For decades, periodontitis has been considered to be a local inflammatory disease of the periodontal tissues in the oral cavity. Initially, associations of periodontitis with a multitude of noncommunicable diseases were each studied separately, and relationships were shown. The associations of periodontitis with morbidities, such as cardiovascular diseases, rheumatoid arthritis, diabetes mellitus, respiratory diseases, have been demonstrated. As most such studies were cross‐sectional in nature, questions about causality cannot be univocally answered. And periodontitis as an independent risk factor for one systemic disease, becomes even more difficult to assess since recently periodontitis has also been associated with multimorbidity. Periodontitis and many systemic diseases share environmental, lifestyle and genetic risk factors, and share immunopathology. Moreover, suffering from one common noncommunicable disease may increase the susceptibility for another such chronic disease; the systemic effects of one condition may be one of various risk factors for another such disease. The overarching effect of any systemic disease is it causing a pro‐inflammatory state in the individual; this has also been shown for periodontitis. Moreover, in periodontitis a prothrombotic state and elevated immunological activity have been shown. As such, when we consider periodontal disease as another systemic disease, it can affect the susceptibility and progression of other systemic diseases, and importantly, vice versa. And with this, it is not surprising that periodontitis is associated with a variety of other noncommunicable diseases. The medical definition of a systemic disease includes diseases that affect different organs and systems. Thus, the aim of this opinion paper is to propose that periodontitis should be considered a systemic disease in its own right and that it affects the individual's systemic condition and wellbeing. The dental and medical profession and researchers alike, should adapt this paradigm shift, advancing periodontal disease out of its isolated anatomical location into the total of chronic noncommunicable diseases, being for some conditions a comorbid disease and, vice versa, comorbidities can affect initiation and progression of periodontal disease.

中文翻译：

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牙周病：一种全身性疾病


几十年来，牙周炎一直被认为是口腔牙周组织的局部炎症性疾病。最初，分别研究了牙周炎与多种非传染性疾病的关联，并显示了关系。牙周炎与心血管疾病、类风湿性关节炎、糖尿病、呼吸系统疾病等疾病的关联已经得到证实。由于大多数此类研究本质上是横断面的，因此不能单独回答有关因果关系的问题。牙周炎作为一种全身性疾病的独立危险因素，变得更加难以评估，因为最近牙周炎也与多病共存有关。牙周炎和许多全身性疾病具有共同的环境、生活方式和遗传风险因素，并且具有相同的免疫病理学。此外，患有一种常见的非传染性疾病可能会增加对另一种此类慢性病的易感性;一种情况的全身影响可能是另一种此类疾病的各种风险因素之一。任何全身性疾病的总体影响是它会导致个体出现促炎状态;牙周炎也证明了这一点。此外，在牙周炎中，已显示出促血栓形成状态和免疫活性升高。因此，当我们将牙周病视为另一种全身性疾病时，它会影响其他全身性疾病的易感性和进展，重要的是，反之亦然。因此，牙周炎与各种其他非传染性疾病有关也就不足为奇了。全身性疾病的医学定义包括影响不同器官和系统的疾病。 因此，本意见书的目的是提出牙周炎本身应被视为一种全身性疾病，它会影响个人的全身状况和健康状况。牙科和医学界以及研究人员都应该适应这种范式转变，将牙周病从其孤立的解剖位置推进到慢性非传染性疾病的总和中，在某些情况下，它们是共病，反之亦然，共病会影响牙周病的发生和进展。