particularly susceptible to dysfunction in the presence of dental disease. In some cases, the direction of impact is reversed, with gastric conditions increasing the chance of periodontal issues. All of this emphasises the importance of effective oral hygiene, as well as regular professional assessment and intervention.
The big ‘C’
A growing body of evidence has established a correlation between periodontitis and several types of cancer within the gut. The transfer of oral bacteria associated with periodontal disease into the gastrointestinal system can disrupt the gut microbiome and increase the risk of dysbiosis.[i] The literature suggests that even a history of periodontitis can increase the risk of oesophageal and gastric adenocarcinoma by up to 43% and 52%, respectively.[ii] Relationships have also been found with liver, gastric, and pancreatic cancers.
Inflammatory bowel diseases
Studies also indicate a correlation between periodontitis and inflammatory bowel diseases (IBD), including Crohn’s disease. As both conditions share inflammatory aetiology, they are linked due to a similar host immune response which causes multiple problems in the body. A loss of the intestinal microbial balance can lead to the release of pathogens, which trigger this inflammation throughout the digestive system. Equally, pathogens already widely associated with periodontitis – P.gingivalis and F. nucleatum – can influence the progression of various IBDs.[iii]
Liver complications
People diagnosed with liver cirrhosis exhibit a high incidence of periodontal disease as well – reported as 25-69%.[iv] Research in the field shows similar findings regardless of whether the cirrhosis was alcohol-induced or not, suggesting a direct link between diseases, with little impact from oral hygiene awareness and performance. Even before the development of cirrhosis, the prevalence of periodontitis is 91% higher among people with non-alcoholic fatty liver disease (NAFLD) than in those without the condition.[v] While a causal relationship is yet to be proven, the correlation must be recognised by dental and healthcare professionals who support patients.
Gallbladder health
Another emerging area of science is investigating the impact of periodontitis on the risk of gallstones, and vice versa. Initial evidence suggests that severe periodontal disease is more prevalent in people with active acute cholecystitis (inflammation of the gallbladder due to gallstone blockages).[vi] Authors postulate that this is influenced by systemic inflammatory mechanisms, highlighting the need for effective periodontal management in this patient group too.
Promoting periodontal health
Whether patients are already living with gastrointestinal conditions, or looking to reduce their risk of developing related complications in the future, the prevention of periodontitis is crucial. Lifestyle factors like a healthy, balanced diet,[vii] and smoking cessation[viii] must also be reviewed.
At-home oral hygiene is important for regular plaque control, which should be achieved with a comprehensive daily routine.[ix] As such, effective oral hygiene instruction is the first line of defence.[x]
Professional intervention is also crucial, with expert removal of plaque significantly improving gingival inflammation and lowering plaque scores.[xi] Effective professional prophylaxis relies on good technique and high-quality products, such as the Prophylaxis Paste from Kemdent. Easy to handle and apply with a special viscosity that sticks to the teeth without splatter, the material is also available in four flavours to improve the patient experience.
Should symptoms present, the key to success is to address early signs of gingivitis as quickly and as efficiently as possible. The dedicated Periodontal Disease Classification system should be used to determine the severity of disease progression and the appropriate treatment approach.[xii] From here, the European Federation of Periodontology offers evidence-based treatment guidelines for clinicians to follow for the best results.[xiii] These break down management techniques according to the staging of periodontitis identified.
A truly holistic approach
Modern dental care is about so much more than supporting oral health. The literature demonstrates a significant correlation between dental and systemic wellbeing, with the gastrointestinal system among those influenced by the development of periodontal diseases. Prevention remains key, with both patient and professional interventions crucial for minimising the risk of plaque accumulation and consequential infection.
For more information about the leading solutions available from Kemdent, please visit www.kemdent.co.uk or call 01793 770 256
Author: Alistair Mayoh – Marketing Director Kemdent
[i] Baima G, Ribaldone DG, Romano F, Aimetti M, Romandini M. The Gum-Gut Axis: Periodontitis and the Risk of Gastrointestinal Cancers. Cancers (Basel). 2023 Sep 15;15(18):4594. doi: 10.3390/cancers15184594. PMID: 37760563; PMCID: PMC10526746.
