IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 19, Issue 2 Ser.17 (February. 2020), PP 17-21 www.iosrjournals.org DOI: 10.9790/0853-1902171721 www.iosrjournals.org 17 | Page Correlation between Signs of Anemia and Chronic Periodontitis Dr. Manisha Mallik 1 , Dr. Anjani Kumar 2 , Dr. Anindita Banerjee 3 , Dr. Prabhat Kumar Singh 4 , Dr. Abhishek Verma 4 , Dr. Nitubroto Biswas 4 1(Senior Lecturer, Department of Periodontology, Buddha Institute of Dental Sciences and Hospital, Patna) 2(MBBS, M.D. Pediatric Medicine & neonatology), Private practice, Patna 3(Professor and HOD, Department of Periodontology, Buddha Institute of Dental Sciences and Hospital, Patna 4Professor, Department of Periodontology, Buddha Institute of Dental Sciences and Hospital, Patna 4Professor, Department of Periodontology, Buddha Institute of Dental Sciences and Hospital, Patna 4Professor, Department of Periodontology, Buddha Institute of Dental Sciences and Hospital, Patna Corresponding Author: Dr. Manisha Mallik --------------------------------------------------------------------------------------------------------------------------------------- Date of Submission: 11-02-2020 Date of Acceptance: 27-02-2020 --------------------------------------------------------------------------------------------------------------------------------------- I. Introduction Periodontitis refers to an inflammatory disease of the supporting structures of the tooth caused by a group of specific microorganisms resulting in recession, pocket formation or both. 1 It represents a mixed type of infection of which the main etiologic factors are Gram negative bacteria. The inflammation of the gingiva begins as a response to colonization of Gram positive periopathogens, but as the disease progresses to deeper structures, pocket formation due to pathological deepening of gingival sulcus occurs. Such an area provides a favorable environment for Gram negative, anaerobic and more virulent microbes to colonize and flourish. Periodontal tissue breakdown occurs as a complex interaction between endotoxins released by bacteria and host immune response. The bacterial products induce an immunoinflammatory response in the host tissue and periodontal diseases being chronic in nature act as a source of constant immunological challenge for the host. Albeit, the host response aims to waive off the microbial challenge, it invariably leads to production of tissue-degrading enzymes. Initially, the epithelial continuity of sulcular epithelium is broken down by tissue- degrading enzymes. This creates a pathway for periodontal pathogens to enter the connective tissue and finally systemic circulation. The systemic bacteremia resulting in persistent low grade systemic inflammation in chronic periodontitis patients has been speculated to be related to periodontal inflammation. 2 The interrelationship between periodontal diseases and systemic conditions like atherosclerosis, cardiovascular diseases, diabetes mellitus and pregnancy is a well-established phenomenon. Studies indicate that the by-products of low-grade inflammatory process in host body contribute in aggravating the disease. Anemia of chronic disease is the second most prevalent type of anemia after iron deficiency anemia and occurs in patients with acute or chronic immune activation. 3 ‘Anemia of Chronic Inflammation’ is defined as anemia occurring in chronic infections, inflammatory conditions or a neoplastic disorder that is not caused by marrow deficiencies or other diseases and in the presence of adequate iron stores and vitamins. 4 Some diseases frequently associated with anemia of chronic inflammation are infections (fungal, bacterial, viral, parasitic), cancer, autoimmune diseases (vasculitis, SLE, Rheumatoid arthritis) and chronic rejection after solid organ transplant. 3 Chronic periodontitis results in a low grade systemic inflammation and it is speculated that it may cause a depression in the no. of erythrocytes and consequently lowering of hemoglobin concentration. 5 The aim of the present study is to assess whether patients with chronic periodontitis have an anemic status. II. Materials and Method Study population This study was carried out in the Out Patient Department of Periodontology, Buddha Institute of Dental Sciences and Hospital, Patna. A total of 80 systemically healthy male subjects were selected for this study. Their age range was 25-60 years. 40 patients recruited were suffering from chronic periodontitis while rest 40 patients were volunteers who visited the dental hospital for regular dental checkups. It was a cross sectional study and prior to commencement of sample collection; the study was approved by the Ethical Committee of the Institute. All patients received a verbal explanation about the nature of the study and informed written consent was obtained from them. A detailed systemic and family history was recorded. Patients with a history of systemic diseases or conditions that could affect the periodontal health were excluded from the study. Following were the exclusion