Table 1.

Mechanisms of systemic diseases associated with periodontal diseases.

Health Problems Associated with Peridontal Disease	Mechanism
Cardiovascular	Elevated acute phase proteins (CRP, haptoglobin, alfa1-antitrypsin, fibrinogen) due to periodontitis Elevated CRP is associated with a higher risk of myocardial infarction and peripheral artery disease
Diabetes	Progression of diabetes: IL-1β and TNF-α increase insulin Endotoxins or LPS → inflammation
Respiratory	Aspiration of oral bacteria Enzymes secreted with saliva in periodontal disease may change mucosa and lead to higher adhesion and colonization of respiratory microbes Enzymes secreted in periodontal disease by P. gingivalis degrade salivary elements that bind pathogens and preclude them from mucosal adhesion Cytokines secreted in periodontal disease may modify respiratory epithelium
Problems with pregnancy	Low birth weight Preterm birth: elevated LPS stimulates placenta calls to secrete IL-1β and PGE-2
Rheumatoid arthritis	P. gingivalis synthetizes citrullinated proteins causing the organism to produce anti-citrullinated proteins antibodies