Reports & Studies

Do lifestyle changes make for a healthier periodontium?

PD Dr. Kristina Bertl, PhD MSc MBA

Periodontitis is an inflammatory disease of the periodontium. Even though the disease is therefore directly confined to the mouth, it nonetheless has an impact on the entire body; for example, on diabetes or cardiovascular diseases. By the same token, however, lifestyle changes can also have an impact on periodontal disease.

 Do lifestyle changes make for a healthier periodontium?

Another theme of the Perio Workshop 2019 was to systematically assess the effect of guidelines that are intended to achieve positive patient lifestyle changes among periodontitis patients. A German–French research group led by Christoph Ramseier conducted a comprehensive literature review of 1) general guidelines for interventions that are intended to influence patient lifestyle, and 2) the application of these guidelines with regard to periodontitis patients (Ramseier et al. 2020).

They identified 13 guidelines on the following topics:

  • Giving up smoking
  • Diabetes control
  • Physical activity
  • Change of diet
  • Reduction of carbohydrate- and sugar-rich foods
  • Weight loss

These 13 guidelines were tested in 25 studies involving periodontitis patients. Two of the main points in relation to periodontitis have a strong scientific basis: giving up smoking and diabetes control. Both ‘interventions’ lead to an improvement in periodontal health.

Although clinical studies on the other guidelines were also available, too few data are currently available to conclude with certainty that these guidelines really do lead to an improvement in periodontal health.

From these findings we can derive the following points for our day-to-day practice:

  1. We should never treat the teeth in isolation, but always the patient as a whole.
  2. Even if we constantly strive to keep our knowledge up to date, it is difficult to be fully up to date in all areas, and certain interventions of this nature simply lie outside our field of activity. It is therefore advisable to build a professional network of suitable contacts who specifically deal with lifestyle changes. As psychologists, dieticians and diabetologists, etc., these contacts can specifically address the additional needs of our patients.

You can find other articles on this topic in the Prophy Community:


  1. Christoph A Ramseier, Johan P Woelber, Julia Kitzmann, Laurent Detzen, Maria Clotilde Carra, Philippe Bouchard. Impact of risk factor control interventions for smoking cessation and promotion of healthy lifestyles in patients with periodontitis: A systematic review. J Clin Periodontol. 2020 Jul;47 Suppl 22:90-106. doi: 10.1111/jcpe.13240.