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Clinical Microbiology Reviews, October 2000, p. 547-558, Vol. 13, No. 4
0893-8512/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.

Systemic Diseases Caused by Oral Infection

Xiaojing Li,1,* Kristin M. Kolltveit,1 Leif Tronstad,2 and Ingar Olsen1

Department of Oral Biology1 and Department of Endodontics,2 Faculty of Dentistry, University of Oslo, Oslo, Norway

Recently, it has been recognized that oral infection, especially periodontitis, may affect the course and pathogenesis of a number of systemic diseases, such as cardiovascular disease, bacterial pneumonia, diabetes mellitus, and low birth weight. The purpose of this review is to evaluate the current status of oral infections, especially periodontitis, as a causal factor for systemic diseases. Three mechanisms or pathways linking oral infections to secondary systemic effects have been proposed: (i) metastatic spread of infection from the oral cavity as a result of transient bacteremia, (ii) metastatic injury from the effects of circulating oral microbial toxins, and (iii) metastatic inflammation caused by immunological injury induced by oral microorganisms. Periodontitis as a major oral infection may affect the host's susceptibility to systemic disease in three ways: by shared risk factors; subgingival biofilms acting as reservoirs of gram-negative bacteria; and the periodontium acting as a reservoir of inflammatory mediators. Proposed evidence and mechanisms of the above odontogenic systemic diseases are given.

* Corresponding author. Mailing address: Department of Oral Biology, Faculty of Dentistry, University of Oslo, P.O. Box 1052 Blindern, N-0316 Oslo, Norway. Phone: (47) 228 40349. Fax: (47) 228 40305. E-mail address: lixj{at}odont.uio.no.

Clinical Microbiology Reviews, October 2000, p. 547-558, Vol. 13, No. 4
0893-8512/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.


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