Mouth-Body Connection®

 

The science and research behind our work.

 
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Oral Health in America

 

From the first Surgeon General’s report in 2000 to the latest findings in 2021, the call has been consistent. To improve health outcomes, oral health must be fully integrated into the broader healthcare system.

 
2000 Surgeon General Report
 

2000 Surgeon General Report

 

In 2000, the U.S. Surgeon General released a landmark report declaring that "oral health is essential to general health." This report highlighted the divide between dental and medical care.

2010 Surgeon General Report Update
 

2010 Surgeon General Report Update

 

The 2010 update emphasized that oral diseases remain prevalent and that many individuals face barriers to accessing care. The report called for enhanced integration of oral health into overall health strategies.

Oral Health in America: Advances and Challenges
 

Oral Health in America: Advances and Challenges

 

The 2021 report called for stronger care coordination, expanded infrastructure and a renewed focus on prevention and education to address ongoing challenges.

 
 
 

Oral health is a key indicator of systemic health.

 

 

 
 

Oral pathogens can enter the bloodstream and trigger immune responses throughout the body. This inflammatory cascade is linked to chronic conditions including diabetes, cardiovascular disease, Alzheimer’s, several cancers and complications in pregnancy. In fact, eight of the ten leading causes of death in the U.S. are linked to inflammation that can begin in the mouth.

 

Oral health impacts every system in the body.

 
 

Industry and Research Partners

 

To continue to increase awareness about oral-systemic health and the Mouth-Body Connection®, PDS Health works with a wide range of partners to advance research that highlights the benefit of integrated care.

 

Smile Generation connects patients to trusted dental providers committed to delivering advanced clinical care and an exceptional patient experience. Smile Generation practices regularly educate patients on the Mouth-Body Connection®.

 
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The Santa Fe Group advocates for integrating oral health into Medicare. Their initiatives focus on equitable, community-driven, and evidence-based policy changes.

CareQuest Institute for Oral Health conducts research on oral-systemic health, health equity and value-based care, with a focus on underserved communities.

ADA Forsyth Institute is a leading research institute exploring the connections between oral health and overall well-being. The institute conducts groundbreaking studies on the mouth's role as a gateway to systemic health.

NACDD’s Medical-Dental Integration Task Force developed a national framework, including awareness, data sharing, interdisciplinary collaboration and sustainable payment models, to integrate oral health into chronic disease prevention.

 
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Evidence-based Research

 

The Mouth-Body Connection® is supported by a growing body of clinical and academic research. This evidence informs the work we do at PDS Health and guides how we partner with researchers, clinicians and organizations across health care.

Explore the research below to see how science is shaping the future of whole-person care.

 

Exploring the shared genetic architecture between periodontitis and cardiovascular disease

BDJ Open | Jin | 2026

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Oral microbiome diversity and all-cause mortality in hypertensive adults: findings from a nationally representative cohort

Journal of Oral Microbiology | Zhou et al | 2026

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How Your Mouth Could Be Killing Your Heart

StudyFinds | Kerrigan | 2025

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Cardiovascular Event Risk Increases More Sharply for Men Than Women at Very Low Average Blood Pressure

EpicResearch | Bartelt et al | 2025

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Association between cardiovascular diseases and apical periodontitis: An umbrella review with stratification of evidence and sensitivity analysis

Journal of Dentistry | Telekar et al | 2025

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Periodontitis and cardiovascular diseases: Consensus report

Journal of Clinical Periodontology | Sanz et al | 2019

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Poor Oral Health and Blood Pressure Control Among US Hypertensive Adults: Results From the National Health and Nutrition Examination Survey 2009 to 2014

Hypertension | Peitropaoli | 2018

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Novel Biomarkers for Cardiovascular Risk Prediction

Journal of Geriatric Cardiology | Wang | 2017

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Childhood oral health is associated with the incidence of atherosclerotic cardiovascular disease in adulthood

International Journal of Cardiology | Nygaard | 2026

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Periodontal Disease and Atherosclerotic Cardiovascular Disease: A Scientific Statement From the American Heart Association

