Periodontists and family physicians call for greater collaboration to reduce the burden of noncommunicable diseases

Closer collaboration between oral health professionals and family physicians is necessary for the prevention, early detection and proper management of noncommunicable diseases (NCDs), and vital to promote healthy lifestyles. Pathways for early detection of periodontitis by family physicians, and of NCDs by dental practitioners should be developed. This is the main conclusion of the recently publishedconsensus report of the joint workshop of the European Federation of Periodontology (EFP) and the European region of the World Organisation of Family Doctors (WONCA Europe).

The paper published by the Journal of Clinical Periodontologysummarises the discussions that took place at the EFP’s focused workshop on periodontology and family doctors in July 2022 in Madrid, Spain. Three subgroups reviewed the latest evidence for associations between periodontal diseases and systemic diseases, such as diabetes, and respiratory and cardiovascular diseases (CVD). The meeting was sponsored by the EFP partner Curasept.

Regarding CVD, experts concluded that periodontitis is linked to systemic inflammation, endothelial dysfunction and raised incidence of future cardiovascular events. On the other hand, and according to recently published evidence, treatment of periodontitis results in systemic health improvements including reducing cardiometabolic risk and systemic inflammation.

“Patients with periodontitis should be informed by oral healthcare professionals that their risk of CVD is higher. Periodontists should collect a history of reported cardiovascular risk factors such as diabetes, obesity, hypertension, and smoking. If the patient presents obvious risk factors, they should be advised to consult with their family doctor and to implement lifestyle changes, including weight loss, smoking cessation, and increasing physical activity,” advises Prof. Lior Shapira, past EFP president (2021-2022) and co-author. “Patients with diabetes or prediabetes should be informed by general practitioners of higher risks of gum disease and advised to visit their dentist. All in all, the main conclusion is that oral health professionals need to be in touch with patients' family doctors all the time,” Shapira explained.

Regarding respiratory diseases, participants looked at a systematic review prepared for the workshop, that found positive associations between periodontitis and chronic obstructive pulmonary disease (COPD), obstructive sleep apnoea (OSA) and COVID-19 complications.

Prof. Shlomo Vinker, president of WONCA Europe and co-author of the publication said: “the current split between oral health on one side, and systemic disease professionals on the other, makes no sense. We should strive for greater integration and better sharing of information. More collaboration on screening, prevention and referrals would clearly benefit our patients and public health.”

Prof. David Herrera, chair of the EFP workshop committee and first author of the publication explained: “Better screening of NCDs, including periodontitis, both by oral health professionals and family doctors, is simple to implement. There are questionnaires, tests, and evaluations that we can carry out to decide if a patient needs to be referred to a colleague. Simple interventions by oral health professionals and by general practitioners can greatly improve overall health and reduce risks and complications.”

Experts concluded that oral health professionals and family physicians should collaborate in managing NCDs, implementing strategies for early detection of periodontitis in primary care centres, and of cardiovascular diseases or diabetes in dental settings. Family doctors should be informed about periodontal diseases and their consequences, and oral health professionals should be informed about the relevance of NCDs and associated risk factors.

Authors hope that the paper will reach a wide audience and count on members of their organisations to help spread the main findings of the workshop.

Experts also called for more clinical trials to be organised to gain more knowledge on the bidirectional links between periodontal and systemic diseases.

The paper: " Association between periodontal diseases and cardiovascular diseases, diabetes and respiratory diseases: Consensus report of the Joint Workshop by the European Federation of Periodontology (EFP) and the European arm of the World Organization of Family Doctors (WONCA Europe),” publishedin JCP can be found here.

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