Association between periodontal disease and chronic obstructive pulmonary disease in adults: A systematic review

Periodontal disease is a chronic inflammatory condition with a high prevalence that compromises the tissues supporting the teeth. This pathology has been linked to various systemic diseases through common inflammatory and immunological mechanisms. On the other hand, chronic obstructive pulmonary disease (COPD) is one of the leading causes of illness and death worldwide, characterized by persistent airflow obstruction and chronic inflammation of the airways. Both conditions share significant risk factors, such as tobacco use, aging, unfavorable socioeconomic conditions, and the presence of systemic comorbidities, such as diabetes mellitus. In addition, a bidirectional relationship between the two diseases has been proposed, mediated by processes such as systemic inflammation, imbalances in the microbiota, and alterations in the body's immune response. Various observational studies indicate that people with COPD tend to have more compromised periodontal health than those without the disease. It has also been suggested that periodontitis could be related to decreased lung function, increased frequency of exacerbations, and poorer clinical outcomes. However, the available evidence is heterogeneous, influenced by differences in diagnostic criteria, control of confounding variables, and the methodologies used to measure effects. Given this situation, it is essential to conduct a comprehensive systematic review that integrates the existing observational evidence in order to accurately estimate the strength and consistency of the association between periodontal disease and COPD, as well as to identify possible methodological limitations that can serve as a guide for future research.