Circulation | Tran et al | 2025

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Gum disease may be linked to plaque buildup in arteries, higher risk of major CVD events
American Heart Association | 2025

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Periodontitis treatment and progression of carotid intima-media thickness: a randomized trial

European Heart Journal | Orlandi et al | 2025

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Atrial Translocation of Porphyromonas gingivalis Exacerbates Atrial Fibrosis and Atrial Fibrillation

Circulation | Miyauchi et al | 2025

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Increased cardiovascular risk in people with type 2 diabetes and periodontitis: an analysis from a global real-world federated database

British Dental Journal | Essa et al | 2025

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Oral microbiome diversity associates with carotid intima media thickness in middle-aged male subjects

Communications Magazine | Akhi et al | 2025

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How Your Mouth Could Be Killing Your Heart

StudyFinds | Kerrigan | 2025

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Cardiovascular Event Risk Increases More Sharply for Men Than Women at Very Low Average Blood Pressure

EpicResearch | Bartelt et al | 2025

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Association between cardiovascular diseases and apical periodontitis: An umbrella review with stratification of evidence and sensitivity analysis

Journal of Dentistry | Telekar et al | 2025

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Inflammation of the Periodontium Associates with Risk of Future Cardiovascular Events
Journal of Periodontology | Van Dyke | 2021

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Association between periodontitis and blood pressure highlighted in systemically healthy individuals

Hypertension | Aguilera | 2021

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Prevention of Viridans Group Streptococcal Infective Endocarditis: A Scientific Statement From the American Heart Association

Circulation | Wilson et al | 2021

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Association Between Periodontal Disease and Atherosclerotic Cardiovascular Diseases: Revisited

Frontiers in Cardiovascular Medicine | Zardawi et al | 2021
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Periodontitis and cardiovascular diseases: Consensus report

Journal of Clinical Periodontology | Sanz et al | 2019

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Poor Oral Health and Blood Pressure Control Among US Hypertensive Adults: Results From the National Health and Nutrition Examination Survey 2009 to 2014

Hypertension | Peitropaoli | 2018

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Novel Biomarkers for Cardiovascular Risk Prediction

Journal of Geriatric Cardiology | Wang | 2017

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High-risk periodontal pathogens contribute to the pathogenesis of atherosclerosis

Postgraduate Medical Journal | Bale et al | 2016

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Increasing Evidence for an Association Between Periodontitis and Cardiovascular Disease

Circulation | Stewart et al | 2016

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Effect of Comprehensive Cardiovascular Disease Risk Management on Longitudinal Changes in Carotid Artery Intima-media Thickness in a Community-based Prevention Clinic

Archives of Medical Science | Cheng et al | 2016

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Periodontitis and heart disease: Researchers connect the molecular dots

EurekAlert | 2015

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Oral infections and cardiovascular disease

CellPress | Kholy et al | 2015

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Bacterial Signatures in Thrombus Aspirates of Patients With Myocardial Infarction

Circulation | Pessi et al | 2013

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Changes in Clinical and Microbiological Periodontal Profiles Relate to Progression of Carotid Intima-Media Thickness: The Oral Infections and Vascular Disease Epidemiology Study

Journal of the American Heart Association | Desvarieux | 2013

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Usefulness of Self-Reported Periodontal Disease to Identify Individuals with Elevated Inflammatory Markers at Risk of Cardiovascular Disease

American Journal of Cardiology | Mochari et al | 2008

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Streptococcus mutans and cardiovascular diseases

Japanese Dental Science Review | Nakano et al | 2007

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Dietary Patterns and Intermittent Fasting as Modulators of the Oral Microbiome and Periodontal Inflammation: A Narrative Review

Biomedical & Pharmacology Journal | Parveen et al | 2026

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Successful endodontic treatment improves glucose and lipid metabolism: a longitudinal metabolomic study
Journal of Translational Medicine | Zhang et al | 2025

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Root canal treatment could significantly lower blood sugar levels, study suggests
The Gaurdian | Sample | 2025

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Borderline HbA1c Levels Among Nondiabetic Patients Associated with Increased Cardiovascular Disease Risk  

