Liver inflammation and gum disease: Is there a link?

In this article, we hear expert insight on the latest studies relating to liver health and its association with gum disease from Dr Sulaman Anwar, a specialist periodontist and implant surgeon.

What does new research tell us about the link between liver health and gum disease?

Researchers from the University Medical Centre Hamburg-Eppendor and the German Centre for Infection Research, spanning the departments of medicine, periodontics, preventative and restorative dentistry, conducted an investigation within a well-defined cohort. The study aimed to explore the relationship between periodontitis, often referred to as gum disease, and liver health.

One notable finding was the association between increased liver stiffness and the severity of periodontitis. This correlation was further supported by positive associations with key periodontitis markers like bleeding on probing and probing pocket depth. The researchers suggest that these findings underscore the importance of reminding patients about the necessity of regular dental visits.

The study involved the examination of detailed periodontal parameters in 132 patients, including 32 with non-alcoholic steatohepatitis (NASH). The data was then correlated with relevant hepatic parameters, such as liver stiffness. Notably, 87.5 per cent of NASH patients, in contrast to 47 per cent of the control group, exhibited moderate to severe periodontitis. Liver stiffness was significantly linked to elevated pocket probing depths and bleeding on probing.

In addition, 34 per cent of the NASH patients surveyed did not receive regular dental care. This subgroup displayed significantly elevated levels of alanine transaminase (ALT), model of end-stage liver disease, and liver stiffness compared to those who maintained regular dental visits.

How significant are these findings?

The study’s findings are great significance of the study, bringing to light established links between periodontitis and systemic health conditions, such as diabetes and obesity, as well as an association between NASH and periodontitis.

Rather than conclusively determining a causal relationship between periodontitis and NASH, the study raises the possibility that the common factor linking the two conditions might be an overall reduced health awareness amongst these patients. The researchers acknowledge the preliminary nature of these findings and advocate for large-scale follow-up research to validate the association and determine if untreated periodontitis could exacerbate NASH.


The study, titled "High prevalence of periodontal disease in patients with NASH - possible association of poor dental health with NASH severity," was published online on January 23, 2023, in the Annals of Hepatology.

To schedule a consultation with Dr Anwar, visit his Top Doctors profile today.