[ii] Lo CH, Kwon S, Wang L, Polychronidis G, Knudsen MD, Zhong R, Cao Y, Wu K, Ogino S, Giovannucci EL, Chan AT, Song M. Periodontal disease, tooth loss, and risk of oesophageal and gastric adenocarcinoma: a prospective study. Gut. 2021 Mar;70(3):620-621. doi: 10.1136/gutjnl-2020-321949. Epub 2020 Jul 20. PMID: 32690603; PMCID: PMC7855151.
[iii] Naghsh N, Karimi F, Tarrahi MJ, Rahimi A. Evaluation of the association between periodontitis and inflammatory bowel disease: A systematic review and Meta-analysis. BMC Gastroenterol. 2025 Aug 18;25(1):594. doi: 10.1186/s12876-025-04181-7. PMID: 40826333; PMCID: PMC12363015.
[iv] Grønkjær LL. Periodontal disease and liver cirrhosis: A systematic review. SAGE Open Med. 2015 Sep 9;3:2050312115601122. doi: 10.1177/2050312115601122. PMID: 26770799; PMCID: PMC4679327.
[v] Aguiar ILS, Santos-Lins LS, Brasil-Oliveira R, Cotrim HP, Lins-Kusterer L. Non-alcoholic fatty liver disease and periodontal disease: A systematic review and meta-analysis of cross-sectional studies. Arab J Gastroenterol. 2023 Nov;24(4):198-203. doi: 10.1016/j.ajg.2023.09.005. Epub 2023 Nov 22. PMID: 37993376.
[vi] Yordanagil, Mevlut & Turgut, Hamdi & Tuzun, Baris & Helvaci, Ercument & Okan, Ismail. (2025). Periodontitis as a potential predisposing factor for gallstone cholecystitis: exploring the role of chronic systemic inflammation. Surgery Today. 10.1007/s00595-025-03199-4.
[vii] Shi X, Zhu P, Du M, Deng K, Li P, Sáenz-Ravello G, Xu S, Li A. Dietary patterns and periodontitis: A systematic review. J Periodontal Res. 2025 Apr;60(4):300-314. doi: 10.1111/jre.13346. Epub 2024 Sep 9. PMID: 39248151.
[viii] Alwithanani N. Periodontal Disease and Smoking: Systematic Review. J Pharm Bioallied Sci. 2023 Jul;15(Suppl 1):S64-S71. doi: 10.4103/jpbs.jpbs_516_22. Epub 2023 Jul 5. PMID: 37654319; PMCID: PMC10466628.
[ix] Chapter 5: periodontal diseases. Gudiance. Department of Health & Social care. NHS England. https://www.gov.uk/government/publications/delivering-better-oral-health-an-evidence-based-toolkit-for-prevention/chapter-5-periodontal-diseases [Accessed May 2026]
[x] Farina, R., A.Simonelli, L.Trombelli, R. J. J.Chew, Y.-K.Tu, and P. M.Preshaw. 2026. “Clinical Efficacy of Interventions Based on Professional Mechanical Plaque Removal in the Treatment of Dental Biofilm–Induced Gingivitis: A Systematic Review and Meta-Analysis.” Journal of Clinical Periodontology53, no. 4: 572–595. https://doi.org/10.1111/jcpe.70083.
[xi] Chapple IL, Van der Weijden F, Doerfer C, Herrera D, Shapira L, Polak D, Madianos P, Louropoulou A, Machtei E, Donos N, Greenwell H, Van Winkelhoff AJ, Eren Kuru B, Arweiler N, Teughels W, Aimetti M, Molina A, Montero E, Graziani F. Primary prevention of periodontitis: managing gingivitis. J Clin Periodontol. 2015 Apr;42 Suppl 16:S71-6. doi: 10.1111/jcpe.12366. PMID: 25639826.
[xii] Implementing the 2018 Classification of Periodontal Diseases to reach a Diagnosis in Clinical Practice. British Society of Periodontology. https://www.bsperio.org.uk/assets/downloads/BSP_Flowchart_Implementing_the_2018_Classification.pdf [Accessed May 2026]
[xiii] EFP publishes first evidence-based treatment guidelines for periodontitis. Perio Insight. 2020; 13. https://www.efp.org/fileadmin/uploads/efp/Documents/Perio_Insight/Perioinsight13.pdf [Accessed May 2026]