Epic-Research | Bartelt | 2025

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Preventive dental care is associated with improved health care outcomes and reduced costs for Medicaid members with diabetes  

Frontiers in Dental Medicine | Lamster | 2022

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Oral Health Care and Primary Health Care: Stronger Together in Recognizing and Managing Diabetes  

American Dental Education Association | Escontrías | 2022

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Impact of Treating Oral Disease on Preventing Vascular Diseases: A Model-Based Cost-effectiveness Analysis of Periodontal Treatment Among Patients With Type 2 Diabetes 

Diabetes Care | Choi | 2020

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Effect of periodontal treatment on diabetes-related healthcare costs  

BMJ Open Diabetes Research & Care | Smits | 2020

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Improved oral hygiene is associated with decreased risk of new-onset diabetes  

Diabetologia | Chang | 2020

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Study links frequent tooth brushing to lower risk of diabetes  

EurekAlert | 2020

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Benefits of Non-Surgical Periodontal Treatment in Patients with Type 2 Diabetes Mellitus and Chronic Periodontitis: A Randomized Controlled Trial  

Journal of Clinical Periodontology | Mauri-Obradors | 2017

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Periodontitis as a possible early sign of diabetes mellitus  

BMJ Open Diabetes Research & Care | Teeuw | 2016

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Dental Care for Diabetics: Better Health, Cost Savings  

Dental Trade Alliance | Jeffcoat | 2013

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Effect of Periodontal Disease on Diabetes: Systematic review of epidemiologic observational evidence  

Journal of Periodontology | Borgnakke | 2013

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Diabetes and Oral Disease: Implications for Health Professionals 

Annals of the New York Academy of Sciences | Albert | 2012

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Periodontal disease and diabetes - A two-way street 

Journal of the American Dental Association | Mealey | 2006

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Periodontal Disease and Mortality in Type 2 Diabetes  

Diabetes Care | Saremi | 2005

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The role of noninfectious comorbidities in the association between severe infections and risk of dementia in Finland: A nationwide registry study

PLOS Medicine | Sipila | 2026

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New study links oral health to brain aneurysm risk

Dentistry iQ | Garlo-Melkas | 2025

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Microbiome signatures of virulence in the oral-gut-brain axis influence Parkinson's disease and cognitive decline pathophysiology

Gut Microbes | Clasen | 2025

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Obstructive Sleep Apnea, Positive Airway Pressure, and Implications of Early Treatment in Parkinson Disease
JAMA Neurology | Neilson | 2025

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Combined Influence of Dental Caries and Periodontal Disease on Ischemic Stroke Risk
Neurology Open Access | Wood | 2025

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(Not) total recall: What dental hygienists need to know about Alzheimer’s disease and its treatment
RDH Magazine | Viola | 2024

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Microglial cell response to experimental periodontal disease
Journal of Neuroinflammation | Almarhoumi | 2023

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Periodontal health, cognitive decline, and dementia
Journal of the American Geriatrics Society | Asher | 2022

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Potential mechanisms between periodontitis and Alzheimer's disease
Canadian Dental Hygienists Association | Lamphere | 2022

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Periodontal dysbiosis associates with reduced CSF Aβ42 in cognitively normal elderly
Alzheimer’s & Dementia: Diagnosis, Assessment & Disease Monitoring | Kamer | 2021

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Dose-response meta-analysis on tooth loss with the risk of cognitive impairment and dementia
Journal of the American Medical Directors Association | Qi | 2021

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Clinical and Bacterial Markers of Periodontitis and Their Association with Incident All-Cause and Alzheimer’s Disease
Journal of Alzheimer’s Disease | Beydoun | 2020

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Porphyromonas gingivalis in Alzheimer’s disease brains
Science Advances | Dominy | 2019

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Chronic oral application of a periodontal pathogen results in brain inflammation, neurodengeneration and amyloid beta production in wild type mice

PLOS One | Illievski | 2018

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Association between chronic periodontitis and the risk of Alzheimer's disease: a retrospective, population-based, matched-cohort study

Alzheimer's Research and Therapy | Chen et al | 2017

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Association between periodontal disease and stroke

