Periodontitis and the Risk of Mortality from All Causes in Humans- A Scoping Review

Abstract

Periodontitis is a highly prevalent disease with strong associations with systemic diseases that are leading causes of death globally. We aimed to systematically map the evidence regarding the association between periodontitis and the risk of all-cause mortality in humans. We systematically searched PubMed, Scopus, Embase and Web of Science databases to identify potential sources published till December 2025. We included all studies that reported the association between periodontitis or related periodontitis parameters and the risk of all-cause mortality in any human population, excluding studies that assessed tooth loss, self-reported periodontitis or periodontitis treatment as the exposure. The data extracted were synthesised descriptively. No study quality assessment was performed. After systematic screening, 80 studies (68 cohort studies, 7 meta-analyses, and 5 conference abstracts) were included in the synthesis. Longitudinal cohort studies in a variety of populations (the general population, the elderly, cohorts with specific chronic diseases like metabolic disease, cardiovascular disease, liver disease, cancer, chronic kidney disease, depression, and migraine) across 13 countries were included. A total of 52 studies (45 cohort studies, 5 meta-analyses, and 2 conference abstracts) reported a positive association between periodontitis/related parameters and all-cause mortality. Heterogeneity in periodontitis definitions across studies and residual confounding are the primary limitations of the current evidence. The scientific literature seems to point in the direction of a potential positive association between periodontitis and the risk of all-cause mortality in humans. This association can be primarily explained by the cumulative burden of common risk factors between periodontitis and mortality, along with potential contributions from the chronic systemic inflammation stemming from periodontitis. Hence, strategies to optimise systemic health by targeting common risk factors should complement optimal oral hygiene in the prevention and management of periodontitis, to integrate systemic health into periodontal health and vice versa.