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JCM
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Interaction Between Systemic Diseases and Oral Diseases
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Interaction Between Systemic Diseases and Oral Diseases

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Dentistry, Oral Surgery and Oral Medicine".

Deadline for manuscript submissions: 25 September 2025 | Viewed by 4274

Special Issue Editor

Dr. Henk S. Brand

E-Mail Website
Guest Editor
Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, the Netherlands.
Interests: medical dental interaction; saliva; xerostomia; diagnostics; inflammatory bowel disease; cancer survivors

Special Issue Information

Dear Colleagues,

Many systemic diseases affect oral health, either directly or as a result of medical treatment. Conversely, the condition of the mouth can affect the functioning of other parts of the human body. Although many such interactions between systemic diseases and oral diseases have already been described, the underlying pathophysiological causes of these interactions remain unclear. In addition, many potential interactions between internal organs and the oral cavity have not yet been investigated. Therefore, this Special Issue of JCM aims to compile studies on the interaction between systemic diseases and oral diseases, and to contribute to enhanced communication between the medical and dental disciplines, which often still function independently of each other.

Dr. Henk S. Brand
Guest Editor

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Keywords

  • medical dental interaction
  • saliva
  • xerostomia
  • diagnostics
  • inflammatory bowel disease
  • cancer survivors
  • dental erosion
  • Sjögren’s disease
  • liver transplantation

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Published Papers (5 papers)