Journal of Vascular Surgery | Sfyoeras | 2012

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Hypertension and Cerebrovascular Dysfunction

Cell Metabolism | Iadecola | 2008

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Periodontal Disease, Tooth Loss, and Incidence of Ischemic Stroke

American Stroke Association | Joshupura | 2002

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Oral microflora and pregnancy: A systematic review and meta-analysis
Scientific Reports | Jang | 2021

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Periodontal Pathogens and Preterm Birth: Current Knowledge and Further Interventions
Pathogens | Terzic | 2021

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Assessing the Association Between Periodontitis and Premature Birth: A Case-control Study
BMC Pregnancy and Childbirth | Uwambaye | 2021

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Treating periodontal disease during pregnancy
European Federation of Periodontology | Bobetsis | 2020

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Periodontal Disease and Pregnancy Outcomes: Overview of Systematic Reviews
JDR Clinical & Translational Research | Daalderop | 2018

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Role of Maternal Periodontitis in Preterm Birth
Frontiers in Immunology | Ren | 2017

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Oral Health in Pregnancy
Journal of Obstetric, Gynecologic & Neonatal Nursing | Hartnett | 2016

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Fusobacterium nucleatum Subspecies Identification by Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry
Journal of Clinical Microbiology | Nie | 2015

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Fusobacterium Nucleatum: A Commensal-Turned Pathogen
Current Opinion in Microbiology | Han | 2015

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Oral Health Care During Pregnancy and Through the Lifespan
The American College of Obstetricians and Gynecologists | Douglas | 2013

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Periodontal Disease: a potential modifiable risk factor limiting conception
Human Reproduction | Hart | 2012

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An Examination of Periodontal Treatment, Dental Care, and Pregnancy Outcomes in an Insured Population in the United States
American Journal of Public Health | Albert | 2011

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Term Stillbirth Caused by Oral Fusobacterium nucleatum
Obstetrics & Gynecology | Han | 2011

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Periodontitis: A risk for delivery of premature labor and low-birth-weight infants
Journal of Natural Science, Biology and Medicine | Saini | 2010

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Periodontal Pathogens and Gestational Diabetes Mellitus
Journal of Dental Research | Dasanayake | 2008

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Exploring the relationship between periodontal disease and pregnancy complications
Journal of the American Dental Association | Bobetsis | 2006

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Periodontitis is Associated With Preeclampsia in Pregnant Women

The Journal of Periodontology | Contreras | 2006

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Periodontal Therapy Reduces the Rate of Preterm Low Birth Weight in Women with Pregnancy-Associated Gingivitis

The Journal of Periodontology | López et al | 2005

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Periodontal disease and preterm delivery of low-birth-weight infants

Journal of the Canadian Dental Association | McGaw | 2002

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Periodontal Therapy May Reduce the Risk of Preterm Low Birth Weight in Women with Periodontal Disease: A Randomized Controlled Trial

Journal of Periodontology | López et al | 2002

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The Case for Oral-Systemic Integration: Is Dental Artificial Intelligence the Missing Link?

Compendium | Ghorbanifarajzadeh, Dolan and Chalmers | 2026

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Oral Healthcare Can't Wait - Patient
Dental Trade Alliance | 2023

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Oral Healthcare Can't Wait - Congress
Dental Trade Alliance | 2023

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Oral Healthcare Can't Wait - Business
Dental Trade Alliance | 2023

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Association between preventive dental care and healthcare cost for enrollees with diabetes or coronary artery disease: 5-year experience
Compendium | Borah | 2022

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Dental Services and Health Outcomes in the New York State Medicaid Program
Journal of Dental Research | Lamster | 2021

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Reimbursement Rates for Child and Adult Dental Services in Medicaid by State
American Dental Association | 2021

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Time to take gum disease seriously: The societal and economic impact of periodontitis
The Economist Intelligence Unit | 2021

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Effect of periodontal treatment on diabetes-related healthcare costs: A retrospective study
BMJ Open Diabetes Research & Care | Smits | 2020

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Clinical Insights Drive Better Outcomes
Cigna | 2019

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Improved Health and Lower Medical Costs - Why good dental care is important
Cigna | 2016

