Title A Low Level of Physical Activity May Be A Risk Factor For Periodontal Disease Development
Clinical Question In a 50 year old male patient, is a low level of physical activity compared to a high level of physical activity, a risk factor for periodontal disease development?
Clinical Bottom Line In a 50 year old male patient, a low level of physical activity may increase the risk of periodontal disease development. (See Comments on the CAT below)
Best Evidence  
PubMed ID Author / Year Patient Group Study type
(level of evidence)
14561049Merchant/200339,461 male, healthcare professionals age 40-75Cohort
Key resultsWhen men in the lowest quintile of physical activity (3 METs/week) were compared to men in the highest quintile of physical activity (58 METs/week),it was determined that men in the lowest quintile had 13% increased risk of periodontal disease development (RR = 0.87;9 5% CI: 0.76-1.01, p-value, test for trend = 0.02)
Evidence Search ("Periodontal Diseases"[Mesh]) AND "Exercise"[Mesh]
Comments on
The Evidence
In this cohort study, 39,461 male healthcare professionals age 40-75 were divided into quintiles based on their self-reported physical activity levels. At the beginning of the study, the selected groups were similar and healthy in regards to periodontal and cardiovascular disease. Throughout the study, the groups received the same written surveys and were followed up for 12 years on their self-reported physical activity and periodontal disease development. Periodontal disease diagnosis was defined as a patient being told by a dental professional that he had the disease. To asses the validity of the self-reported periodontal data, a subgroup was created in the study that evaluated dentist diagnosed periodontal disease in 137 men based on radiographic bone loss. Survey compliance was adequate throughout the study. However, recall bias may be likely since participants in the study were required to self-report their periodontal disease development and physical activity. There were no competing interests in this study.
Applicability The health care professionals in this study were representative of my patient’s age, but not representative of my patient’s career. The decrease in periodontal disease risk found in this study suggests another benefit of incorporating regular physical activity into my patient’s life to improve his overall health. However, finding time and motivation are significant barriers to regular exercise. Daily oral hygiene is less time consuming than daily exercise. More research is needed to further study the association of periodontal disease risk and physical activity.
Specialty (General Dentistry) (Periodontics) (Dental Hygiene)
Keywords periodontal disease, periodontitis, exercise
ID# 2259
Date of submission 04/19/2012
E-mail nellisn@livemail.uthscsa.edu
Author Nicole Nellis
Co-author(s) e-mail
Faculty mentor Charles Hermesch, DMD
Faculty mentor e-mail hermesch@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
None available
Comments and Evidence-Based Updates on the CAT
by Stephanie Trahan (San Antonio, TX) on 07/18/2012
A survey was done on a non-health career population in Jordan and found low physical activity was significantly associated with increased odds of periodontal disease. (PMID 20860591). The association between periodontal disease, physical activity and healthy diet among adults in Jordan.