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Research

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14 pages, 1031 KiB  
Article
Remineralizing Treatments for Dental Erosion and Sensitivity in Patients Suffering from Gastroesophageal Reflux Disease (GERD): Randomized Clinical Trial
by Andrea Scribante, Alessia Pardo, Maurizio Pascadopoli, Federico Biagi, Annalisa Schiepatti, Valentina Giammona, Marco Vecchio, Christian Alquati, Gioia Giada Modica, Cinzia Casu and Andrea Butera
J. Clin. Med. 2025, 14(10), 3525; https://doi.org/10.3390/jcm14103525 - 18 May 2025
Viewed by 548
Abstract
Background: Gastroesophageal reflux disease (GERD) is a chronic condition that causes an abrupt decrease in salivary pH in the oral cavity, which can lead to demineralization, erosion, hypersensitivity, functional impairment, and possibly fracture of dental elements. The aim of this clinical study is [...] Read more.
Background: Gastroesophageal reflux disease (GERD) is a chronic condition that causes an abrupt decrease in salivary pH in the oral cavity, which can lead to demineralization, erosion, hypersensitivity, functional impairment, and possibly fracture of dental elements. The aim of this clinical study is to compare two types of treatment in patients with dental erosion diagnosed with gastroesophageal reflux. Methods: Thirty patients were enrolled in this randomized clinical trial. Each patient underwent clinical evaluation and esophageal pH measurement, in order to diagnose GERD. After an initial examination and assessment by an experienced dentist, the Trial group (15 patients) was assigned to home treatment with a zinc hydroxyapatite-based toothpaste and a hydroxyapatite-based paste, while the Control group (15 patients) was assigned to home treatment with zinc hydroxyapatite-based toothpaste only. The following indices were measured: Basic Erosive Wear Examination Index (BEWE); Schiff Air Index (SAI); Plaque Index (PI); and Bleeding Score (BS). Each index was assessed at T0 during the first visit, one month (T1), three months (T2), six months (T3), nine months (T4), and 12 months (T5). The Kolmogorov–Smirnov test was used to analyze the normality of the data, while Friedman’s test followed by Dunn’s post hoc test were used to compare the two groups (significance threshold: p < 0.05). Results: The results showed no statistically significant change in the BEWE and SAI indexes (p > 0.05). However, an improvement in dentin sensitivity and BS was observed. Plaque control also improved. Conclusions: The results of this study indicate that the additional hydroxyapatite paste did not significantly improve the outcomes of the study in respect to hydroxyapatite toothpaste alone. However, there was an improvement in the oral health of GERD patients using hydroxyapatite-based remineralizing treatment in terms of oral and periodontal indices calculated. Full article
(This article belongs to the Special Issue Interaction Between Systemic Diseases and Oral Diseases)
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9 pages, 398 KiB  
Article
Association Between Oral Lichen Planus and Thyroid Disease: A Cross-Sectional Study
by Stephanie Rodríguez-Fernández, Sonia Egido-Moreno, Sharon Rodríguez-Fernández, Joan Valls-Roca-Umbert, August Vidal-Bel, Andrés Blanco-Carrión and José López-López
J. Clin. Med. 2025, 14(9), 3106; https://doi.org/10.3390/jcm14093106 - 30 Apr 2025
Viewed by 319
Abstract
Background: In recent years, various authors have suggested a potential association between oral lichen planus (OLP) and thyroid disease (TD), although other studies have failed to confirm a significant relationship. The available literature presents inconsistent and sometimes contradictory findings. Additionally, other conditions—such as [...] Read more.
Background: In recent years, various authors have suggested a potential association between oral lichen planus (OLP) and thyroid disease (TD), although other studies have failed to confirm a significant relationship. The available literature presents inconsistent and sometimes contradictory findings. Additionally, other conditions—such as anxiety and depression, hypertension, diabetes mellitus, and dyslipidemia—have also been linked with OLP. Methods: A cross-sectional study was conducted involving 120 participants, comprising 60 patients diagnosed with OLP and 60 controls. Medical histories related to TD and other comorbidities were collected for both groups. Results: The prevalence of TD among the OLP patients was 20%, compared to 6.7% in the control group. The most frequently observed thyroid disorder was hypothyroidism, identified in 13.3% of the patients with OLP. Statistically, there was a moderate probability of an association between OLP and TD (p = 0.054). No statistically significant associations were found between OLP and hypertension (p = 0.378), type 2 diabetes mellitus (p = 0.550), dyslipidemia (p = 0.562), anxiety (p = 0.959), or depression (p = 0.532). Conclusions: Although the association between OLP and TD remains inconclusive, our findings suggest a moderate statistical probability of a relationship. Full article
(This article belongs to the Special Issue Interaction Between Systemic Diseases and Oral Diseases)
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16 pages, 2600 KiB  
Article
Effects of Combined Periodontal, Endodontic, and Dentoalveolar Surgical Treatments on Laboratory Parameters in Patients with Hyperlipidemia—A Clinical Interventional Study
by Renáta Martos, Mariann Harangi, Judit Szabó, Anett Földvári, János Sándor, Éva Katona, Ildikó Tar, György Paragh, Csongor Kiss and Ildikó Márton
J. Clin. Med. 2025, 14(1), 241; https://doi.org/10.3390/jcm14010241 - 3 Jan 2025
Viewed by 1140
Abstract
Background: Patients with hyperlipidemia are of interest because of the possible interplay between chronic local dental infections and hyperlipidemia. This interventional clinical study aimed to evaluate the oral health status of hyperlipidemic patients receiving lipid-lowering therapy for at least 6 months and the [...] Read more.
Background: Patients with hyperlipidemia are of interest because of the possible interplay between chronic local dental infections and hyperlipidemia. This interventional clinical study aimed to evaluate the oral health status of hyperlipidemic patients receiving lipid-lowering therapy for at least 6 months and the effects of non-surgical and surgical dental treatments on serum C-reactive protein (CRP) levels and lipid markers. Methods: Twenty-eight patients with controlled hyperlipidemia and 18 healthy controls were enrolled in the study. All participants underwent dental examinations (clinical evaluation, X-ray imaging, and microbial analysis of subgingival and supragingival plaque samples) at baseline. Hyperlipidemic patients received periodontal, endodontic, and dentoalveolar surgical treatments. Serum CRP and lipid parameters were assessed at baseline, 1 week, and 3 months, while subgingival and supragingival plaque samples were analyzed at baseline and 3 months after completing dental treatments. Results: At the 3-month follow-up, clinical periodontal characteristics, including the plaque index, gingival index, and periodontal probing depth, improved significantly (p < 0.05). A significant shift in microflora was observed in both subgingival and supragingival plaque samples (p < 0.05), alongside improvements in periodontal values and a significant reduction in serum CRP levels (p < 0.05). Serum cholesterol levels decreased significantly, while moderate improvements in serum triglycerides, low-density lipoprotein, and high-density lipoprotein levels were observed but were not statistically significant (p > 0.05). Conclusions: Treating local dental inflammation is associated with a significant decrease in CRP and cholesterol levels and may serve as beneficial adjunct therapy alongside lipid-lowering therapy in patients with hyperlipidemia. Full article