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Economic Costs of Oral Care in the United States in 2014
American Society of Health Economists | Kelekar | 2016

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Evaluation of Cost Savings Associated with Periodontal Disease Treatment Benefits
Avalere Health | 2016

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Oral Health and the Triple Aim: Evidence and Strategies to Improve Care and Reduce Costs
National Academy for State Health Policy | Andrew Snyder | 2015

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Impact of periodontal therapy on general health evidence from insurance data for five systemic conditions

American Journal of Preventive Medicine | Jeffcoat | 2014

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Connections Matter: How Integrating Medical and Dental Data Improves Member Health and Lowers Cost for Employers
Aetna | 2013

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A pro-carcinogenic oral microbe internalized by breast cancer cells promotes mammary tumorigenesis

Cell Communication and Signaling | Parida | 2026

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A High-Sensitivity, Bluetooth-Enabled PCB Biosensor for HER2 and CA15-3 Protein Detection in Saliva: A Rapid, Non-Invasive Approach to Breast Cancer Screening
Biosensors | Wan | 2025

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Oral Bacterial and Fungal Microbiome and Subsequent Risk for Pancreatic Cancer
JAMA Oncology | Meng | 2025

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A distinct Fusobacterium nucleatum clade dominates the colorectal cancer niche
Nature | Zepeda-Rivera | 2024

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Human gut, breast, and oral microbiome in breast cancer: A systematic review and meta-analysis
Frontiers in Oncology | Thu | 2023

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Periodontal disease as a risk factor for sporadic colorectal cancer: Results from COLDENT study
Cancer Causes & Control | Janati | 2022

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Periodontal Disease, Tooth Loss, and Risk of Serrated Polyps and Conventional Adenomas
American Association for Cancer Research | Lo | 2020

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Mediators of Inflammation – A Potential Source of Biomarkers in Oral Squamous Cell Carcinoma
Journal of Immunology Research | Tampa | 2018

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Salivary Biomarkers in Cancer Detection
Medical Oncology | Wang | 2017

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The effect of chairside chronic disease screenings by oral health professionals on healthcare costs

American Journal of Public Health | Nasseh et al | 2014

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The Mouth: The Missing Piece to Overall Wellness and Lower Medical Costs

United Concordia Dental | 2014

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Impact of Periodontal Therapy on General Health: Evidence from Insurance Data for Five Systemic Conditions

American Journal of Preventive Medicine | Jeffcoat | 2014

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Connections Matter: How Integrating Medical and Dental Data Improves Member Health and Lowers Cost for Employers

Aetna | 2013

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United Healthcare Medical Dental Integration Study

United Healthcare | 2013

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Variations of Oral Microbiota Are Associated with Pancreatic Disease Including Pancreatic Cancer
Gut | Farrell | 2012

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Oral Microbiota and Cancer
Journal of Oral Microbiology | Meurman | 2010

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An Examination of Periodontal Treatment and Per Member Per Month Medical Costs in an Insured Population

BMC Health Services Research | Albert et al | 2006

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Salivary biomarkers and their diagnostic importance in oral diseases

Archives of Oral Biology | Thangasamy and Sivagnanam | 2026

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Biomarker-Guided Implant Maintenance (BGIM): A Narrative Review and Protocol Proposal

Journal of Clinical Medicine | Testori et al | 2026

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How reimbursement is holding back patient health and salivary diagnostics

Dentistry iQ | Butkovic | 2026

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Tannerella forsythia: The legend of a red-complex queen, part 1

RDH Magazine | Moons | 2026

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Rethinking periodontal care: A medical condition with a dental solution

Dental Economics | Obrotka | 2025

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The role of salivary metabolomics in chronic periodontitis: Bridging oral and systemic diseases

Metabolomics | Albahri | 2025

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Active Matrixmetalloproteinase-8 in Periodontal Diagnosis: A Scoping Review

MDPI | Goyal | 2025

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Spit Science: Why Saliva Is A Great Way To Detect Disease
SF Study Finds | The Conversation | 2025

