From Periodontal Inflammation to Multimorbidity: Epidemiologic Evidence and Policy Implications for Integrated Prevention

Periodontal diseases are highly prevalent chronic inflammatory conditions that contribute to tooth loss and impaired quality of life. Growing epidemiological and mechanistic evidence also links periodontitis with systemic outcomes, including cardiometabolic disease, adverse pregnancy outcomes, respiratory disease, chronic kidney disease, and all-cause mortality. These associations likely reflect a combination of shared risk factors, dysregulated host inflammatory responses, microbial translocation, and bidirectional effects between systemic conditions and periodontal inflammation. However, the strength and direction of reported relationships vary across populations and study designs, and residual confounding and reverse causality remain key concerns. Clarifying oral–systemic interconnections is increasingly important for public health because the burden of periodontitis and major non-communicable diseases concentrates in socially disadvantaged groups with limited access to preventive services.This Research Topic aims to strengthen causal and translational inference on the relationship between periodontal health and systemic disease, and to define how this evidence can inform prevention policy and health system planning. The field faces several challenges: heterogeneous case definitions and outcome measures, limited representativeness of high-risk and underserved populations, inconsistent adjustment for behavioural and socioeconomic confounders, and uncertainty about whether periodontal interventions meaningfully improve systemic endpoints. We seek contributions that use contemporary epidemiologic approaches to address these gaps, including causal inference frameworks, mediation analyses, quasi-experimental designs, and robust prediction or forecasting models that integrate clinical, behavioural, and social determinants of health. We also welcome clinical effectiveness research evaluating periodontal prevention and treatment strategies and their effects on systemic biomarkers and patient-centred outcomes. By connecting population data to implementable interventions and policy levers, this Topic will support integrated, equitable strategies to reduce the combined burden of periodontal and systemic disease.This Research Topic welcomes population-based and patient-oriented research that advances oral epidemiology and clarifies periodontal–systemic relationships with explicit public health relevance. Themes include:• Descriptive epidemiology and trends in periodontitis and multimorbidity across populations• Risk factors and social determinants (inequities, access to care, diet, tobacco, alcohol, medications)• Causal inference (including Mendelian randomisation, target trial emulation, mediation, and sensitivity analyses)• Mechanisms and pathways supporting epidemiologic associations (inflammation, microbiome, cardiometabolic pathways)• Clinical effectiveness studies and trials of periodontal interventions with systemic outcomes or biomarkers• Screening, diagnostic test evaluation, and risk stratification tools for integrated care• Policy and implementation research (prevention programs, service integration, cost-effectiveness)Manuscripts of interest include cohort and registry studies, pragmatic trials, diagnostic accuracy studies, methodological papers, systematic reviews/meta-analyses, and high-quality scoping reviews. Topic editors: Ricardo Castro Alves, Kunaal Dhingra, Abiola Adeniyi Source: https://www.frontiersin.org/research-topics/77569/from-periodontal-inflammation-to-multimorbidity-epidemiologic-evidence-and-policy-implications-for-integrated-prevention