(This article belongs to the Special Issue Interaction Between Systemic Diseases and Oral Diseases)
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13 pages, 568 KiB  
Article
The Prevalence of Sjögren’s Disease in Dental Clinics in the Netherlands Compared with the Prevalence in a Systematic Literature Review of Studies in Other Countries
by Floor Maarse, Jitse F. Huisinga, Derk Hendrik Jan Jager and Henk S. Brand
J. Clin. Med. 2024, 13(19), 5918; https://doi.org/10.3390/jcm13195918 - 3 Oct 2024
Viewed by 1584
Abstract
Background/Objectives: Sjögren’s disease (SjD) is an autoimmune disease causing irreversible damage to the exocrine glands but can have symptoms throughout the entire body. The aim of this study is to determine the prevalence of Sjogren’s disease (SjD) in the Netherlands, compare this [...] Read more.
Background/Objectives: Sjögren’s disease (SjD) is an autoimmune disease causing irreversible damage to the exocrine glands but can have symptoms throughout the entire body. The aim of this study is to determine the prevalence of Sjogren’s disease (SjD) in the Netherlands, compare this with the prevalence for other countries in a systematic literature review. Methods: In the first part of this study, the prevalence of SjD was determined at two academic dental clinics in the Netherlands by electronically analysing patient records. In the second part of this study, a systematic literature search was performed in PubMed. Studies in the English language reporting prevalence ratios (PRs), incidence ratios (IRs) or sufficient data to calculate these parameters were included. Population-based studies and population surveys aiming to examine an entire geographic region or using a clearly defined sampling procedure were included. Review studies were excluded. Studies that did not report sufficient data or contained no original data were excluded. Included studies were assessed using the Newcastle–Ottawa assessment scale. Results: At the dental clinic in Amsterdam, 76 SJD patients were identified among a patient population of 81941, resulting in a prevalence ratio of 93 per 100,000 (0.093%) patients. In Nijmegen, 21 SjD patients were identified in a total patient population of 14,240, resulting in a prevalence ratio of 147 per 100,000 (0.15%). Thirty-one studies were included in the systematic review. They varied in diagnostic criteria for SjD with the American-European Consensus Group (AECG) criteria being the most widely used. The reported prevalence ratio varied from 0.008% to 3.3%. The overall pooled prevalence ratio of SjD using the AECG criteria was 0.031%, while the pooled prevalence of SjD using the EU criteria was 0.029%. The overall pooled incidence ratio was 5.2 (95%CI 4.7 to 5.6) per 100,000 person-years. Conclusions: The estimated prevalence ratio of SjD in the Netherlands (0.09% to 0.15%) falls within the worldwide range but is higher than the worldwide pooled prevalence ratio. Full article
(This article belongs to the Special Issue Interaction Between Systemic Diseases and Oral Diseases)
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20 pages, 1947 KiB  
Systematic Review
Oral Findings Linked to Chronic Kidney Disease: A Comprehensive Systematic Review
by Paula García-Rios, Francisco Javier Rodríguez-Lozano and Nuria Pérez-Guzmán
J. Clin. Med. 2025, 14(12), 4380; https://doi.org/10.3390/jcm14124380 - 19 Jun 2025
Viewed by 1
Abstract
Background\Objectives: Chronic kidney disease (CKD) is defined as a clinical syndrome secondary to a permanent change in kidney function or structure, making it irreversible. Most patients at the onset of the disease are asymptomatic or present nonspecific symptoms, including signs and symptoms at [...] Read more.
Background\Objectives: Chronic kidney disease (CKD) is defined as a clinical syndrome secondary to a permanent change in kidney function or structure, making it irreversible. Most patients at the onset of the disease are asymptomatic or present nonspecific symptoms, including signs and symptoms at the oral level. These manifestations, such as hyposalivation, increased calculus index, enamel defects, or changes in saliva composition, contribute to the diagnosis of this pathology and can also significantly affect the patient’s quality of life. The aim is to systematically assess the presence and relevance of oral manifestations in patients with CKD, and to identify correlations between these symptoms and clinical parameters such as glomerular filtration rate or concomitant conditions of the patient. Materials and Methods: A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A search was carried out in the PubMed, Scopus, Scielo, and The Cochrane Library databases on 7 April 2025, using terms related to “chronic kidney disease” and “oral manifestations”. Inclusion criteria referred to observational studies published in the last ten years that reported oral symptoms in patients with CKD. The quality of cohort and case-control studies was assessed using the Newcastle–Ottawa Scale (NOS), while for cross-sectional studies, the Joanna Briggs Institute (JBI) critical appraisal checklist was used. Results: A total of 27 studies met the inclusion criteria, primarily cross-sectional in design. The most frequently reported oral manifestations included hyposalivation, increased calculus and plaque indices, enamel defects, periodontal disease, and oral candidiasis. Significant associations were identified between the duration of dialysis and severity of periodontal disease, as well as between CKD stage and taste dysfunction. Findings varied by age group and CKD stage, with children showing distinct salivary profiles and adults presenting more pronounced periodontal and mucosal conditions. Conclusions: This review highlights a clear relationship between CKD and various oral health disturbances, although more studies are needed to better understand oral–systemic interactions in CKD. What is necessary is the establishment of multidisciplinary care approaches. Full article
(This article belongs to the Special Issue Interaction Between Systemic Diseases and Oral Diseases)
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