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Inflammasome targeting for periodontitis prevention is sex dependent
The Proceedings of the National Academy of Sciences (PNAS) | Alves et al | 2025

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Saliva: The next frontier in cancer detection

Knowable Magazine | Loewy | 2023

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Fusobacterium in the microbiome: from health to disease across the oral–gut axis and beyond
Biofilms and Microbiomes | Cafiero | 2021

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Predictive Periodontitis: The Most Promising Salivary Biomarkers for Early Diagnosis of Periodontitis
Journal of Clinical Medicine | Cafiero | 2021

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The Potential Impact of Salivary IL-1 on the Diagnosis of Periodontal Disease: A Pilot Study
Healthcare | Kim | 2021

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aMMP-8 Point-of-Care/Chairside Oral Fluid Technology as a Rapid, Non-Invasive Tool for Periodontitis and Peri-Implantitis Screening in a Medical Care Setting
Diagnostics | Lähteenmäki | 2020

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Prediabetes/Diabetes Can Be Screened at the Dental Office by a Low-Cost and Fast Chair-Side/Point-of-Care aMMP-8 Immunotest
Diagnostics | Grigoriadis | 2019

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Novel Biomarkers for Cardiovascular Risk Prediction
Journal of Geriatric Cardiology | Wang | 2017

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Interleukin-6 receptor pathways in coronary heart disease: a collaborative meta-analysis of 82 studies
The Lancet | Sarwar | 2012

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Gingival crevicular fluid MMP-8-concentrations in patients after acute myocardial infarction
Head & Face Medicine | Ehlers | 2011

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Oral-Systemic Interactions in Modern Healthcare: A Systematic Review of the Interrelationship Between Dental Pathologies and Systemic Diseases

Cureus | Padmavathy et al | 2026

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Periodontitis and systemic diseases: insights into the correlation, mechanisms, and clinical implications

Frontiers in Immunology | Wu | 2026

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High Frequency Ultrasound Attenuation of Periodontal Soft Tissues for In Vivo Characterization

University of Michigan | Poul | 2026

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How will periodontitis impact US adults in 2050? New research from JADA highlights growing national disparity
Dentistry iQ | Butkovic | 2026

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For Patients, Shared Medical Records Enable Safer Dental Visits
Epic | 2026

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America’s well-being depends on oral health

Washington Post | Kessler | 2025

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Report: Public Understanding of Oral-Systemic Health Links Declines, Dental Anxiety Persists

Inside Dentistry | 2025

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Collagenase as a molecular link between oral and systemic disease

RDH Magazine | Rice | 2025

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Rethinking periodontal care: A medical condition with a dental solution
Dental Economics | Obrotka | 2025

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The Medical-Dental Divide Is Harming Your Patients
Medscape | Schwerdt | 2025

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The root of the matter: Linking oral health to chronic diseases prevention
International Journal of Cardiology | D’Aiuto | 2025

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The dangers of high fibrinogen levels
RDH Magazine | Rice | 2022
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Burden of Chronic Diseases Associated with Periodontal Diseases: A retrospective cohort study using UK Primary Care Data
BMJ Open | Zemedikun | 2021

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Oral health and all-cause, cardiovascular disease, and respiratory mortality in older people in the UK and USA

Scientific Reports | Kotronia et al | 2021

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Time to take gum disease seriously: The societal and economic impact of periodontitis

The Economist Intelligence Unit | 2021

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Oral Health In America: Advances and Challenges (2021)
National Institutes of Health | 2021

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Porphyromonas gingivalis, Periodontal and Systemic Implications: A Systematic Review

Dentistry Journal | Fiorillo | 2019

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Current Knowledge on Correlations Between Highly Prevalent Dental Conditions and Chronic Diseases: An Umbrella Review
Preventing Chronic Disease | Seitz | 2019

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Association between periodontal pathogens and systemic disease
Biomedical Journal | Bui | 2018

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The ADA Practical Guide to Patients with Medical Conditions
American Dental Association | Patton | 2012

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Oral Health: The Silent Epidemic (2010)
Public Health Reports | 2010

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Oral Health in America: A Report of the Surgeon General (2000)
U.S. Department of Health and Human Services | 2000

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