More than half of the study participants were found to have high LDL levels. The figure was striking: 61.54 percent. And when the researchers began comparing the blood laboratory data with the periodontal condition of these elderly participants, a pattern that could not be ignored began to emerge.
This prompted drg. Elastria Widita, MSc, PhD, together with a research team from the Faculty of Dentistry (FKG), Universitas Gadjah Mada (UGM), to investigate further the relationship between periodontal health and blood lipid profiles among the elderly population in Yogyakarta. The findings were published in the December 2017 issue of the Journal of Dentistry Indonesia, and the main findings are enough to make anyone think twice about the importance of maintaining good oral and periodontal hygiene.
When the Gums Become Inflamed, the Blood Is Affected Too
The study involved 78 participants aged 60–76 years, all of whom were patients receiving primary healthcare services at the UGM Gadjah Mada Medical Centre. They underwent dental examinations at Prof. Soedomo Dental Hospital, FKG UGM, as well as blood sampling to measure total cholesterol, LDL, HDL, and triglyceride levels.
From the periodontal perspective, two primary indicators were measured: pocket depth (PD) and loss of attachment (LoA). Both parameters reflect the severity of damage to the tissues supporting the teeth.
The logistic regression analysis revealed significant findings. Participants with loss of attachment greater than 6 mm had a 5.3-fold higher risk of having abnormal total cholesterol levels and a 2.87-fold higher risk of having elevated LDL levels compared with participants with better periodontal conditions. Meanwhile, pocket depth alone was not significantly associated with lipid levels.
“These findings indicate that subjects with greater loss of attachment were significantly associated with higher serum total cholesterol and LDL levels. This may place elderly individuals with poor periodontal conditions at greater risk of abnormal blood lipid profiles.”
This was the conclusion drawn by the research team, which also included drg. Lisdrianto Hanindriyo, drg. Rini Widyaningrum, Prof. Bambang Priyono, and Prof. Dewi Agustina from FKG UGM.
Bacteria in the Gums, Cholesterol in the Blood Vessels
What is the underlying biological mechanism? The researchers explained that chronic inflammation in periodontal tissues can trigger a series of systemic reactions. Periodontal pathogenic bacteria release lipopolysaccharide (LPS), which enters the bloodstream and triggers an inflammatory response. This response can ultimately alter the lipoprotein profile toward a more pro-atherogenic state, which promotes plaque formation on blood vessel walls.
Oxidized LDL, for example, is one of the key players in the development of atherosclerosis. Bacteria such as Porphyromonas gingivalis, a major pathogen associated with periodontitis, have been reported in the scientific literature to increase LDL levels and induce hypercholesterolemia. On the other hand, HDL, which normally serves a protective role by neutralizing LPS, did not show significant changes in this study, consistent with findings from previous similar studies.
The characteristics of the study participants were also concerning. More than 53 percent had a pocket depth of 6 mm or greater, while 59 percent had loss of attachment exceeding 6 mm. Yet 98.7 percent reported brushing their teeth more than twice a day. However, none of the participants used dental floss. This indicates that cleaning between the teeth remains extremely limited, even among a highly educated population: 97.4 percent of the participants had a higher level of education.
Why Elderly People in Yogyakarta Need to Be More Vigilant
The demographic context makes this study even more relevant. National statistical projections estimate that Yogyakarta will be one of the Indonesian provinces with the largest elderly populations by 2035, with more than 10 percent of its population aged 65 years or older. At the same time, cardiovascular disease continues to be a leading cause of death from non-communicable diseases both globally and nationally.
The study does have several limitations. Its cross-sectional design does not allow a direct causal relationship to be established. The sample size was also relatively small. The researchers themselves recommended longitudinal studies involving larger and more diverse samples to strengthen these findings.
Nevertheless, one thing has become clear from the research conducted by drg. Elastria Widita and colleagues: gum health is not merely an oral health issue. Among older adults, severely damaged periodontal tissues may both reflect and contribute to much more serious health problems. In this context, regular dental examinations are no longer simply a matter of aesthetics or preventing toothache; they may also form part of a broader strategy for preventing cardiovascular disease—an aspect that is often overlooked.
Source DOI: doi: 10.14693/jdi.v24i3.1056
Authors: Anny Anggraini; drg. Achmad Zam Zam Aghasy, M.Kes.
Photo: Freepik