Effect of periodontal therapy on hemoglobin and erythrocyte levels in chronic generalized periodontitis patients: an interventional study

J Indian Soc Periodontol. 2009 Jan-Apr; 13(1): 6–11. doi:  10.4103/0972-124X.51887 | PMCID: PMC2846680 |
Copyright © Journal of Indian Society of PeriodontologyEffect of periodontal therapy on hemoglobin and erythrocyte levels in chronic generalized periodontitis patients: An interventional studyNupur Agarwal,1 Veerendra S. C. Kumar,2 and Sheela A. Gujjari31PG Student, Department ofPeriodontics, J.S.S. Dental College & Hospital, Mysore, India 2Professor and Head, Department of Periodontics, J.S.S. Dental College & Hospital, Mysore, India. 3Associate Professor, Department of Periodontics, J.S.S. Dental College & Hospital, Mysore, IndiaAddress for correspondence: Dr. Nupur Agarwal, House No. 753, 1st Main Road, 2A cross, S.S. Nagar, Banimantap, Mysore, India Email:drnupurg@yahoo.com Received December 12, 2008; Accepted April 11, 2009.AbstractAims and Objectives:Anemia of chronic disease (ACD) is one of the most common forms of anemia. It is defined as anemia occurring in chronic infections, inflammatory conditions or neoplastic disorders which are not due to marrow deficiencies or other diseases, and occurring despite the presence of adequate iron stores and vitamins.Periodontitis is one of the most prevalent chronic inflammatory diseases in humans. This study aimed at finding out if periodontitis, like other inflammatory conditions, could lead to anemia.Materials and Methods:Thirty chronic generalized periodontitis male patients with hemoglobin levels below 15 mg/dl and serum ferritin values above 30 ng/ml were selected. The various blood parameters recordedat baseline were hemoglobin levels(Hb), erythrocyte count (RBC), erythrocyte sedimentation rate (ESR), mean corpuscular volume(MCV), mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC).Periodontal parameters recorded at baseline included: plaque index, gingival index, probing pocket depth, clinical attachment level. Periodontal treatment including surgery ifrequired was carried out in all the patients. Periodontal status of patients was monitored by repeating evaluation of periodontal indices at three months and at the end of one year. The hematological values were again measured at the end of one year.Results:The results showed that correction of periodontal inflammation resulted in a significant increase in hemoglobin levels and erythrocyte counts.The erythrocyte sedimentation rate showed a reduction indicating resolution of periodontal inflammation. There was a significant, but much lesser, improvement in MCV, MCH and MCHC values.Conclusion:The results of this study showed that treatment of periodontitis leads to an improvement in hematocrit and other related blood parameters in chronic generalized periodontitis patients with anemia. Thisprovides evidence that periodontitis like other chronic diseases may also cause anemia.Keywords: ACD, anemia, hemoglobin, periodontitisINTRODUCTIONThe initiation and progression of gingivitis and periodontitis may be affected by certain systemic conditions. The converse side of the relationship between systemic health and oral health has also been demonstrated. This means that there may be potentialeffects of periodontal disease on a wide range of organ systems.[1]Anemia of chronic disease is defined as anemia occurring in chronic infections, inflammatory conditions or neoplastic disorders that are not due to marrow deficiencies or other diseases, and occurring despite presence of adequate iron stores and vitamins.[2]Recently, Hutter[2] have concluded that periodontitis, like other chronicconditions, lead to anemia. Other studies has failed to prove this relationship.[3] The present interventional study was carried out to evaluate periodontitis as one of the etiological factors leading to ACD.MATERIALS AND METHODSThirty male patients, aged between 30-55 years, with chronic generalized periodontitis were selected for the study. Patients chosen for the study had at least 30% or...