Proton Pump Inhibitors May Reduce Severity of Gum Disease

The use of proton pump inhibitors (PPIs) was associated with decreased gum disease severity in study results published online ahead of print in Clinical and Experimental Dental Research.

“Proton pump inhibitors (PPIs) are commonly prescribed for the management of acid-related gastrointestinal disorders,” explained researchers from the University of Buffalo in the study background. “PPIs modulate osteoclast function, reduce gastric acid secretion, and are associated with the establishment of a more diverse gastrointestinal microbiota.”

To assess whether PPI use affects periodontitis, or gum disease, researchers looked at the records of more than 1093 patients at a faculty periodontal practice. They found that smaller probing depths—the gap between teeth and gums—were more likely in patients who used PPIs.

While healthy gums tend to fit snuggly against teeth, harmful bacteria can deepen gaps and lead to inflammation, bone loss, and periodontitis, they explained. Probing depths can serve as an indicator of periodontitis severity.

According to the study, just 14% of teeth from patients who used PPIs had probing depths of 6 millimeters or more compared with 24% of teeth from patients who did not use PPIs. Meanwhile, 27% of teeth from patients who used PPIs had probing depths of 5 millimeters or more compared with 40% of teeth from patients who did not use PPIs.

The association between PPI use and reduced proportion of elevated probing depths may stem from the medication’s ability to alter bone metabolism or the gut microbiome, as well at its potential impact on periodontal microorganisms, researchers speculated.

“PPIs could potentially be used in combination with other periodontal treatments,” said lead investigator Lisa M Yerke, DDS, clinical assistant professor in the department of periodontics and endodontics at the University of Buffalo School of Dental Medicine. “However, additional studies are first needed to understand the underlying mechanisms behind the role PPIs play in reducing the severity of periodontitis.”

References
Chawla BK, Cohen RE, Yerke LM. Association between proton pump inhibitors and periodontal disease severity. Clin Exp Dent Res. 2021 Sep 21. doi:10.1002/cre2.495